Bariatric Times

JUN 2017

A peer-reviewed, evidence-based journal that promotes clinical development and metabolic insights in total bariatric patient care for the healthcare professional

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A2 Bariatric Times [V O L U M E 1 4 , N U M B E R 6 • J U N E 2 0 1 7 • S U P P L E M E N T A ] SPOTLIGHT ON NUTRITION The B420 group consumed approximately 300 calories per day less than the placebo group. This is relevant for weight maintenance as lower calorie requirements are required to maintain a lower body weight. Interestingly, those supplemented with B420 also showed an increase in fecal short-chain fatty acid (SCFA) concentrations. SCFAs are produced by the microbiome, suggesting that B420 is influencing the microbiome. This change in SCFA concentration may also shed light on the mechanisms behind the reduced calorie intake, as SCFAs have been shown to simulate the production of gut peptides to increase satiety and reduce consumption. 23,24 Summary and Conclusion Research has shown that weight loss surgery patients may experience difficulty in losing and maintaining body weight. Therefore, the development and use of adjunctive weight loss therapies becomes critical for the long-term support of patients with obesity. A surge in data over the past decade has linked the microbiome to body weight regulation. Our ability to regulate body weight through targeted probiotic strains, such as B420, can contribute to patient success; thus the addition of certain probiotics to these patients' weight loss/maintenance plans should be considered by those clinicians who treat patients with overweight and obesity. References 1. Courcoulas AP1, Christian NJ, Belle SH, et al. Weight change and health outcomes at 3 years after bariatric surgery among individuals with severe obesity. JAMA. 2013;310(22):2416–2425. 2. Fildes A, Charlton J, Rudisill C, et al. Probability of an obese person attaining normal body weight: cohort study using Electronic Health Records. Am J Public Health. 2015;105(9):e54–e59. 3. Speakman JR, Levitsky DA, Allison DB, et al. Set points, settling points and some alternative models: theoretical options to understand how genes and environments combine to regulate body adiposity. Dis Model Mech. 2011;4(6): 733–745. 4. Leibel RL, Rosenbaum M, Hirsch J. Changes in energy expenditure resulting from altered body weight. N Eng J Med. 1995;332(10):621–628. 5. Sumithran P, Prendergast LA, Delbridge E, et al. Long-term persistence of hormonal adaptations to weight loss. N Eng J Med. 2011;365:1597–604. 6. The Obesity Society. Potential Contributors to Obesity. Obesity.org. http://www.obesity.org/obesity/resources/facts- a bout-obesity/infographics/potential- c ontributors-to-obesity. Accessed March 20, 2017. 7. Human Microbiome Project Consortium. Structure, function and diversity of the healthy human microbiome. Nature. 2 012;486(7402):207–214. 8 . Alang N, Kelly CR. Weight gain after fecal microbiota transplantation. Open Forum Infect Dis. 2015;2(1):ofv004. 9. Ridaura VK, Faith JJ, Rey FE, et al. Gut microbiota from twins discordant for obesity m odulate metabolism in mice. Science. 2 013;341(6150):1241214. 10. Beaumont M, Goodrich JK, Jackson MA, et al. Heritable components of the human fecal microbiome are associated with visceral fat. Genome Biol. 2016;17(1):189. 1 1. Le Chatelier E1, Nielsen T, Qin J, et al. R ichness of human gut microbiome correlates with metabolic markers. Nature. 2013;500(7464):541–546. 12. Walters WA, Xu Z, Knight R. Meta-analyses of human gut microbes associated with obesity a nd IBD. FEBS Lett. 2014;588:4223–4233. 1 3. Boulangé CL, Neves AL, Chilloux J, et al. Impact of the gut microbiota on inflammation, o besity, and metabolic disease. Genome Med. 2016;8(1):42. 14. Probiotics in food. Joint FAO/WHO Working Group; 2006. http://www.fao.org/3/a- a0512e.pdf. Accessed March 20, 2017. 15. Guidelines for the Evaluation of Probiotics in Food. Joint FAO/WHO Working Group; 2002. http://www.who.int/foodsafety/fs_management /en/probiotic_guidelines.pdf. Accessed March 20, 2017. 16. Stenman LK, Lehtinen MJ, Meland N, et al. Probiotic with or without fiber controls body fat mass, associated with serum zonulin, in overweight and obese adults-randomized controlled trial. EBioMedicine. 2016;13:190–200. 17. Stahl B, Barrangou R. Complete genome sequences of probiotic strains Bifidobacterium animalis subsp. lactis B420 and Bi-07. J Bacteriol. 2012;194:4131–4132. 18. Stenman LK, Waget A, Garret C, et al. Probiotic B420 and prebiotic polydextrose improve efficacy of antidiabetic drugs in mice. Diabetol Metab Syndr. 2015;7:75. 19. Amar J, Chabo C, Waget A, et al. Intestinal mucosal adherence and translocation of commensal bacteria at the early onset of type 2 diabetes: molecular mechanisms and probiotic treatment. EMBO Mol Med. 2011;3:559–572. 20. Cani PD, Amar J, Iglesias MA, et al. Metabolic endotoxemia initiates obesity and insulin resistance. Diabetes. 2007;56(7):1761–1772. 21. Dudele A, Rasmussen GM, Mayntz D, et al. Effects of ambient temperature on glucose tolerance and insulin sensitivity test outcomes in normal and obese C57 male mice. Physiol Rep. 2015;3(5):e12396. 22. Amar J, Burcelin R, Ruidavets JB, et al. Energy intake is associated with endotoxemia in apparently healthy men. Am J Clin Nutr. 2008;87(5):1219–1223. 23. Tolhurst G, Heffron H, Lam YS, et al. Short- chain fatty acids stimulate glucagon-like peptide-1 secretion via the G-protein-coupled receptor FFAR2. Diabetes. 2012;61(2):364–371. 24. Psichas A, Sleeth ML, Murphy KG, et al. The short chain fatty acid propionate stimulates GLP-1 and PYY secretion via free fatty acid receptor 2 in rodents. Int J Obes (Lond). 2015;39:424–429. FIGURE 1. Differences in the intestinal microbiome identified in obesity 9 ,12,13 Disclaimer: This article did not undergo peer review by the Bariatric Times editorial advisory board.

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