Please cite this article in press as: Casta ˜ neda-Márquez AC, et al. Lactobacillus paracasei as a protective factor of obesity induced by an unhealthy diet in children. Obes Res Clin Pract (2020), https://doi.org/10.1016/j.orcp.2020.04.005 ARTICLE IN PRESS G Model ORCP-849; No. of Pages 8 Obesity Research & Clinical Practice xxx (2020) xxx–xxx Contents lists available at ScienceDirect Obesity Research & Clinical Practice jou rn al hom epage: www.elsevier.com/locate/orcp Original Article Lactobacillus paracasei as a protective factor of obesity induced by an unhealthy diet in children Ana Cristina Casta ˜ neda-Márquez a,1 , Cinthya Estefhany Díaz-Benítez a,1 , Margarita Bahena-Roman a , Guadalupe Evelin Campuzano-Benítez a , Marcia Galván-Portillo b , Julio César Campuzano-Rincón b , Alfredo Lagunas-Martínez a , Victor Hugo Bermudez-Morales a , Yaneth Citlalli Orbe-Orihuela a , Jesús Peralta-Romero c , Miguel Cruz c,∗∗ , Ana Isabel Burguete-García a,∗ a Centro de Investigación en Enfermedades Infecciosas, INSP, Cuernavaca, Morelos 62100, Mexico b Centro de Investigación en Salud Poblacional, Instituto Nacional de Salud Pública, Cuernavaca, Morelos 62100, Mexico c Unidad de Investigación Médica en Bioquímica, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Juárez, Ciudad de México CDMX 06600, Mexico a r t i c l e i n f o Article history: Received 24 January 2020 Received in revised form 7 April 2020 Accepted 14 April 2020 Keywords: Gut microbiota Intestinal lactobacilli Childhood obesity Dietary patterns Cross-sectional a b s t r a c t This study examined the association between intestinal lactobacilli and obesity dependent on dietary patterns in children. A cross-sectional study was conducted including 1111 children, 6–12 years old. Obesity was determined according to the WHO cut-off points. Diet information from a Food Frequency Questionnaire identified three dietary patterns. Lactobacillus sp. were determined by a real-time poly- merase chain reaction (PCR). The consumption of complex carbohydrates and a high abundance of L. paracasei were associated with a lower risk of obesity (0.35, Confidence Interval 95% 0.19–0.65). The same happened with a medium consumption of fats and a medium abundance of L. paracasei (0.43, CI95% 0.24–0.78). In contrast, an increased risk of obesity is observed with a medium and high consumption of simple carbohydrates (2.37, CI95% 1.29–4.34 and 2.52, CI95% 1.36–4.66, respectively, p-trend < 0.05), and low consumption of complex carbohydrates (2.49, CI95% 1.35–4.58), in the presence of a high relative abundance of L. reuteri. A high relative abundance of L. paracasei decreased the risk of obesity, even when high-fat and simple carbohydrate diets were consumed; while a high relative abundance of L. reuteri was associated with a greater possibility of obesity with these types of diets. Our results provide evidence of diet implication in metabolism regulators like lactobacilli. This is helpful in strategies development to promote healthy diets during early stages of life. © 2020 Asia Oceania Association for the Study of Obesity. Published by Elsevier Ltd. All rights reserved. Introduction Obesity is a major public health problem worldwide due to the increasing number of cases [1]. Childhood obesity and overweight increased to 41 million children <5 years in 2016 according to the Abbreviations: BMI, body mass index; DNA, deoxyribonucleic acids; FFQ, Food Frequency Questionnaire; CI, confidence interval; INSP, National Institute of Public Health; OR, odds ratio; PCR, polymerase chain reaction; qPCR, quantitative real time polymerase chain reaction; RA, relative abundance; UNICEF, Fondo de las Naciones Unidas para la Infancia; SD, standard deviation; TNF-, tumor necrosis factor alpha; VLDL, very low density lipoproteins; WHO, World Health Organization. ∗ Corresponding author at: Instituto Nacional de Salud Pública, Av. Universidad 655, Santa María Ahuacatitlán, Cuernavaca C.P.62508, Mexico. ∗∗ Corresponding author at: Centro Médico Nacional Siglo XXI, IMSS, Av. Cuauhtémoc 330, Col. Doctores C.P. 06720, Mexico. E-mail addresses: ana.castaneda@espm.insp.mx (A.C. Casta ˜ neda-Márquez), cediaz@insp.mx (C.E. Díaz-Benítez), mbahena@insp.mx (M. Bahena-Roman), evelin c.b@hotmail.com (G.E. Campuzano-Benítez), mgalvan@insp.mx (M. Galván-Portillo), jcampuzano@insp.mx (J.C. Campuzano-Rincón), alagunas@insp.mx (A. Lagunas-Martínez), vbermudez@insp.mx (V.H. Bermudez-Morales), yaneth.orbe@esmp.insp.mx (Y.C. Orbe-Orihuela), drjperalta@hotmail.com (J. Peralta-Romero), miguel.cruzlo@imss.gob.mx (M. Cruz), aburguete@insp.mx (A.I. Burguete-García). 1 These authors contributed equally to this work. World Health Organization (WHO) [1] and in Mexico the preva- lence of these morbidities are above 30% for children between 5 and 11 years of age [2], being in first ranked in terms of childhood obesity worldwide, as reported by UNICEF [3]. It is important to note that children who are overweight or obese may continue to https://doi.org/10.1016/j.orcp.2020.04.005 1871-403X/© 2020 Asia Oceania Association for the Study of Obesity. Published by Elsevier Ltd. All rights reserved.