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Among the mechanisms, our research group and others have demonstrated that the gut microbiota fermentation (i.e., bacterial digestion of specific compounds) of specific prebiotics or other non-digestible carbohydrates is associated with the secretion of enteroendocrine peptides, such as the glucagon-like peptide-1 (GLP-1) and peptide YY (PYY), produced by L-cells

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Its premise is an upstream intervention targeting substantial weight reduction to improve key risk factors with the aim to avoid potential downstream complications from multiple co-morbidities, e.g., hypertension, dyslipidaemia, heart failure, kidney disease, NAFLD/NASH or diabetes