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The composition of gut microbiota is emerging as a risk factor for obesity, with studies reporting lower levels of Bifidobacterium and higher levels of Firmicutes in obese subjects than in lean subjects. Higher levels of the lipopolysaccharide (LPS)-binding protein have been detected in overweight and obese individuals, suggesting that intestinal permeability, subclinical endotoxemia, and low-grade inflammation mechanistically link changes in the gut microbiome to changes in metabolism and body weight.

Nonalcoholic fatty liver disease (NAFLD) is the hepatic manifestation of metabolic syndrome and occurs on a continuum from simple steatosis to steatohepatitis (NASH) and cirrhosis. The pathophysiology of NAFLD is thought to begin with insulin resistance and progress because of oxidative stress and inflammation. In the absence of pharmaceutical treatments for NAFLD, the mainstay approach to therapy is dietary modification, exercise, and weight loss. In addition, antioxidant supplementation has been explored as a therapeutic option in NAFLD. 

Studies suggest that the intestinal microbiota influence depression, anxiety, and stress. The bidirectional communication of the gut-brain axis is thought to link the microbiome to mood, and the microbiome is known to be affected by diet. A review of studies related to diet, the microbiome, and mood was published in 2018 in Nutritional Neuroscience

More than 1 in 5 patients with chronic heart failure (CHF) also experience depression, which is associated with mortality rates that are 2 to 3 times higher than those of non-depressed patients. The SADHART-CHF (Sertraline Against Depression and Heart Disease in Chronic Heart Failure) trial showed that improvement in depression correlated with reduced cardiovascular events in patients with CHF. A post-hoc analysis of this trial found that 80% of the patients with both CHF and depression had low plasma omega-3 levels.