Abstract:
Childhood obesity is one of the most alarming public health crises of the 21st century. While traditionally addressed through energy balance approaches, current evidence points to a less visible yet highly influential factor: the gut microbiota. This microbial ecosystem plays a key role in regulating metabolism, systemic inflammation, energy absorption, and neuroendocrine signals that control appetite and energy expenditure.
Multiple studies have shown that alterations in the microbiota during the first 1,000 days of life can predispose children to obesity, even in the absence of an evident caloric imbalance. Factors such as mode of delivery, infant feeding practices (breastfeeding vs. formula), introduction of solid foods, early antibiotic exposure, and overall diet quality directly affect the composition and function of the gut microbiota.
This work presents a review of the most recent and rigorous literature on the relationship between microbiota, metabolism, and childhood obesity. Key findings discussed include meta-analyses linking early antibiotic use to increased obesity risk, as well as observational studies showing protective effects of probiotic supplementation in children under three. Specific bacterial strains such as Bifidobacterium and Akkermansia are also examined for their anti-inflammatory and metabolic benefits.
Beyond summarizing the available scientific evidence, this work addresses clinical and public health implications. These include the importance of avoiding unnecessary antibiotic prescriptions, promoting exclusive breastfeeding, and exploring early dietary interventions that support a healthy gut microbiota. The need for public policies that recognize the microbiota as a modifiable factor in obesity prevention is also emphasized.
We conclude that modulation of the gut microbiota represents a promising and underutilized strategy in the fight against childhood obesity. The microbiota-metabolism axis deserves greater attention in both research and clinical practice, particularly in pediatric settings.
