Abstract

Obesity has been associated with changes in the gut microbiota and its metabolites. The study explored changes in the faecal microbiota and short-chain fatty acids (SCFA) associated with the diet (including nonnutritive sweeteners (NNSs)) and evaluated metabolic consequences in subjects with morbid obesity. The diet was assessed with a validated food frequency questionnaire. One unit of NNSs was 100 mL beverage with NNSs or 2 tablets/teaspoons of NNSs. The faecal microbiota was assessed with GA-map® dysbiosis test and SCFA with gas chromatography and flame ionisation detection. Fourteen men and 75 women with a mean age of 44.6 (SD 8.7) years, BMI 41.8 (SD 3.6) kg/m2, and intake of NNSs 7.5 units/day (SD 3.2; range 0–43) were included. Faecal butyric acid was positively and negatively associated with the intake of starch (partial correlation = 0.264; p=0.015) and NNSs (partial correlation = −0.274; p=0.011), respectively. NNSs were associated with changes in four out of 39 bacterial groups. Butyric acid has antiobesogenic effects, reduces insulin resistance, and improves dyslipidaemia. Since the weight-reducing effect of NNSs on obese adults trying to lose weight is dubious, it seems imprudent to use NNSs that might counteract the favourable effects of butyric acid.

Highlights

  • Obesity, which has nearly tripled worldwide since 1975, has health-related consequences such as increased risk of cardiovascular diseases, metabolic syndrome with diabetes type 2, musculoskeletal disorders, and cancer [1,2,3]. e high and increasing prevalence of obesity, estimated to 13% of the world population and mentioned as the global obesity epidemic [4], has been linked to alterations in the diet with increased intake of high fat, energy-dense food, and reduced physical activity [1]. e dietary alterations affect the gut microbiota and the microbiota’s metabolites (e.g., straight and branched short-chain fatty acids, referred to as short-chain fatty acids (SCFA) in this paper) [5]

  • Eighty-nine out of 350 consecutive subjects with morbid obesity in the period from December 2012 to September 2014 were included in the study

  • nonnutritive sweeteners (NNSs) were negatively associated with butyric acid and valeric acid

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Summary

Introduction

Obesity, which has nearly tripled worldwide since 1975, has health-related consequences such as increased risk of cardiovascular diseases, metabolic syndrome with diabetes type 2, musculoskeletal disorders, and cancer [1,2,3]. e high and increasing prevalence of obesity, estimated to 13% of the world population and mentioned as the global obesity epidemic [4], has been linked to alterations in the diet with increased intake of high fat, energy-dense food, and reduced physical activity [1]. e dietary alterations affect the gut microbiota (induce dysbiosis) and the microbiota’s metabolites (e.g., straight and branched short-chain fatty acids, referred to as short-chain fatty acids (SCFA) in this paper) [5]. Propionic and butyric acids have been ascribed antiobesogenic effects, and a high Firmicutes/Bacteroidetes ratio has been associated with obesity [10,11,12,13,14,15,16]. These changes have been observed in both animals and humans, a causal role of the gut microbiome in the pathogenesis of obesity has not yet been proven in humans [6, 17]. A secondary aim was to study direct and indirect effects (mediated via the faecal microbiota) of NNSs on SCFA

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