The Microbiota-Gut-Brain Axis: Clinical Applications in Obesity and Type 2 Diabetes.

Abstract: Recent investigations highlight the importance of the gut microbiota and bacteria-derived metabolites as key components in obesity and metabolic health. The microbiota-gut-brain axis presents promising targets for future obesity treatments and prevention. However, the current state of evidence and existing clinical applications of the microbiota-gut-brain axis have yet to be summarized in a thorough review. Therefore, we sought to examine current evidence on the effect of lifestyle, dietary, pharmacological, and surgical interventions on the microbiota-gut-brain axis. In addition, this review highlights potential next steps in research toward characterizing the role of the microbiota-gut-brain axis in metabolic health, along with possible interventions to address obesity.

Perceived intrinsic, social, and environmental barriers for weight management in older Hispanic/Latino adults with obesity.

Background: The burden of obesity and chronic disease is increasing in the older US Hispanic/Latino adult population. There is limited evidence on successful weight management strategies as perceived by this population. Assessing barriers and opportunities for weight management using mixed methods is a robust approach to collect in-depth information that can be applied to the development of well-tailored weight management interventions for this population. Objective: The objective of this study was to assess perceived individual, interpersonal, and environmental factors that influence weight management in older Hispanic/Latino adults. Methods: This community-based cross-sectional study included 23 Hispanic/Latino older (>50y) adults with obesity (BMI >30 kg/m2). Perceived barriers and opportunities for weight management were assessed through validated questionnaires and focus groups. Prospectively registered on ClinicalTrials.gov (NCT03978416) on 7 June 2019. Results: In this demographically heterogeneous population, language acculturation was generally low, and the frequency of poor dietary behaviors was high. Participants linked financial strain to lower diet quality, as well as anxiety to uncontrolled eating and food cravings. Social support and trust in healthcare professionals were perceived as priorities for healthy eating. Structural and environmental barriers such as affordability and availability of culturally preferred foods were also identified as influences on food choices and eating behavior. Conclusions: This study revealed opportunities for culturally tailored weight management interventions in older Hispanic/Latino adults with obesity. Clinical Trial Registry Number: NCT03978416 (ClinicalTrials.gov).

Association between inflammation, lipopolysaccharide binding protein, and gut microbiota composition in a New Hampshire Bhutanese refugee population with a high burden of type 2 diabetes.

Introduction: South Asian refugees experience a high risk of obesity and diabetes yet are often underrepresented in studies on chronic diseases and their risk factors. The gut microbiota and gut permeability, as assessed through circulating lipopolysaccharide binding protein (LBP), may underlie the link between chronic inflammation and type 2 diabetes (T2D). The composition of the gut microbiota varies according to multiple factors including demographics, migration, and dietary patterns, particularly fiber intake. However, there is no evidence on the composition of the gut microbiota and its relationship with metabolic health in refugee populations, including those migrating to the United States from Bhutan. The objective of this study was to examine glycemic status in relation to LBP, systemic inflammation fiber intake, and gut microbiota composition in Bhutanese refugee adults residing in New Hampshire (n = 50). Methods: This cross-sectional study included a convenience sample of Bhutanese refugee adults (N = 50) in NH. Established bioinformatics pipelines for metagenomic analysis were used to determine relative genus abundance, species richness, and alpha diversity measures from shallow shotgun sequences. The relationships between inflammatory markers, gut microbiota composition, dietary fiber, and glycemic status were analyzed. Results: We identified a substantial chronic disease burden in this study population, and observed a correlation between glycemic status, LBP, and inflammation, and a correlation between glycemic status and gut microbiome alpha diversity. Further, we identified a significant correlation between proinflammatory taxa and inflammatory cytokines. SCFA-producing taxa were found to be inversely correlated with age. Conclusion: To date, this is the most comprehensive examination of metabolic health and the gut microbiome in a Bhutanese refugee population in NH. The findings highlight areas for future investigations of inflammation and glycemic impairment, in addition to informing potential interventions targeting this vulnerable population.

The Microbiota-Gut-Brain Axis: Clinical Applications in Obesity and Type 2 Diabetes

ABSTRACT Recent investigations highlight the importance of the gut microbiota and bacteria-derived metabolites as key components in obesity and metabolic health. The microbiota-gut-brain axis presents promising targets for future obesity treatments and prevention. However, the current state of evidence and existing clinical applications of the microbiota-gut-brain axis have yet to be summarized in a thorough review. Therefore, we sought to examine current evidence on the effect of lifestyle, dietary, pharmacological, and surgical interventions on the microbiota-gut-brain axis. In addition, this review highlights potential next steps in research toward characterizing the role of the microbiota-gut-brain axis in metabolic health, along with possible interventions to address obesity.