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The immunity–diet–microbiota axis in the development of metabolic syndrome

Brandsma, Eelkea; Houben, Tomb; Fu, Jingyuanc; Shiri-Sverdlov, Ronitb; Hofker, Marten H.a

Current Opinion in Lipidology: April 2015 - Volume 26 - Issue 2 - p 73–81
doi: 10.1097/MOL.0000000000000154

Purpose of review Recent evidence demonstrates that the gut–microbiota can be considered as one of the major factors causing metabolic and cardiovascular diseases.

Recent findings Pattern recognition receptors as well as antimicrobial peptides are a key factor in controlling the intestinal microbiota composition. Deficiencies in these genes lead to changes in the composition of the gut–microbiota, causing leakage of endotoxins into the circulation, and the development of low-grade chronic inflammation and insulin resistance. Dietary composition can also affect the microbiota: a diet rich in saturated fats allows the expansion of pathobionts that damage the intestinal epithelial cell layer and compromise its barrier function. In contrast, a diet high in fiber supports the microbiota to produce short-chain fatty acids, thereby promoting energy expenditure and protecting against inflammation and insulin resistance.

Summary The interactions between the microbiota, innate immunity, and diet play an important role in controlling metabolic homeostasis. A properly functioning innate immune system, combined with a low-fat and high-fiber diet, is important in preventing dysbiosis and reducing the susceptibility to developing the metabolic syndrome and its associated cardiovascular diseases.

aDepartment of Pediatrics, Molecular Genetics, University of Groningen, University Medical Center Groningen, Groningen

bDepartment of Molecular Genetics, Maastricht University, Maastricht

cDepartment of Genetics, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands

Correspondence to Marten H. Hofker, Department of Pediatrics, Molecular Genetics, University of Groningen, University Medical Center Groningen, Building 3226 (ERIBA), EA12, Antonius Deusinglaan 1, 9713AV Groningen, the Netherlands. Tel: +31 50 3635777; e-mail:

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