Dietary modulation of the gut microbiota in type 2 diabetes and obesity: mechanisms, interventions, and clinical perspectives.

Summary

This narrative review synthesises evidence linking dietary patterns to gut microbiota changes in type 2 diabetes and obesity, integrating mechanistic pathways and clinical intervention data. While dietary patterns demonstrably modify microbial functions and metabolites, responses are heterogeneous across populations, baseline microbiota, medications and study methods. The authors conclude that current evidence does not support routine microbiome-guided clinical treatment selection, and individualised microbiome-based nutrition remains an emerging research domain requiring validation.

Regional applicability

The review's conclusions apply broadly to UK clinical and nutritional practice, though the heterogeneity of responses across populations means findings require contextualisation within UK population characteristics. The cautious stance on routine microbiome-guided treatment aligns with current UK clinical guidance, which has not yet adopted personalised microbiome profiling as standard practice.

Key measures

Gut microbial composition and function; microbial metabolites; intestinal barrier function markers; immune signalling; metabolic outcomes; effects of prebiotics, probiotics, synbiotics and postbiotics

Outcomes reported

The review examines how dietary patterns (high-fibre, Mediterranean, plant-based, Western-style) modify gut microbial composition, function and metabolites in type 2 diabetes and obesity. It synthesises evidence on clinical metabolic effects of dietary and microbiome-targeted interventions and their heterogeneity across populations.

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