Department of Medicine, The University of Melbourne, Melbourne, Victoria, Australia.
Department of Gastroenterology, St Vincent's Hospital, Melbourne, Victoria, Australia.
J Gastroenterol Hepatol. 2022 Feb;37(2):237-245. doi: 10.1111/jgh.15728. Epub 2021 Nov 16.
The composition and function of the dynamic microbial community that constitutes the gut microbiome is continuously shaped by the host genome, mode of birth delivery, geography, life stage, antibiotic consumption, and diet. Diet is one of the most potent factors in determining microbiome integrity. Dietary factors in early life appear to substantially determine the risk of later health or disease; for example, exposure to ultra-processed foods in childhood or adolescence may increase the risk of the later development of inflammatory bowel disease or colorectal cancer, thought to be mediated by modulation of the gut microbiota. Dietary factors when gut diseases are established influence symptoms and disease activity, can form a risk factor for ongoing disease, or can be used as therapy to decrease disease activity. The characterization of dietary content is currently complex and imperfect, but tools are emerging to define precisely the nature of dietary composition. Similarly, the revolution in microbial analysis allows greater understanding of how diet influences microbial composition and function. Defining the interaction between diet, the gut microbiome, and gastrointestinal disease is leading to radical changes in our clinical approach to these disorders.
肠道微生物组由动态微生物群落组成，其组成和功能不断受到宿主基因组、分娩方式、地理位置、生命阶段、抗生素使用和饮食的影响。饮食是决定微生物组完整性的最有力因素之一。生命早期的饮食因素似乎极大地决定了以后健康或疾病的风险；例如，儿童或青少年时期暴露于超加工食品可能会增加以后发展为炎症性肠病或结直肠癌的风险，这被认为是通过调节肠道微生物群来介导的。当肠道疾病确立后，饮食因素会影响症状和疾病活动，可以成为疾病持续存在的危险因素，或者可以用作治疗方法来降低疾病活动度。饮食内容的描述目前较为复杂和不完善，但正在出现一些工具来精确定义饮食组成的性质。同样，微生物分析的革命使我们能够更好地了解饮食如何影响微生物的组成和功能。定义饮食、肠道微生物组和胃肠道疾病之间的相互作用正在导致我们对这些疾病的临床治疗方法发生根本性变化。
