Microbial enterotypes in personalized nutrition and obesity management

Human gut microbiota has been suggested to play an important role in nutrition and obesity. However, formulating meaningful and clinically relevant dietary advice based on knowledge about gut microbiota remains a key challenge. A number of recent studies have found evidence that stratification of individuals according to 2 microbial enterotypes (dominance of either Prevotella or Bacteroides) may be useful in predicting responses to diets and drugs. Here, we review enterotypes in a nutritional context and discuss how enterotype stratification may be used in personalized nutrition in obesity management. Enterotypes are characterized by distinct digestive functions with preference for specific dietary substrate, resulting in short-chain fatty acids that may influence energy balance in the host. Consequently, the enterotype potentially affects the individual's ability to lose weight when following a specific diet. In short, a high-fiber diet seems to optimize weight loss among Prevotella-enterotype subjects but not among Bacteroides-enterotype subjects. In contrast, increasing bifidobacteria in the gut among Bacteroides-enterotype subjects improves metabolic parameters, suggesting that this approach can be used as an alternative weight loss strategy. Thus, enterotypes, as a pretreatment gut microbiota biomarker, have the potential to become an important tool in personalized nutrition and obesity management, although further interventions assessing their applicability are warranted.