A diverse and robust colonic microbial community is beneficial to human health. Numerous studies have shown that imbalances in the microbial ecosystem are linked with disease risk. The composition of the gut microbiota also has implications in obesity. While the mechanisms that link the intestinal microbiota and obesity are not fully understood, studies have observed distinct microbial profiles between non-obese and obese individuals. 

Moreover, enterotypes, microbial clusters within the bacterial community residing in the gut, are associated with long-term eating patterns. The Prevotella-enterotype is associated with high dietary fiber and carbohydrate intake, whereas Bacteroides-enterotype is linked to a Westernized diet, high in fat. A new study published in The Journal of Nutrition suggests the key to effective weight loss might not be energy restriction per se, but rather requires a match between diet and microbial enterotype.

In a 6-wk randomized trial to investigate difference in body weight changes of 46 healthy, overweight adults consuming either a high-fiber, whole-grain or moderate-fiber, refined-wheat diet, Lars Christensen (University of Copenhagen) and colleagues grouped subjects based on  enterotype: Prevotella-enterotype subjects vs. Bacteroides-enterotype subjects. The researchers hypothesized that Prevotella-enterotype subjects would lose more weight than Bacteroides-enterotype subjects when consuming a high-fiber, whole grain diet, compared to a moderate-fiber, refined wheat diet.

Subjects with high Prevotella abundances experienced greater weight loss on the high-fiber, whole-grain diet, whereas those with low Prevotella abundances were weight stable. The results are consistent with the long-held view that high-fiber, whole-grain diets help lower body weight.  These findings also support the link between dietary fiber intake and Prevotella abundances, further emphasizing microbial enterotypes as promising biomarkers in personalized nutrition for obesity management.

A corresponding editorial by Carmen Ortega-Santos and Corrie Whisner suggests that weight management may be more complex than energy balance as increasing fiber intake among individuals with certain microbial enterotypes may result in greater weight loss in the absence of caloric restriction.

Reference Christensen L, Vuholm S, Roager HM, Nielsen DS, Krych L, Kristensen M, Astrup A, Hjorth MF. Prevotella abundance predicts weight loss success in healthy, overweight adults consuming a whole-grain diet ad libitum: A post hoc analysis of a 6-wk randomized controlled trial. The Journal of Nutrition, Volume 149, Issue 12, December 2019, Pages 2174–2181. https://doi.org/10.1093/jn/nxz198.

Ortega-Santos CP, Whisner CM. The key to successful weight loss on a high-fiber diet may be in gut microbiome Prevotella abundance. The Journal of Nutrition, Volume 149, Issue 12, December 2019, Pages 2083–2084, https://doi.org/10.1093/jn/nxz248.

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