Reproducible changes in the anorexia nervosa gut microbiota following inpatient therapy remain distinct from non-eating disorder controls
Farnaz Fouladi,
Emily C. Bulik-Sullivan,
Elaine M. Glenny,
Laura M. Thornton,
Kylie K. Reed,
Stephanie Thomas,
Susan Kleiman,
Ashlie Watters,
Judy Oakes,
Eun-Young Huh,
Quyen Tang,
Jintong Liu,
Zorka Djukic,
Lauren Harper,
Yesel Trillo-Ordoñez,
Shan Sun,
Ivory Blakely,
Philip S. Mehler,
Anthony A. Fodor,
Lisa M. Tarantino,
Cynthia M. Bulik,
Ian M. Carroll
Affiliations
Farnaz Fouladi
Department of Bioinformatics and Genomics, University of North Carolina at Charlotte, Charlotte, NC 28223, USA
Emily C. Bulik-Sullivan
Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
Elaine M. Glenny
Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
Laura M. Thornton
Department of Psychiatry, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
Kylie K. Reed
Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
Stephanie Thomas
Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
Susan Kleiman
Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
Ashlie Watters
ACUTE Center for Eating Disorders and Severe Malnutrition at Denver Health, University of Colorado School of Medicine, Denver, CO 80204, USA
Judy Oakes
ACUTE Center for Eating Disorders and Severe Malnutrition at Denver Health, Department of Medicine, Medical Intensive Care Unit, Denver Health Hospital Authority, Denver, CO 80204, USA
Eun-Young Huh
Center for Gastrointestinal Biology and Disease, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
Quyen Tang
Graduate School of Professional Psychology, Morrison Family College of Health, University of St. Thomas, Minneapolis, MN, USA
Jintong Liu
Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
Zorka Djukic
Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
Lauren Harper
Department of Psychiatry, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
Yesel Trillo-Ordoñez
Center for Gastrointestinal Biology and Disease, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
Shan Sun
Department of Bioinformatics and Genomics, University of North Carolina at Charlotte, Charlotte, NC 28223, USA
Ivory Blakely
Department of Bioinformatics and Genomics, University of North Carolina at Charlotte, Charlotte, NC 28223, USA
Philip S. Mehler
ACUTE Center for Eating Disorders and Severe Malnutrition at Denver Health, University of Colorado School of Medicine, Denver, CO 80204, USA
Anthony A. Fodor
Department of Bioinformatics and Genomics, University of North Carolina at Charlotte, Charlotte, NC 28223, USA
Lisa M. Tarantino
Department of Genetics, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
Cynthia M. Bulik
Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
Ian M. Carroll
Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
The composition of the gut microbiota in patients with anorexia nervosa (AN), and the ability of this microbial community to influence the host, remains uncertain. To achieve a broader understanding of the role of the intestinal microbiota in patients with AN, we collected fecal samples before and following clinical treatment at two geographically distinct eating disorder units (Center of Excellence for Eating Disorders [UNC-CH] and ACUTE Center for Eating Disorders [Denver Health]). Gut microbiotas were characterized in patients with AN, before and after inpatient treatment, and in non-eating disorder (non-ED) controls using shotgun metagenomic sequencing. The impact of inpatient treatment on the AN gut microbiota was remarkably consistent between eating disorder units. Although weight in patients with AN showed improvements, AN microbiotas post-treatment remained distinct from non-ED controls. Additionally, AN gut microbiotas prior to treatment exhibited more fermentation pathways and a lower ability to degrade carbohydrates than non-ED controls. As the intestinal microbiota can influence nutrient metabolism, our data highlight the complex microbial communities in patients with AN as an element needing further attention post inpatient treatment. Additionally, this study defines the effects of renourishment on the AN gut microbiota and serves as a platform to develop precision nutrition approaches to potentially mitigate impediments to recovery.
