A gut microbiota-targeted dietary intervention for amelioration of chronic inflammation underlying metabolic syndrome

TLDR

Chronic inflammation driven by endotoxin from a dysbiotic gut microbiota contributes to obesity‑related metabolic disorders. The study aims to test whether a diet that balances gut microbiota can manage obesity. A 9‑week self‑controlled trial of a whole‑grain, traditional Chinese medicinal food, and prebiotic (WTP) diet was administered to 93 centrally obese adults, followed by a 14‑week maintenance period. The intervention produced an average weight loss of 5.8 kg, improved insulin sensitivity, lipid profiles, and blood pressure, and reduced endotoxin‑producing bacteria, gut permeability, plasma endotoxin load, and inflammatory cytokines while increasing adiponectin, indicating enhanced barrier integrity and reduced inflammation.

Abstract

Chronic inflammation induced by endotoxin from a dysbiotic gut microbiota contributes to the development of obesity-related metabolic disorders. Modification of gut microbiota by a diet to balance its composition becomes a promising strategy to help manage obesity. A dietary scheme based on whole grains, traditional Chinese medicinal foods, and prebiotics (WTP diet) was designed to meet human nutritional needs as well as balance the gut microbiota. Ninety-three of 123 central obese volunteers (BMI ≥ 28 kg m(-2) ) completed a self-controlled clinical trial consisting of 9-week intervention on WTP diet followed by a 14-week maintenance period. The average weight loss reached 5.79 ± 4.64 kg (6.62 ± 4.94%), in addition to improvement in insulin sensitivity, lipid profiles, and blood pressure. Pyrosequencing of fecal samples showed that phylotypes related to endotoxin-producing opportunistic pathogens of Enterobacteriaceae and Desulfovibrionaceae were reduced significantly, while those related to gut barrier-protecting bacteria of Bifidobacteriaceae increased. Gut permeability, measured as lactulose/mannitol ratio, was decreased compared with the baseline. Plasma endotoxin load as lipopolysaccharide-binding protein was also significantly reduced, with concomitant decrease in tumor necrosis factor-α, interleukin-6, and an increase in adiponectin. These results suggest that modulation of the gut microbiota via dietary intervention may enhance the intestinal barrier integrity, reduce circulating antigen load, and ultimately ameliorate the inflammation and metabolic phenotypes.