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'Gut Microbiome' Key to Obesity, Metabolism



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Couldn't log in as you, logged in as myself. For everyone else:

Good morning. I am Professor Karine Clement. I'm a professor of nutrition at the Institute of Cardiometabolism and Nutrition in Paris. I'm here at the American Diabetes Association (ADA) conference to tell you about gut microbiota, metabolism, and bariatric surgery.

You all know that there has been an increase in the morbid form of obesity worldwide. There is a specific tool to improve these patients' condition: bariatric surgery. Actually, there are different tools. One is purely restrictive, where you have a diminution of food intake, using either a banding ring or a sleeve gastrectomy. But one of the most popular tools in bariatric surgery uses not only a restrictive procedure but also a malabsorptive procedure; it's called gastric bypass, or Roux-en-Y, and it has been well shown to induce major and sustained weight loss. It improves a lot of cardiometabolic risks, and there is also an improvement in systemic and tissue inflammation. This procedure is not only very effective for patients by reducing their risk, but it also has helped us better understand the factors associated with the improvements from bariatric surgery -- not only metabolic factors and inflammatory factors, but other aspects as well.

Indeed, obesity is a very complex condition associated with many environmental factors and with our own biology. There is basically an interaction between multiple environmental factors and individual biology and genes. In fact, we have been surprised in the past year to determine that we have another genome that is based on the genes inside the gut: the gut microbiota, or gut microbiome.[1-3]

Gut microbiota change after bariatric surgery.[4,5] There is kind of a switch in the composition of bacteria as well as in bacterial genes. We followed 30 subjects before and after bariatric surgery and found that some bacterial species are associated with a change in metabolism, change in fat mass, change in leptin, and change in insulin.

Often, bacterial groups are associated with inflammatory factors, but we have demonstrated that only a part of this association depends on changing food intake. There are many factors that could explain this change in gut microbiota -- of course, calorie change per se -- but also the surgical procedure.

The question now, going further, is that if we have a person in a given context --with known environmental factors, his own biology and gut microbiota -- then what is the link between this clinical phenotype, tissue phenotype, and gut microbiome? There are growing data in the literature showing that, indeed, the specific gut microbiota profile could modify the host biology. But we have seen in a rodent model that, if you transfer the gut microbiota of an animal after surgery, you can actually mimic some of the effects found after bariatric surgery, such as an improvement of weight and metabolic conditions.[6]

Now the challenge is to better understand this aspect, to understand how bariatric surgery works to improve metabolic condition. Is gut microbiota important in this context? We need more mechanistic studies to understand how this works. Thank you for your attention.

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Thanks Fluff, I always forget you need to log in... I got myself on their mailing list and get all kinds of cool research papers mostly on weight loss info. Worth getting on if you like such things.

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    • Alisa_S

      On day 4 of the 2 week liquid pre-op diet. Surgery scheduled for June 11th.
      Soooo I am coming to a realization
      of something and I'm not sure what to do about it. For years the only thing I've enjoyed is eating. We rarely do anything or go anywhere and if we do it always includes food. Family comes over? Big family dinner! Go camping? Food! Take a short ride or trip? Food! Holiday? Food! Go out of town for a Dr appointment? Food! When we go to a new town we don't look for any attractions, we look for restaurants we haven't been to. Heck, I look forward to getting off work because that means it's almost supper time. Now that I'm drinking these pre-op shakes for breakfast, lunch, and supper I have nothing to look forward to.  And once I have surgery on June 11th it'll be more of the same shakes. Even after pureed stage, soft food stage, and finally regular food stage, it's going to be a drastic change for the rest of my life. I'm giving up the one thing that really brings me joy. Eating. How do you cope with that? What do you do to fill that void? Wow. Now I'm sad.
      · 1 reply
      1. LeighaTR

        I hope your surgery on Wednesday goes well. You will be able to do all sorts of new things as you find your new normal after surgery. I don't know this from experience yet, but I am seeing a lot of positive things from people who have had it done. Best of luck!

    • Alisa_S

      On day 4 of the 2 week liquid pre-op diet. Surgery scheduled for June 11th.
      Soooo I am coming to a realization
      of something and I'm not sure what to do about it. For years the only thing I've enjoyed is eating. We rarely do anything or go anywhere and if we do it always includes food. Family comes over? Big family dinner! Go camping? Food! Take a short ride or trip? Food! Holiday? Food! Go out of town for a Dr appointment? Food! When we go to a new town we don't look for any attractions, we look for restaurants we haven't been to. Heck, I look forward to getting off work because that means it's almost supper time. Now that I'm drinking these pre-op shakes for breakfast, lunch, and supper I have nothing to look forward to.  And once I have surgery on June 11th it'll be more of the same shakes. Even after pureed stage, soft food stage, and finally regular food stage, it's going to be a drastic change for the rest of my life. I'm giving up the one thing that really brings me joy. Eating. How do you cope with that? What do you do to fill that void? Wow. Now I'm sad.
      · 1 reply
      1. summerseeker

        Life as a big person had limited my life to what I knew I could manage to do each day. That was eat. I hadn't anything else to look forward to. So my eating choices were the best I could dream up. I planned the cooking in managable lots in my head and filled my day with and around it.

        Now I have a whole new big, bigger, biggest, best days ever. I am out there with those skinny people doing stuff i could never have dreamt of. Food is now an after thought. It doesn't consume my day. I still enjoy the good home cooked food but I eat smaller portions. I leave food on my plate when I am full. I can no longer hear my mother's voice saying eat it all up, ther are starving children in Africa who would want that!

        I still cook for family feasts, I love cooking. I still do holidays but I have changed from the All inclusive drinking and eating everything everyday kind to Self catering accommodation. This gives me the choice of cooking or eating out as I choose. I rarely drink anymore as I usually travel alone now and I feel I need to keep aware of my surroundings.

        I don't know at what point my life expanded, was it when I lost 100 pounds? Was it when I left my walking stick at home ? Was it when I said yes to an outing instead of finding an excuse to stay home ? i look back at my last five years and wonder how loosing weight has made such a difference. Be ready to amaze yourself.

        BTW, the liquid diet sucks, one more day and you are over the worst. You can do it.

    • CaseyP1011

      Officially here for a long time, not just a good time💪
      · 0 replies
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