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A low protein diet drives short and long-term improvements in metabolic health in a mouse model of sleeve gastrectomy

ABSTRACT: Despite the largely beneficial impact of bariatric surgery on obesity and metabolic disease, many patients continue to suffer from obesity after surgery and weight recurrence is common. The success of bariatric surgery may be impacted by diet. While bariatric surgery guidelines recommend a high-protein diet following surgery based on the theory that this will preserve lean mass, emerging evidence suggests that both humans and mice are metabolically healthier when consuming low protein diets. Here, we assess the effect of varying dietary protein levels on post-surgical weight loss and weight regain in a mouse model of bariatric surgery, sleeve gastrectomy. We find that a low protein diet optimally drives post-surgical weight loss, boosting energy expenditure and improving blood glucose regulation. Using a multi-omics approach, we identified clusters of differentially expressed genes and metabolites that correlated with these phenotypes and find that diet heavily influences the molecular response of the liver to sleeve gastrectomy. These results suggest that current post-surgical dietary guidelines recommending a high protein diet may limit both the short and long-term benefits of surgery and lead us to conclude that a low protein diet may improve patient outcomes.

ORGANISM(S): Mus musculus

PROVIDER: GSE307617 | GEO | 2025/10/14

REPOSITORIES: GEO

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Project description:Obesity is associated with multiple diseases. Bariatric surgery is the most effective therapy for severe obesity that can reduce body weight and obesity-associated morbidity. The metabolic alterations associated with obesity and respective changes after bariatric surgery are incompletely understood.We comprehensively assessed metabolic alterations associated with severe obesity and distinct bariatric procedures. In our longitudinal observational study, we applied a (1)H-nuclear magnetic resonance-based global, untargeted metabolomics strategy on human serum samples that were collected before and repeatedly <=1 y after distinct bariatric procedures [i.e., a sleeve gastrectomy, proximal Roux-en Y gastric bypass (RYGB), and distal RYGB]. For comparison, we also analyzed serum samples from normal-weight and less-obese subjects who were matched for 1-y postoperative body mass index (BMI) values of the surgical groups. We identified a metabolomic fingerprint in obese subjects that was clearly discriminated from that of normal-weight subjects. Furthermore, we showed that bariatric surgery (sleeve gastrectomy and proximal and distal RYGB) dynamically affected this fingerprint in a procedure-dependent manner, thereby establishing new fingerprints that could be discriminated from those of BMI-matched and normal-weight control subjects. Metabolites that largely contributed to the metabolomic fingerprints of severe obesity were aromatic and branched-chain amino acids (elevated), metabolites related to energy metabolism (pyruvate and citrate; elevated), and metabolites suggested to be derived from gut microbiota (formate, methanol, and isopropanol; all elevated). Our data indicate that bariatric surgery, irrespective of the specific kind of procedure used, reverses most of the metabolic alterations associated with obesity and suggest profound changes in gut microbiome-host interactions after the surgery. This trial was registered at clinicaltrials.gov as NCT02480322.

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A low protein diet drives short and long-term improvements in metabolic health in a mouse model of sleeve gastrectomy

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