Influência da abordagem nutricional e clínica do tratamento da obesidade na relação Firmicutes e Bacteroidetes da microbiota intestinal em adolescentes

Abstract

Obesity is a multifactorial problem that is increasingly prevalent today, particularly among younger individuals due to specific characteristics of this group. This health issue originates from an imbalance between calorie intake and expenditure, but is also influenced by various factors such as genetic predisposition, insulin resistance, behavioral, nutritional, biochemical, social variables, and, as some studies suggest, the microbiological composition of individuals. These studies indicate that the gut microbiota is closely connected with the health of its hosts, affecting various biological, neurological, inflammatory, and pathogenic processes. It has been identified that the Firmicutes and Bacteroidetes phyla and the ratio between them may be relevant and correlated with the prevalence of this comorbidity. With the aid of biochemical tests and the collection of behavioral and nutritional data, appropriate nutritional follow-up emerges as an alternative for treating this comorbidity. An effective approach can prevent nutritional deficiencies and excessive food intake, as well as encourage a varied diet with different groups of fresh and minimally processed foods, promoting healthy eating habits and behaviors, thereby improving several indicators associated with obesity. This study assessed the impact of nutritional follow-up on clinical indicators for obesity control in adolescent patients and the correlation with changes in microbiota through the measurement of the Firmicutes/Bacteroidetes ratio in fecal metagenome. Out of 35 individuals in the sample, 12 completed all stages of the 6-month longitudinal study. Data collected from clinical and laboratory follow-ups indicate that despite improvements in the average BMI (from 31.7 to 29.6) and diet quality, with significant changes in carbohydrate intake (from 50.6% to 55.7%) and reduction in lipid intake (from 25.9% to 20.6%), there were no significant changes in most clinical indicators, with only a notable reduction in the HOMA Beta index from 413.2 to 286.6 during the analyzed period, reflecting improved insulin secretion by the pancreas. The variation in the average Firmicutes/Bacteroidetes ratio between assessments was small but relevant, from 3.02 to 1.89. Through multiple correspondence analysis, it was noted that although the global change in microbiota and calorie intake did not follow a clustering pattern, all other parameters correlated positively with participant progress during the study period. However, the Firmicutes/Bacteroidetes ratio had little influence or relevance on the clinical outcome, suggesting that this microbiota ratio was not an adequate marker for measuring, relating, or stratifying clinical success in this study compared to other biochemical or nutritional markers. These findings may assist in treating obesity in younger individuals but also highlight that further research with this participant profile needs to be more thoroughly explored, given the specific biochemical, microbiological, social, and anthropometric characteristics of this population.