Effects of Weight Loss Interventions on Gut Microbiota-Derived Metabolites Linked to Cardiometabolic Health: A Systematic Review and Meta-Analysis.
Fernando Q Iorra, Leonardo André Swarowsky Loebens, Andrea Auler et al.
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In 30 seconds
This systematic review and meta-analysis assessed how weight-loss interventions affect circulating gut microbiota-derived metabolites in people with overweight or obesity. Across 67 studies, non-surgical interventions were associated with lower TMAO (SMD: -0.56; 95% CI -0.90 to -0.22), but not LPS. Surgical interventions were associated with lower LPS (SMD: -0.47; 95% CI -0.80 to -0.14) and higher TMAO and secondary bile acids. Evidence for short-chain fatty acids and indole derivatives was limited, and the findings differed by intervention type.
Key findings
- Non-surgical interventions were associated with reduced TMAO (SMD: -0.56; 95% CI -0.90 to -0.22; I 2 = 74.7%).
- Non-surgical interventions were not associated with a clear change in LPS (SMD: -0.11; 95% CI -0.58 to 0.35).
- Surgical interventions were associated with decreased LPS (SMD: -0.47; 95% CI -0.80 to -0.14) and increased TMAO (SMD: 0.49; 95% CI 0.08 to 0.90).
- Surgical interventions were associated with increased secondary bile acids (SMD: 0.48; 95% CI 0.30 to 0.66); evidence for SCFAs and indole derivatives was limited.
Why it matters
The differing metabolite patterns suggest that weight loss does not produce a uniform change in circulating microbial products. These findings add context to the complex relationship between obesity, gut microbiota and cardiometabolic health, while highlighting that metabolite responses may vary with intervention type. The clinical significance of these changes is not established by the reported results.
What to keep in mind
Heterogeneity was substantial for several pooled outcomes, including TMAO and LPS, and evidence for SCFAs and indole derivatives was limited.