Integrative Weight Management

Abstract

The gut microbiota helps balance key vital functions for the host, including immunity and nutritional status. Studies have also linked the microbiome to human mood and behavior, as well as many gut disorders, eczema, and a number of systemic disorders (Azad et al., CMAJ 185:385–394, 2013). Changes in the gut microbiota composition and/or activity may be implicated in the control of infl ammation, fat storage, and altered glucose response in obese patients. Dietary short-chain fatty acids appear to be “indirect nutrients” produced by the gut microbiota that can modulate adiposity and immunity as well as send signals to the gut to produce hormones that regulate appetite, permeability, and infl ammation. Numerous data have been published regarding differences in the composition of the gut microbiota in obesity. Taken together, the data currently published suggest that specifi c changes in the gut microbiota occur in overweight or obese patients and are either positively or nega- tively linked with adiposity, infl ammation, and glucose or lipid homeostasis. Manipulation of the microbiota though diet can promote healthy weight loss by altering gut function and metabolism. Probiotics and prebiotics are interesting research tools to assess the relevance of specifi c bacteria in obesity. Prebiotics may lessen obesity and related metabolic stress by modulating gut peptides involved in the control of appetite and gut barrier function.