Background
Being overweight over the years overwhelmingly translates into obesity, which increases the risk of adverse health consequences and the development of many diseases. These conditions include type 2 diabetes, coronary artery disease, biliary cholelithiasis, and cystic osteoporosis. As they progress, they become a source of unnecessary costs to the individual and public health. The World Health Organization has declared that obesity is one of the major problems of the modern world (Cani, 2018). The results of numerous clinical studies have shown a connection between qualitative and quantitative changes in the microbiome’s composition and syndromes such as obesity and atherosclerosis (Basson & Wijeyesekera, 2017). In this context, the investigation of the gut microbiome, a considerable segment of the body’s immune and neuroendocrine circuits, is of great concern.
Literature review
According to current data, the source of low-molecular-weight bioactive molecules in addition to food is the gut microbiome (Cani, 2018). Symbiosis and healthy interaction within the body are possible if the microbiome’s composition is sufficiently diverse. Despite the massive diversity of microorganisms, five dominant divisions form a minor and variable segment of microbiome – Firmicutes, Bacteroidetes, Actinobacteria, Proteobacteria, Verrucomicrobia. In a healthy person, up to 90% of the gut microbiome consists of bacteria of two phyla: Firmicutes and Bacteroidetes (Cani, 2018). The diversity of its composition is an essential indicator of human health (Marco, 2021). In various pilot and clinical trials, it has been demonstrated that when the variety of gut macrobiotics decreases, the permeability of the enteric barrier increases, which is related to the progression of morbidity.
Changes in the microbiome associated with obesity are controversial. Some authors point to an increase in the representation of Firmicutes bacteria; conversely, the others point to the growth of Bacteroidetes and decline of Firmicutes (Dhanasekaran et al., 2021). Nevertheless, what one eats profoundly affects the diversity of one’s gut microbiome. Eating high-calorie meals raises the density of special bacterial strains in the large and small intestines, influencing metabolism and the potential for weight gain.
Research gap
Therefore, there are currently numerous investigations on the structure of the gut microbiome and its relationship to a person’s health. The results of experimental and clinical studies have demonstrated that bariatric surgery affects weight loss (Dhanasekaran et al., 2021). This is accomplished, among other things, by drastically limiting the food intake and changing the quantitative and qualitative composition of the gut microbiome, which in turn affects energy extraction and storage. In my study, however, I propose to find out exactly how weight loss can be promoted in an obese patient without bariatric surgery, given the composition of his gut microbiome. There is very little practical research on this topic, and so I am going to fill this research gap. The results of my study will open up new possibilities in the treatment of obesity and weight maintenance by modifying the gut microbiome. In addition, I will investigate the use of healthy microbial communities as a remedy without replacing exercise and diet.
Original contribution to knowledge
Bariatric surgery is a widespread and effective way to fight weight loss. It makes it possible to achieve significant weight loss even when all other approaches are unsuccessful. About half a million bariatric surgeries are performed worldwide each year (Durack & Lynch, 2019). However, these surgeries can have unpleasant consequences for patients. For example, patients must eat only liquid foods after surgery, severely restricting their food intake. For an obese patient who is used to eating several thousand calories a day, the dietary restriction can negatively impact their psychological state. In addition, bariatric surgery does not guarantee long-term weight loss because the stomach can stretch back when the patient switches to a standard diet. That is why it is essential to research whether it is possible to promote weight loss in patients with gut microbiology manipulation without bariatric surgery. This study will make an original contribution to existing knowledge on dietetics. This could provide new insights into the study of the gut microbiome.
Purpose of the study
The aim of this research is to generalize scientific and clinical evidence on the connection between obesity and alterations in the intestinal microbiome. The examination also assumes that the gut microbiome is a sort of indicator of the condition of the macroorganism. It responds to age, physiological, dietary, and climatic-geographical factors by changing qualitative and quantitative composition (Newby & Stokes, 2019). These changes lead to an increase in its metabolic activity with the formation of additional energy from the food eaten, contributing to the absorption of nutrients through various mechanisms. The goal of the research is to verify the effect of the gut microbiome on energy balance through the effective extraction of energy from macronutrients and the influence on the genes that govern the expenditure and retention of energy. I also aim to justify the idea that qualitative and quantitative modifications in the gut microbiome may promote the progression of obesity.
Methodology
To conduct my experiment, I will need to make a clinical trial. Clinical trials are a widespread form of scientific research in modern medicine. Clinical trials are conducted on human subjects in specially designed controlled conditions to evaluate medical interventions. When conducting medical-scientific research, including clinical trials, specific methodological schemes are used, which are also called study design. The most rigorous design, which provides the most reliable evidence for the tested medical interventions, is considered a so-called randomized clinical trial. According to current thinking, it should serve as the standard for clinical trials in general. That is why I chose this design for my study.
The point of a randomized clinical trial is to compare two groups of patients that are as similar as possible. One group will receive the experimental treatment, and the other will control. The randomization will consist of assigning patients to groups in such a way that they are randomly allocated and have an equal probability of being in both groups, without any preference. A random number table will be used for this purpose. The trial will consist of one group taking specific actions to change the gut microbiome and the other group not. At the same time, the weight changes of the patients will be monitored. The other group, whose gut microbiome will not be changed, will still lose weight with classic diets and exercise. Thus, the difference between the groups would be that there would be manipulation of the microbiome for one of them and not for the other. Exercise and diet would be independent variables in this study. In this way, it will be possible to obtain data on the possibility of effective weight loss by changing the gut microbiome for obese patients.
References
Basson, A. R., & Wijeyesekera, A. (2017). Metabolic phenotyping for understanding the gut microbiome and host metabolic interplay.Emerging Topics in Life Sciences, 1(4), 325332.
Cani, P. D. (2018). Human gut microbiome: hopes, threats, and promises.Gut, 67(1), 1716-1725.
Dhanasekaran, D., Paul, D., Amaresan, N., Sankaranarayanan, A., & Shouche, Y. S. (Eds.). (2021). Microbiome-host interactions. CRC Press.
Durack, J., & Lynch, S. V. (2019). The gut microbiome: Relationships with disease and opportunities for therapy.Journal of Experimental Medicine, 216(1), 20–40.
Marco, M. L. (2021). Defining how microorganisms benefit human health. Microbial Biotechnology, 14(1), 35–40. 10.1111/1751-7915.13685
Newby, T. J., & Stokes, C. R. (Eds.). (2019). Local immune responses of the gut. CRC Press.