Abstract
While low-carbohydrate and low-fat diets can both lead to weight-loss, a substantial variability in achieved long-term outcomes exists among obese but otherwise healthy adults. We examined the hypothesis that structural differences in the gut microbiota explain a portion of variability in weight-loss using two cohorts of obese adults enrolled in the Diet Intervention Examining The Factors Interacting with Treatment Success (DIETFITS) study. A total of 161 pre-diet fecal samples were sequenced from a discovery cohort (n = 66) and 106 from a validation cohort (n = 56). An additional 157 fecal samples were sequenced from the discovery cohort after 10 weeks of dietary intervention. We found no specific bacterial signatures associated with weight loss that were consistent across both cohorts. However, the gut microbiota plasticity (i.e. variability), was correlated with long-term (12-month) weight loss in a diet-dependent manner; on the low-fat diet subjects with higher pre-diet daily plasticity had higher sustained weight loss, whereas on the low-carbohydrate diet those with higher plasticity over 10 weeks of dieting had higher 12-month weight loss. Our findings suggest the potential importance of gut microbiota plasticity for sustained weight-loss. We highlight the advantages of evaluating kinetic trends and assessing reproducibility in studies of the gut microbiota.
Highlights
The global obesity pandemic has claimed one in three American adults and prevalences continue to rise in many other countries as well[1]
Our study suggests the potential importance of gut microbiota plasticity in sustained weight loss
Individual temporal variability of the gut microbiota was seemingly eclipsed by larger-scale variability across body habitats[23], severe perturbations[24], or geographically distinct populations[25], which may have led some to underestimate the importance of plasticity within an individual
Summary
The global obesity pandemic has claimed one in three American adults and prevalences continue to rise in many other countries as well[1]. The personal, social and economic costs provide an urgent need for consistently effective, and possibly more personalized, weight-reduction therapies. Different dietary interventions, such as low-carbohydrate (low-carb) and low-fat diets, can lead to weight loss, but not always; there remains substantial variability in diet success outcomes among obese, but otherwise healthy, adults[3]. The DIETFITS study[19,20] was a randomized trial of 609 adults designed to elucidate predisposing individual characteristics – genotype, insulin-glucose dynamics, physiological and psychosocial attributes – that contribute to successful 12-month weight loss on ad libitum diets designed to be lower in carbs or fat. Identifying pre-diet features of the gut microbiota that can predict adherence and/or success on a specific diet might permit personalization of dietary intervention strategies to maximize weight loss
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