Abstract

BackgroundThe association between the gut microbiota and pediatric obesity was analyzed in a cross-sectional study. A prospective study of obese children was conducted to assess the gut microbial alterations after a weight change. We collected fecal samples from obese children before and after a 2-month weight reduction program that consisted of individual counseling for nutritional education and physical activity, and we performed 16S rRNA gene amplicon sequencing using an Illumina MiSeq platform.ResultsThirty-six participants, aged 7 to 18 years, were classified into the fat loss (n = 17) and the fat gain (n = 19) groups according to the change in total body fat (%) after the intervention. The baseline analysis of the gut microbiota in the preintervention stages showed dysbiotic features of both groups compared with those of normal-weight children. In the fat loss group, significantly decreased proportions of Bacteroidetes phylum, Bacteroidia class, Bacteroidales order, Bacteroidaceae family, and Bacteroides genus, along with increased proportions of Firmicutes phylum, Clostridia class, and Clostridiales order, were observed after intervention. The microbial richness was significantly reduced, without a change in beta diversity in the fat loss group. The fat gain group showed significantly deceased proportions of Firmicutes phylum, Clostridia class, Clostridiales order, Lachnospiraceae family, and Eubacterium hallii group genus, without a change in diversity after the intervention. According to the functional metabolic analysis by the Phylogenetic Investigation of Communities by Reconstruction of Unobserved States 2, the “Nitrate Reduction VI” and “Aspartate Superpathway” pathways were predicted to increase significantly in the fat loss group. The cooccurring networks of genera were constructed and showed the different microbes that drove the changes between the pre- and postintervention stages in the fat loss and fat gain groups.ConclusionsThis study demonstrated that lifestyle modifications can impact the composition, richness, and predicted functional profiles of the gut microbiota in obese children after weight changes.Trial registrationClinicalTrials.govNCT03812497, registration date January 23, 2019, retrospectively registered.

Highlights

  • The association between the gut microbiota and pediatric obesity was analyzed in a cross-sectional study

  • A total of 36 participants in all of the interventions were classified into two groups: the fat loss group (n = 17, 47.2%), including those who experienced a decrease in total body fat (%) after the intervention, and the fat gain group (n = 19, 52.8%), including those who experienced an increase in total body fat (%) after the intervention

  • The insulin level was significantly decreased in the fat loss group; the homeostasis model assessment method-insulin resistance (HOMA-IR) levels were significantly increased in both groups (Wilcoxon’s signed-rank test, P < 0.05, Table 2)

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Summary

Introduction

The association between the gut microbiota and pediatric obesity was analyzed in a cross-sectional study. A prospective study of obese children was conducted to assess the gut microbial alterations after a weight change. Many studies, regarding weight loss interventions in adults, have investigated the relationship between the gut microbiota and obesity [8]. Most previous studies of the gut microbiota have been cross-sectional in design [13, 14]. A recent study in obese children revealed that secreted proteins of the gut microbiota affect the microbial composition [15]. One prospective study of children that investigated the microbial changes with weight gain over a four-year period showed that the microbiome-host-diet configuration could be a possible predictor of obesity [16]. Research on microbial changes over time after weight reduction interventions has remained scarce [13, 17]

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