Abstract
The era of pediatric obesity is no longer a myth. Unfortunately, pediatric obesity has reached alarming incidence levels worldwide and the factors that contribute to its development have been intensely studied in multiple recent and emerging studies. Gut microbiota was recently included in the wide spectrum of factors implicated in the determination of obesity, but its role in pediatric obese patients is far from being fully understood. In terms of the infant gut microbiome, multiple factors have been demonstrated to shape its content, including maternal diet and health, type of delivery, feeding patterns, weaning and dietary habits. Nevertheless, the role of the intrauterine environment, such as the placental microbial community, cannot be completely excluded. Most studies have identified Firmicutes and Bacteroidetes as the most important players related to obesity risk in gut microbiota reflecting an increase of Firmicutes and a decrease in Bacteroidetes in the context of obesity; however, multiple inconsistencies between studies were recently reported, especially in pediatric populations, and there is a scarcity of studies performed in this age group.
Highlights
Pediatric obesity has reached epidemic proportions worldwide regardless of age
The shaping of the gut microbiota begins in utero and continues up to the age of 3–4 years being influenced by the maternal diet, amniotic fluid and placental microbial community, type of delivery, feeding practices and hygiene habits, such as brushing the teeth after meals [121]
The findings assessing the relationship between gut microbial composition and obesity remain contradictory, since other studies have found the contrary, with observed decrease in bacteria belonging to the same phyla
Summary
Pediatric obesity has reached epidemic proportions worldwide regardless of age. The prevalence of obesity varies by age, sex, ethnicity, race, and socio-economic status [1]. Genetic factors play a major role since multiple studies have shown that certain maternal gene polymorphisms are associated with increased risk for obesity in offspring [9–12], suggesting that predisposition to the development of obesity begins during intrauterine life. Several human and animal studies have shown that obesity might be considered a major risk factor for carcinogenesis [16–19] These findings were supported by the relationship observed between pediatric obesity and primary liver carcinoma in later adulthood [20]. Most of these complications are directly related to the early inflammatory status identified in overweight and obese children [21]. Additional factors that might be related to obesity determinism should be identified and thoroughly studied in order to develop effective strategies to prevent obesity development, and especially its long-term complications. The gut microbiota and humans evolved together and might be considered mutual partners; dysbiosis represents a life-threatening imbalance of this partnership since it has been demonstrated to be associated with several other conditions aside from obesity, such as diabetes, atherosclerosis, allergic and autoimmune disorders, gastrointestinal diseases and neoplasia [27–30]
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