Childhood Obesity and the Cryptic Language of the Microbiota: Metabolomics’ Upgrading

Abstract

The growing obesity epidemic in childhood is increasingly concerning for the related physical and psychological consequences, with a significant impact on health care costs in both the short and the long term. Nonetheless, the scientific community has not yet completely clarified the complex metabolic mechanisms underlying body weight alterations. In only a small percentage of cases, obesity is the result of endocrine, monogenic, or syndromic causes, while in much more cases, lifestyle plays a crucial role in obesity development. In this context, the pediatric age appears to be of considerable importance as prevention strategies together with early intervention can represent important therapeutic tools not only to counteract the comorbidities that increasingly affect children but also to hinder the persistence of obesity in adulthood. Although evidence in the literature supporting the alteration of the microbiota as a critical factor in the etiology of obesity is abundant, it is not yet fully defined and understood. However, increasingly clear evidence is emerging regarding the existence of differentiated metabolic profiles in obese children, with characteristic metabolites. The identification of specific pathology-related biomarkers and the elucidation of the altered metabolic pathways would therefore be desirable in order to clarify aspects that are still poorly understood, such as the consequences of the interaction between the host, the diet, and the microbiota. In fact, metabolomics can characterize the biological behavior of a specific individual in response to external stimuli, offering not only an eventual effective screening and prevention strategy but also the possibility of evaluating adherence and response to dietary intervention.

Prebiotics, Probiotics, and Synbiotics—A Research Hotspot for Pediatric Obesity

“…Therefore, the implications of pediatric obesity go beyond childhood into adulthood, increasing considerably the health-related costs. Other important long-term complications of obesity consist of chronic inflammation, which was proven to be present also in children [46], dyslipidemia, hypertension, hyperuricemia, obstructive sleep apnea, nonalcoholic fatty liver disease, and even cancer [6]. Although genetic background plays a major role in predisposing individuals to obesity, obesogenic factors such as eating habits, sedentary lifestyle, and urbanizations seem to be the ones that decide, finally, whether an individual will become obese or not [16].…”

“…Childhood obesity, a real pandemic, represents, in fact, a major public health problem worldwide, with an increasing trend in prevalence during the last decades, especially in developed countries [1][2][3][4][5]. Due to its associated short-and long-term complications, it carries an important burden not only for health services, but also for society, since it is associated with both psychosocial problems like bullying, resulting in school absences and consequent poor school results, and organic conditions such as metabolic syndrome with insulin resistance, cardiovascular disorders, hypertension, dyslipidemia, non-alcoholic fatty liver disease, obstructive sleep apnea, and even neoplasia [6][7][8][9][10][11][12][13][14]. According to the most recent reports of the World Health Organization (2020), 39 million children under the age of 5 years suffer from either overweight or obesity, with an impressive increase between 5 and 19 years, reaching up to 340 million cases [15].…”

“…Nevertheless, it is clearly established that the colonization process ends between 3-5 years of age, when the child's microbiota resembles to that of an adult [28]. Several external factors were proven to be essential for the maturation of the microbiota composition, such as maternal diet, type of delivery and feeding, and the early use of antibiotics [6,29]. Thus, in vaginally born infants, studies revealed that facultative anaerobic bacteria, including Escherichia spp.…”

“…In addition, several differences were noticed depending on the type of feeding, consisting in a predominance of Bifidobacteria in breastfed infants and a more diversified microbiota in formula-fed infant with a predominance of Bacteroides, Staphylococci, Clostridia, Enterobacteria, Enterococci, and the genus Atopobium [6]. Human milk oligosaccharides were proven to favor the growth of Bifidobacteria and Bacteroides, acting also as modulators of innate immune responses, anti-inflammatory molecules, and prebiotics [40].…”

CCL3 as a novel biomarker in diagnosis of Necrotizing Enterocolitis

“…Our Past study indicated that CC motif chemokine ligand 3 (CCL3) is highly expressed in the intestinal lesions of NEC patients, mediates macrophage in ltration and induces M1-type polarization, thus participating in the occurrence and development of NEC 11,12 . However, its utility as a biomarker for early detection of NEC has not been explored.…”