Essay on the Gut Microbiome: Connecting Obesity and Bariatric Research

Introduction

This chapter provides the background for the significance of this research study. It is also emphasizing that a connection between the Bariatric and Gut microbiome exists due to the interaction between obesity and gut microbiota. The gut microbiome regulates the intestinal structure and functions of the digestive system. The microorganisms are essential since they interact directly with food intake. Ozdemiran and Buyuktuncer (2018) argued that the children are exposed to bacteria a few days after they are born through colonization of the intestines by microbiota (Fouhy et al., 2012; Marchesi, 2011; Ozdemiran &Buyuktuncer, 2018; Palmer et al., 2007). The composition of gut microbiomes in children varies according to the mother's microbiota, method of delivery, breastfeeding, the host environment, and child's use of antibiotics (Long-Smith et al., 2019). The research was conducted on males and females who had bariatric surgery within 12 months, with the age of 18 to 50. The research sought to analyze the effects of gut microbiota on the success of bariatric research. Different results from different demographics groups were used to show the development of gut microbiota in different backgrounds.

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Development of Microbiome

Gut microbiome develops from childhood to adulthood and influence obesity through the host genes, dietary factors, socio-economic, and environment (Marchesi, 2011; Ozdemir&Buyuktuncer, 2018). Gut microbiome regulates energy in the stomach leading to the increased processing capacity of indigestible diets. Ozdemir and Buyuktuncer (2018) argue that regulating energy ''ensures the absorption of short-chain fatty acids from the intestine'' (preceded by "p. 209") (Ozdemir&Buyuktuncer, 2018; Topping & Clifton, 2001). The research also confirms the presence of fatty acids oxidation elements in the gut microbiome of obese people. Obesity is a result of the infiltration of macrophages. Obesity, according to the research, is connected to low inflammation that is caused by changes in the composition of intestinal microbes when the patients take a high-fat diet. Gut microbiota, according to Ozdemir and Buyuktuncer, are the causes of obesity, a condition connected to microbiota and adiposity (Ozdemir&Buyuktuncer, 2018).

Environment and Gut Microbiome

Research shows that environmental factors and genetic factors influence the emergence of obesity in human bodies. According to a study conducted by Ulker and Yildiran (2019), patients with obesity have less unpredictability in gut microbiota than thin individuals (Duranti et al., 2017; Ulker & Yildiran, 2019; Wang, 2017). Microbial worries between obese and thin individuals are their inability to create fermentation (Ulker & Yildiran, 2019). Short-chain fatty acids cannot be produced from indigestible food material by obese individuals. Individuals with obesity have more Firmicutes and fewer Bacteroides than normal-weight individuals. These microorganism ratios determine the development of obesity and hepatic conditions. The ratio of Firmicutes and Bacteroidetes is low in the gut intestines of normal-weight people (Fava et al., 2013; Ulker &Yildiran, 2019). Eating diets with fat and carbohydrate restrictions lead to the reduction of amounts of Bacteroidetes, which in return lead to the reduction of body weight (David et al., 2014; Ulker & Yildiran, 2019). Gut microbiota is affected by the loss of weight, which is affected by exercise, diet, and bariatric surgery.

Effects of Bariatric Surgery on Gut Microbiota

According to Paganelli et al (2019), Bariatric surgery on the gut system considered to have significant effects on gut microbiota (Paganelli, et al., 2019). The operation aims at changing the environment and conditions in the stomach and the intestines to reduce weight to individuals who are obese (Haange et al, 2020). A research conducted by Ulker and Yildiran (2019) show that the bariatric surgery alters the level of hormones and enzymes, food choices, and composition of the microbiota. Individuals undergoing bariatric surgery understand the risks associated with the surgery accept to take risks since other non-surgical treatments have failed. Bariatric surgery conducted through gastric bypass, which includes reducing the stomach capacity to 30cm3 (Ulker & Yildiran, 2019). The process reduces the intake of energy and food and disrupts the intake of fat (Nguyen, Varela, 2017; Ulker & Yildiran, 2019). The stomach removed vertically, leaving a tubular gastric tube on super obese individuals (Ulker & Yildiran, 2019). The surgery restricts gastric volume, as well as the nutrient and energy intakes (Danner, 2019; Toussi et al., 2009). Bariatric surgery implemented by placing adjustable silicone around the stomach's upper region to form a smell gastric space (Danner et al., 2019). The method reduces nutrient uptake in the stomach. The surgery reduces body weight through a reduction of gastric volume and hormonal changes. All bariatric surgery techniques ensured sustain a reduction of leptin, and peptide YY. Reduction of these factors influences the increase of ghrelin and pancreatic polypeptide increase, leading to weight loss.

