Socioeconomic position and the gut microbiota: a narrative synthesis of the association and recommendations.
Jasmine Samantha Ratcliff, Meena Kumari, Patrick Varga-Weisz et al.
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In 30 seconds
This narrative systematic review synthesised observational studies of socioeconomic position (SEP) and gut microbiota (GM) diversity, composition, or function across participants of any age and location. Of 1,479 unique studies identified, 26 met the inclusion criteria. SEP indicators were associated with multiple GM features, but patterns varied by context: alpha diversity was greater in advantaged groups in high-income countries and in disadvantaged groups in low- and middle-income countries. Beta-diversity findings also indicated distinct GM profiles across socioeconomic groups. The authors noted substantial methodological heterogeneity and called for stronger studies to clarify these relationships.
Key findings
- Of 1,479 unique studies identified, 26 observational studies met the review’s inclusion criteria.
- Alpha diversity was greater in advantaged groups in high-income countries, but in disadvantaged groups in low- and middle-income countries.
- Beta-diversity differences suggested distinct gut microbiota profiles between advantaged and disadvantaged groups.
- Studies varied considerably in sampling, sequencing, and analytical methods.
Why it matters
The findings suggest that social and environmental conditions may be associated with gut microbiota differences relevant to health inequalities. The contrasting alpha-diversity patterns across income settings caution against assuming a uniform socioeconomic gradient. Better understanding of these relationships may help assess whether microbiota-related pathways contribute to disparities, although the review does not establish causation.
What to keep in mind
The evidence came from observational studies and was heterogeneous, particularly in sampling, sequencing, and analytical methods. The authors call for larger, more diverse cohorts, longitudinal designs, metagenomic sequencing, and more comprehensive covariate measurement and adjustment.