- •This prospective, 15-month longitudinal study, aims to elucidate the associations between bariatric-induced changes in dietary and gut microbiota patterns with post-surgical cognition and brain structure.
- •The project uses varied and comprehensive evaluations including standardized questionnaires, physiological assessments (anthropometrics, blood, urine, and fecal samples), neuropsychological tests, and structural MRI.
- •This innovative project could provide information about potential individually-targeted diet-based preventative strategies to reduce the development of neurodegenerative disorders, and will be able to explore biological mediators related to improvements in cognition and brain health.
- •Extensive collaboration with stakeholders (including patient-investigators) has streamlined as much as possible this novel but burdensome protocol to optimize participant engagement, minimize participant impact, and enhance retention.
Ethics and dissemination
Abbreviations:BIA (bioelectrical impedance analysis), BMI (Body mass index), CRP (C-reactive protein), EWL (Excess weight loss), GI (Gastrointestinal), GLP-1 (Glucagon-like peptide), GM (Grey matter), HbA1c (Hemoglobin A1c), IL-6 (Interleukin 6), IL-10 (Interleukin 10), MRI (Magnetic resonance imaging), NTB (Neuropsychological test battery), PYY (Peptide YY), SAA (Serum amyloid A), SCFA (Short chain fatty acids), SG (Sleeve gastrectomy), TBWL (Total body weight loss), TNF- α (Tumor necrosis factor alpha), TSH (Thyroid-Stimulating Hormone), WC (Waist circumference), WM (White matter)
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Publication stageIn Press Journal Pre-Proof
Bariatric surgery, the gut microbiota, dietary changes and brain function
Funding information: This work was supported by the Weston Family Foundation.
Program name: Brain Health: Lifestyle Approaches and Microbiome Contributions 2021.
Grant application number: BH210129
Conflict of Interest: Competing interests: SLB has received consultancy fees from Merck for the development of behavior change continuing education modules, speaker fees from Novartis and Janssen and has served on advisory boards for Bayer, Sanofi and Sojecci Inc, none of which are related to the current article. SLB serves on the advisory board and is consultant for Lucilab Inc. and is author of the MEMO, Atelier de Stimulation Cognitive, e-Space and Brain Health PRO programs, none of which are related to the topic of the current article. KLL has received investigator-initiated grants from GSK and Abbvie, consultancy fees from Boehringer Ingelheim, Abbvie, Janssen, Astra-Zeneca, and Astellas for the development of behavior change continuing education modules, speaker fees from GSK, Abbvie, Boehringer Ingelheim, Novartis, Astra-Zeneca, Astellas, Bayer, X-Facto and Janssen and has served on advisory boards for Bayer, Bausche, Astra-Zeneca and Sojecci Inc, none of which are related to the current article. SB serves on the advisory board and is consultant for Lucilab Inc. DV serves on the scientific board of Biotwin Inc. and has current funding with Lallemand Health Solutions Inc, none of which are related to the current article. All other authors have no conflict of interest to declare.
Ethical approval: All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Informed consent will be obtained from all individual participants included in the study.
Registration details: Trial registration number: NCT05318781 (https://www.clinicaltrials.gov/)
Authors’ contributions: The authors' responsibilities were as follows – TBP and SLB designed this study, wrote this manuscript and will oversee participants recruitment, data collection and statistical analyses during the study. The whole EMBRACE study team collaboratively contributed substantially to conception and design of the study, drafted the article, revised it critically for important intellectual content and approved the final manuscript.
Acknowledgements: EMRACE Study Team collaborators: lead investigators: Tair Ben-Porat, PhD, Concordia University and CIUSSS-NIM, Canada; Simon L Bacon, PhD, Concordia University and CIUSSS-NIM, Canada. Co-investigators (in alphabetical order by surname): Angela Alberga, PhD, Concordia University, Canada; Marie-Claude Audet, PhD, University of Ottawa, and The Royal’s Institute of Mental Health Research, Canada; Sylvie Belleville, PhD, Research center of the Institut Universitaire de Gériatrie de Montréal (CRIUGM) and University of Montreal, Canada; Tamara Cohen, PhD, University of British Columbia (UBC), Canada; Pierre Y. Garneau, MD, CIUSSS-NIM Canada; Kim L Lavoie, PhD, University of Quebec at Montreal (UQAM) and CIUSSS-NIM, Canada; Patrick Marion, CIUSSS-NIM, Canada; Samira Mellah, Research center of the Institut Universitaire de Gériatrie de Montréal (CRIUGM), Canada; Elham Rahme, PhD, McGill university, Canada; Sylvia Santosa, PhD, Concordia University, Canada; Anne-Sophie Studer, MD, CIUSSS-NIM, Canada; Dajana Vuckovic, PhD, Concordia University, Canada; Robbie Woods, Concordia University and CIUSSS-NIM, Canada; Reyhaneh Yousefi, Concordia University and CIUSSS-NIM, Canada.