It has also reported that Bariatric surgery affects the gut microbiota significantly. The research conducted by Ulker and Yildiran (2019) shows that the change in lifestyle achieved after the surgery change gut microbiota's composition through food choices and preferences, change in volume of food consumed, and change in nutrient absorption (Peat et al., 2015; Ulker & Yildiran, 2019). Ulker and Yildiran (2019), argues that the short-term diet changes have a swift effect on the changes in the intestinal composition of the microbiota (Ulker & Yildiran, 2019). Different diets affect microbiota components differently. Complex and simple carbohydrate-rich diets affect the prevotella enterotypes, while animal proteins and saturated fat affect Bacteroides enterotypes (Paganelli et al., 2019). The diet therapy that the patients go through after bariatric surgery aim at regulating the low-fat uptake diets, high-carbohydrate, and low-glycemic-indexed diets to influence the change of certain intestinal microbiota.

Bariatric Surgery and Bile Acid

Fundamentally, Bariatric Surgery affects Bile Acids. Bile acids control glucose homeostasis, beta-cell function, and energy consumption (Ozdemir&Buyuktuncer, 2018; Vrieze et al., 2014). Bariatric surgery affects the bile acid metabolisms by changing the flow, thus affecting gut microbiota (Catoi et al., 2015; Ozdemir&Buyuktuncer, 2018). Bile acids transport nutrients from the upper part of the stomach, increasing influencing obesity. Through bariatric surgery, dietary lipids affect bile acid cycling in the upper intestines leading to reduced nutrient transportation (Ilhan, DiBaise, Dautel, Isern, Kim, Hoyt, Schepmoes, Brewer, Weitz, Metz, Crowell, Kang, Rittmann, &Krajmalnik-Brown, 2020; Ridlon et al., 2014). Ideally, the process leads to the increase of bacteria and change of intestinal microbiota capable of synthesis of secondary bile acids (Gutierrez al et al, 2019). Bariatric surgery shrinks the volume of the stomach leading to an increase of PH levels. The changes experienced in the pH affects the entire digestive system. Intestinal microbiota decreases due to changes in the pH of the stomach changes leading to an increase of Firmicutes and Actinobacteria that reduce body weight. Bariatric surgery affects microorganism that makes microbiota differently. The diversity that exists between microorganisms is affected by the changes experienced in microbiota after surgery.

Gut Microbiota and Bariatric Surgery Success

Undeniably, the intestinal microbiota plays a significant role in determining the success of bariatric surgery. The study conducted by Gutierrez-Repiso et al.'s (2019) show gut microbiota as an essential factor in determining the metabolic process of an obese individual and their reaction after bariatric surgery. The changes in gut microbiota composition and diversity experienced after bariatric surgery connect to the host interactions (Paganelli et al., 2019). The research conducted with an individual who had bariatric procedures within the last 12 months to the research (Gutierrez-Repiso et al., 2019; Moize et al., 2010). The study analyzed the success rate of bariatric surgery of different individuals and connected the result to their gut microbiota. The research shows that the composition of gut microbiota change and microbiota functioning differ after the surgery.

Additionally, the research showed that microbiota composition left after the surgery remained the same, indicating the success of the surgery. Bacteroides were lower in obese people and collated with low-grade inflammation affecting calorie intake and leading to low weight. The differences noticed in success rates connected to the host dietary components, biochemistry affected by host gut bacteria and metabolites that the host produced (Cani, 2018). The differences connected to the presence of some bacteria in either the success group or the failure ground. For instance, Acinetobacter and Serratia were found to the failure of patients and connected to bile tolerance. The pH of the patients who had undergone surgery was low. The bacteria were not able to live in an environment with a low pH. Microbial communities through pH modification affected short-chain fatty acid production.

Bariatric Surgery Effects on Gut Microbiota Bacteria

Research conducted by Pajecki et al. (2019) shows that patients that recorded less weight loss had increased their Firmicutes and decreased Bacteroidetes Those that recorded more than 50% excess weight loss had no differences in their Firmicutes and Bacteroidetes. The differences connected to the lifestyle of the patients after bariatric surgery. Those that maintained low-fat diets, restricted carbohydrates, and physical exercise and recorded success. These lifestyle factors affected the gut microbiota of the host affecting the surgery success. The success of bariatric surgery depends on the gut microbiota composition, diversification, and pH levels.

It is critical to note that while many patients may present varied amounts of the characteristics, the significant changes have often been reported within the intestinal microbiota after surgery (Danner et al., 2019). The possible mechanism for the changes within the microbiota general includes the food choices and preferences, food consumption reduction, as well as the nutrient malabsorption. He dietary changes that occur in the short-term have also been reported to contribute to the changes in the intestinal microbiota composition. More specifically, the Prevotella enterotypes have been linked to the complex carbohydrate-rich and simple carbohydrate-rich diets.

Treatment of obesity depends on the strategy used to reduce body weight. Bariatric surgery is the most effective strategy in reducing weight (Vallianou et al., 2019). The strategy involves regulating the intestinal environment and factors that induce obesity. The process consists of restricting uptake of some nutrients, reducing the volume of food, and avoidance of some foods. According to Wang et al., (2271,2019). Bariatric surgery changes the acids metabolism, changes, pH, and change in some microbial hormones lead to sustainable weight loss. Research, however, shows disparities in the success rates of bariatric surgery due to changes observed in gut microbiotas (Vallianou et al., 2019). Different patients react differently according to their genes, diet intake, and metabolism characters of the patient. More research identifies ways in which sustainable weight loss...