Autologous fecal microbiota transplantation can retain the metabolic achievements of dietary interventions

Ehud Rinott, Ilan Youngster, Anat Yaskolka Meir, Gal Tsaban, Alon Kaplan, Hila Zelicha, Elad Rubin, Omry Koren, Iris Shai

Research output: Contribution to journalArticlepeer-review

10 Scopus citations


Background: We recently reported that autologous fecal microbiota transplantation (aFMT), derived from the time of maximal weight-loss and administrated in the regain-phase, might preserve weight loss and glycemic control in moderately obese subjects, and is associated with specific microbiome signatures. Here, we sought to explore the global effect of aFMT on adipokines, inflammatory markers and blood cholesterol and on the overall gut microbiome preservation. Methods: In the DIRECT-PLUS weight-loss trial, abdominally obese participants were randomized to three distinct weight-loss diets. Following the expected weight loss phase (0–6 m), 90 participants were randomized to receive their personal frozen fecal microbiota or placebo oral capsules (ten 1 g-capsules over ten sessions-total=100 g) during the expected weight regain phase (8–14 m). Results: Of the 90 participants (age=52 yr; 0–6 m weight loss=-8.3 kg), 95.6% ingested at least 80/100 oral aFMT/placebo capsules over 6 months. Overall, the gut microbiome community structure was associated with plasma levels of leptin, cholesterol and interleukin-6 at baseline and after 6 m, whereas 6 m (weight loss phase) changes in specific microbiome species associated with the dynamic of leptin and inflammatory biomarkers. Following the 8–14 m aFMT administration phase, aFMT maintained decreased levels of leptin (ΔaFMT=-3.54 ng/mL vs. Δplacebo=-0.82 ng/mL;P = 0.04), C-reactive-protein (ΔaFMT=-1.45 mg/L vs. Δplacebo=-0.66 mg/L;P = 0.009), Interleukin-6 (ΔaFMT=-0.03pg/mL vs. Δplacebo=1.11pg/mL;P = 0.03) and total cholesterol (ΔaFMT=2.2 mg/dl vs. Δplacebo=13.1 mg/dl;P = 0.04) achieved in the weight loss phase. Overall, aFMT induced a significant preservatory effect on personal gut microbiome global composition (P = 0.03;Jensen-Shannon distance), as compared to placebo. Conclusions: aFMT treatment in the regain phase might retain weight-loss induced metabolic benefits. These findings may suggest a novel aFMT treatment approach for personal metabolic attainment preservation.

Original languageEnglish
Pages (from-to)17-23
Number of pages7
JournalEuropean Journal of Internal Medicine
StatePublished - Oct 2021

Bibliographical note

Funding Information:
This work was funded by grants from the Deutsche Forschungsgemeinschaft (DFG, German Research Foundation)—Project number 209933838 —Collaborative Research CenterCentre SFB1052 ’Obesity Mechanisms’, to I Shai (SFB-1052/B11); the Rosetrees trust (grant A2623); the Israel Ministry of Health (grant no. 87472511), Israel Ministry of Science and Technology (grant 3-13604 ); Israeli Science Foundation (grant 1733/ 18) and the California Walnuts Commission. None of the funders were involved in any stage of the design, conduct, or analysis of the study, and had no access to the study results before publication.

Publisher Copyright:
© 2021 The Authors


  • Inflammatory markers
  • Personalized medicine
  • Weight loss
  • Weight regain
  • aFMT


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