Exercise reprograms the gut microbiota to enhance metabolic outcomes after bariatric surgery: a translational, cross-species study
9 affiliations
- 1Applied Physiology and Nutrition Research Group – School of Physical Education and Sport and School of Medicine, University of Sao Paulo, Sao Paulo, SP Brazil
- 2Center of Lifestyle Medicine, School of Medicine, University of Sao Paulo, Sao Paulo, SP Brazil
- 3Laboratory of Assessment and Conditioning in Rheumatology; Hospital das Clínicas HCFMUSP, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, São Paulo, SP Brazil
- 4School of Physical Education, Faculty IELUSC, Joinville, SC Brazil
- 5Universidade Estadual de Campinas, Faculdade de Ciencias Aplicadas, Limeira, SP Brazil
- 6Department of Biotechnology, University of Verona, Verona, Italy
- 7Gastroenterology Department, Digestive Surgery Division, Faculdade de Medicina - FMUSP, Universidade de São Paulo, São Paulo, SP Brazil
- 8Department of Human Physiology, University of Oregon, Eugene, OR USA
- 9Laboratory of Nutritional & Exercise Biology, Department of Anatomy, Institute of Biomedical Sciences, University of Sao Paulo, Sao Paulo, Brazil
Abstract
Background/Objectives: Exercise training has been associated with metabolic improvements in bariatric patients beyond weight and fat loss, potentially involving modulation of the gut microbiota. We investigated whether exercise-related microbial changes are associated with metabolic adaptations in women undergoing Roux-en-Y gastric bypass (RYGB) by combining a randomized controlled exercise intervention trial in women post-surgery with a human-to-mouse fecal microbiota transplantation (FMT) experiment.
Subjects/Methods: Thirty-two women were randomized to RYGB (n = 16) or RYGB plus a 6-month exercise training program initiated three months post-surgery (RYGB + ET; n = 16), while a lean control group (LEAN; n = 16) was evaluated at baseline. Blood and fecal samples were collected before surgery, and at 3 (POST3) and 9 (POST9) months following surgery for biochemical, inflammatory, and microbiota analyses.
Results: Both surgical groups showed comparable improvements in body composition and inflammation; however, RYGB + ET was associated with greater improvements in HDL, triglycerides, fasting glucose, and fasting insulin. Exercise was also associated with increased gut microbiota α-diversity and shifts in microbial composition, including enrichment of genera previously linked to short-chain fatty acid (SCFA) metabolism and host metabolic health. To explore the potential contribution of these microbial communities, fecal microbiota collected at POST9 were transplanted into 36 high-fat diet-fed female mice, generating recipient groups rRYGB, rRYGB+ET, and rLEAN. Mice receiving RYGB + ET microbiota displayed similar inflammatory status and glucose tolerance, but lower fasting insulin and HOMA-IR, along with partial preservation of intestinal morphology, compared with mice receiving RYGB microbiota.
Conclusions: These findings suggest that exercise following bariatric surgery is associated with distinct gut microbial configurations and metabolic improvements, and that exercise-conditioned microbiota may contribute to aspects of host metabolic regulation after surgery.
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BibTeX
@article{lima2026exercise,
title = {{Exercise reprograms the gut microbiota to enhance metabolic outcomes after bariatric surgery: a translational, cross-species study}},
author = {Alisson Padilha de Lima and Juliana Bueno de Novais and Adriane Elisabete Costa Antunes and Matteo Calgaro and Carlos Merege-Filho and Diego Nunes Rezende and Marina Alvarenga Romero and Heloisa Castanheira Santo André and Igor Baptista and Ana Lúcia de Sá Pinto and Roberto de Cleva and Marco Aurélio Santo and Wagner Silva Dantas and Saulo Gil and Maria Rita Camargo Rodrigues and Guilherme Gianini Artioli and Nicola Vitulo and Hamilton Roschel and Bruno Gualano and Carolina Ferreira Nicoletti and Fabiana Braga Benatti},
journal = {International Journal of Obesity (2005)},
year = {2026},
month = jun,
doi = {10.1038/s41366-026-02121-3},
url = {https://doi.org/10.1038/s41366-026-02121-3},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Exercise reprograms the gut microbiota to enhance metabolic outcomes after bariatric surgery: a translational, cross-species study
AU - Alisson Padilha de Lima
AU - Juliana Bueno de Novais
AU - Adriane Elisabete Costa Antunes
AU - Matteo Calgaro
AU - Carlos Merege-Filho
AU - Diego Nunes Rezende
AU - Marina Alvarenga Romero
AU - Heloisa Castanheira Santo André
AU - Igor Baptista
AU - Ana Lúcia de Sá Pinto
AU - Roberto de Cleva
AU - Marco Aurélio Santo
AU - Wagner Silva Dantas
AU - Saulo Gil
AU - Maria Rita Camargo Rodrigues
AU - Guilherme Gianini Artioli
AU - Nicola Vitulo
AU - Hamilton Roschel
AU - Bruno Gualano
AU - Carolina Ferreira Nicoletti
AU - Fabiana Braga Benatti
PY - 2026
DA - 2026/06/04
JO - International Journal of Obesity (2005)
DO - 10.1038/s41366-026-02121-3
UR - https://doi.org/10.1038/s41366-026-02121-3
AB - Background/Objectives: Exercise training has been associated with metabolic improvements in bariatric patients beyond weight and fat loss, potentially involving modulation of the gut microbiota. We investigated whether exercise-related microbial changes are associated with metabolic adaptations in women undergoing Roux-en-Y gastric bypass (RYGB) by combining a randomized controlled exercise intervention trial in women post-surgery with a human-to-mouse fecal microbiota transplantation (FMT) experiment. Subjects/Methods: Thirty-two women were randomized to RYGB (n = 16) or RYGB plus a 6-month exercise training program initiated three months post-surgery (RYGB + ET; n = 16), while a lean control group (LEAN; n = 16) was evaluated at baseline. Blood and fecal samples were collected before surgery, and at 3 (POST3) and 9 (POST9) months following surgery for biochemical, inflammatory, and microbiota analyses. Results: Both surgical groups showed comparable improvements in body composition and inflammation; however, RYGB + ET was associated with greater improvements in HDL, triglycerides, fasting glucose, and fasting insulin. Exercise was also associated with increased gut microbiota α-diversity and shifts in microbial composition, including enrichment of genera previously linked to short-chain fatty acid (SCFA) metabolism and host metabolic health. To explore the potential contribution of these microbial communities, fecal microbiota collected at POST9 were transplanted into 36 high-fat diet-fed female mice, generating recipient groups rRYGB, rRYGB+ET, and rLEAN. Mice receiving RYGB + ET microbiota displayed similar inflammatory status and glucose tolerance, but lower fasting insulin and HOMA-IR, along with partial preservation of intestinal morphology, compared with mice receiving RYGB microbiota. Conclusions: These findings suggest that exercise following bariatric surgery is associated with distinct gut microbial configurations and metabolic improvements, and that exercise-conditioned microbiota may contribute to aspects of host metabolic regulation after surgery.
SN - 0307-0565
SN - 1476-5497
ER -