**4.3 Dietary modulation**

*Parasitology and Microbiology Research*

**4.2 Prebiotics and probiotics**

**Types of cure Effects**

Antibiotics • Affect GM diversity

Prebiotics and probiotics • Compete with pathogenic bacteria

Dietary modulation • Increase GM ecosystem diversity

*Types of treatments for T2D involving modulation of GM and their effects.*

function.

GM. Bacterio-therapeutic use of antibiotics in farm animals has increased increase growth and food production, but has taken a toll of their metabolic pathways [115]. Excess of usage of antibiotics in early infancy show chronic effects on GM diversity, overweight in infants, obesity in adults. For example, excess of bacterio-therapy with vancomycin has increased the incidence of obesity in adults. Even, short-term treatment with vancomycin impeded peripheral insulin sensitivity and other related metabolic syndromes affecting GM (**Table 2**) [115]. Hence, even short-term treatment with oral antibiotics harness intense and chronic damage to GM diversity and

Recently prebiotics and probiotics have gained a lot of popularity among individuals as a healthy substitute for antibiotics. Prebiotics are actually indigestible carbohydrates that improve the growth and function of colonic bacteria boosting host health. Prebiotics include oligosaccharides which cannot be digested in the upper GI tract. These oligosaccharides are fermented, producing SCFAs in the colon and result in stimulation of growth of colonic. Prebiotics can be obtained from a large number of dietary elements like barley, garlic, asparagus, wheat bran and onions and both prebiotics and probiotics can be obtained from pickled and fermented foods like sauerkraut, kimchi, miso, yogurt [15, 16]. Probiotics obtained from food and supplements contain some very popular strains like bifidobacteria and lactobacilli. These bacteria alter the composition and function of GM as well as host system activity. The prebiotics and probiotics compete with pathogenic

> • Overweight in infant • Obesity in adult

• Enhances SCFA

Metformin • Increases levels of butyrate-producing bacteria

• Vancomycin impede insulin sensitivity [115]

• Enhances immune system [15, 16, 115]

• Decreases levels of Lactobacillus [125] Fecal microbiota transplant • Allogenic infusion from lean donors lead to significant rise in GM

insulin sensitivity [114, 115] Bariatric surgery • Proteobacteria rises and Firmicutes and Bacteroides lowers • BMI reduces by 15–32% • C-reactive protein decreases • T2DM is attenuated [112, 115]

• Intensify intestinal barrier by secreting some antimicrobial substances

• Reduces fasting and postprandial glucose, A1C, serum cholesterol, insulin resistance, BMI, waist and hip circumferences [124]

diversity, enhanced levels of butyrate producing bacteria and improved

**164**

**Table 2.**

Changes in diet plan can modulate activity of GM and host metabolism. A fat and carbohydrate restricted diet increased the ratio of Bacteroidetes to Firmicutes in obese patients with T2D [118]. Also calorie deficient diet plans or diet plans rich in high-fiber macrobiotics like complex carbohydrates, legumes, fermented products, sea salt, and green tea and free of animal protein fat, and added sugar improved dysbiosis, increased GM ecosystem diversity, and enhanced SCFA producers in T2D patients. Macrobiotic diet can more efficiently reduce fasting and postprandial glucose, A1C, serum cholesterol, insulin resistance, BMI, waist and hip circumferences than the control diet. Also macrobiotic diet could effectively reduce pro-inflammatory bacterial strains (**Table 2**) [124].
