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Obesity and Weight Loss

O is one of the greatest public health challenges of the 21st century. Its prevalence has tripled in many countries of the World Health Organization (WHO) European Region since the 1980s, and the numbers of those affected continue to rise at an alarming rate. In addition to causing various physical disabilities and psychological problems, excess weight drastically increases a person’s risk of developing a number of non-communicable diseases), including cardiovascular disease, cancer and diabetes. Worldwide, current dietary recommendations don’t refer to the role of the gut microbiome in health. Nevertheless, from a public health perspective, establishment of a physiologically relevant, beneficial health effect following modification of the microbiome on obesity should best be established by the favourable modification of one common denominator that is directly linked to a physiological beneficial effect.As common denominator of studies into the dietary modulation of the microbiome by probiotic and prebiotic foods, ‘insulin resistance’ has been proposed. Not only is insulin resistance a hallmark in the development of obesity and type 2 diabetes, but it is also implicated in a plethora of disease states and diseases associated with metabolic syndrome, like excessive weight, hypertension, atherogenic dyslipidemia and chronic low-grade inflammation. This notion implies that insulin resistance should be one of the important, if not the most important primary outcome measure in clinical studies, applying preand probiotic interventions and performed in the context of applied microbiome research. Taken together, in order to make the shift from microbiome research towards its application in dietary strategies and recommendations, as well as into health claims made on newly developed microbiome-modifying foods, we hypothesize that microbiome research should, at least in part, be targeted at deciphering the impact of (un)favourable modulation of the micro biome on insulin resistance.