Altered nutrient status reprograms host inflammation and metabolic health via gut microbiota

J Nutr Biochem. 2020 Jun:80:108360. doi: 10.1016/j.jnutbio.2020.108360. Epub 2020 Feb 22.


The metabolism of macro- and micronutrients is a complex and highly regulated biological process. An imbalance in the metabolites and their signaling networks can lead to nonresolving inflammation and consequently to the development of chronic inflammatory-associated diseases. Therefore, identifying the accumulated metabolites and altered pathways during inflammatory disorders would not only serve as "real-time" markers but also help in the development of nutritional therapeutics. In this review, we explore recent research that has delved into elucidating the effects of carbohydrate/calorie restriction, protein malnutrition, lipid emulsions and micronutrient deficiencies on metabolic health and inflammation. Moreover, we describe the integrated stress response in terms of amino acid starvation and lipemia and how this modulates new age diseases such as inflammatory bowel disease and atherosclerosis. Lastly, we explain the latest research on metaflammation and inflammaging. This review focuses on multiple signaling pathways, including, but not limited to, the FGF21-β-hydroxybutryate-NLRP3 axis, the GCN2-eIF2α-ATF4 pathway, the von Hippel-Lindau/hypoxia-inducible transcription factor pathway and the TMAO-PERK-FoxO1 axis. Additionally, throughout the review, we explain how the gut microbiota responds to altered nutrient status and also how antimicrobial peptides generated from nutrient-based signaling pathways can modulate the gut microbiota. Collectively, it must be emphasized that metabolic starvation and inflammation are strongly regulated by both environmental (i.e., nutrition, gut microbiome) and nonenvironmental (i.e., genetics) factors, which can influence the susceptibility to inflammatory disorders.

Keywords: Inflammaging; Integrated stress response; Ketogenic diet; Lipid emulsions; Metaflammation; Micronutrient deficiency.

Publication types

  • Research Support, N.I.H., Extramural
  • Review

MeSH terms

  • Anemia, Iron-Deficiency / epidemiology
  • Anemia, Iron-Deficiency / metabolism
  • Animals
  • Diet, Ketogenic / methods
  • Dietary Carbohydrates / administration & dosage
  • Gastrointestinal Microbiome*
  • Humans
  • Inflammation / epidemiology
  • Inflammation / metabolism*
  • Inflammation / therapy
  • Inflammatory Bowel Diseases / epidemiology
  • Inflammatory Bowel Diseases / metabolism
  • Malnutrition / epidemiology
  • Malnutrition / metabolism
  • Metabolic Syndrome / epidemiology
  • Metabolic Syndrome / metabolism*
  • Micronutrients / administration & dosage
  • Micronutrients / deficiency
  • Nutrients / administration & dosage
  • Nutritional Status*
  • Vitamin A Deficiency / epidemiology
  • Vitamin A Deficiency / metabolism


  • Dietary Carbohydrates
  • Micronutrients