A study found that a high-fat, high-protein "Atkins-type" diet worsened Clostridium difficile infection (CDI) in mice, while a high-carbohydrate diet protected against CDI. Mice fed the Atkins-type diet had the worst CDI outcomes and 100% mortality rate, while those on a high-carbohydrate diet were protected from CDI despite antibiotic treatment. The study suggests popular high-fat, high-protein weight loss diets may increase CDI risk by reducing protective gut bacteria and increasing amino acids that promote C. difficile growth.

1. BP Limb Length &
Complications of MGB & Other Bariatric Surgery
Its the Microbiome!
The World Has Changed
Bariatric Surgeons:
Wrong Again?

2. Bypass Limb Length in MGB
Gut Dysbiosis & FMT
It’s NOT the Bypass Limb Length
Dr Rutledge
Dysbiosis Not Short Bowel Syndrome

3. High-Fat/High-Protein, “Atkins-Type”
Diet Worsens Clostridium difficile
It’s NOT the Bypass Limb Length
Dr Rutledge says:
It’s Dysbiosis Not Short Bowel Syndrome

4. The content is not intended to be a substitute for
professional medical advice, diagnosis, or
treatment, and does not constitute medical or other
professional advice.
For Entertainment Purposes Only

5. Dr. Illan: San Diego & Tijuana Offices
International Center for Laparoscopic Obesity Surgery
MGB-Original Technique
Sleeve & New MGB-2
Dr's Rutledge & Illan

6. C Diff & Intestinal Sx Post Bariatric Surgery
• mSystems 2020 Feb 11;5(1)
• A High-Fat/High-Protein, Atkins-Type Diet
Exacerbates Clostridioides ( Clostridium)
difficile Infection in Mice, whereas a High-
Carbohydrate Diet Protects
• Chrisabelle C Mefferd et al

7. A High-Fat/High-Protein, Atkins-Type Diet
Worsens Clostridium difficile Infection
Western diets & high fat weight-loss diets drive large
changes in the gut microbiome
C. Diff outcome & microbial community fed
either 1 of 2 high-fat diets vs. a high-carbohydrate diet
or a standard diet

8. Experimental Design

9. Results

10. Results: CDI Infection
• Control
• Low Carb
• High Fat - LOW PROTEIN
• High Fat - High Protein

11. Results: CDI Infection
• Control
• Low Carb
• High Fat - LOW PROTEIN
• High Fat - High Protein

12. A High-Fat/High-Protein, Atkins-Type Diet
Worsens Clostridium Difficile Infection (CDI)
Both high-fat diets worsened CDI,
The high-fat/high-protein,Atkins-like diet
=> worst CDI & 100% mortality
High-fat/low-protein, “standard” diet
=> variable CDI outcome.
The high-carbohydrate diet prevented CDI,
in spite of high level refined carb & low level fiber

13. A High-Fat/High-Protein, Atkins-Type Diet
Worsens Clostridium Difficile Infection (CDI)
28 Bacterial species were destroyed/decreased
due to diet &/or antibiotics
the organisms may compete w C. Diffi & protect from CDI
Hi Fat/Hi Pro Diet like antibiotics leads to
loss of C. difficile competitors
Creating a favorable environment for C. difficile overgrowth

14. High Carb/High Fiber Diets & Health of the Microbiome
Improved gut health due to high-carbohydrate diets,
especially those rich in fiber, has been well
documented and is suggested to be related to the
production of Short Chain Fatty Acids (SCFAs) by
gut microbes (26–30)

15. A High-Fat/High-Protein, Atkins-Type Diet
Worsens Clostridium Difficile Infection (CDI)
The Study Shows
CDI Virulence was intensified by
“Atkins” type high-fat/high-protein diet
High-carbohydrate diets were protective
regardless of carbohydrate source
or antibiotic treatment of C. difficile competitors.

16. A High-Fat/High-Protein, Atkins-Type Diet
Worsens Clostridium Difficile Infection (CDI)
IMPORTANCE: Study Question
High Fat/protein western/weight-loss diets
& the risk/severity of CDI?
Study showed:
High-fat/high-protein, Atkins-type diet severely worsened CDI,
High-carbohydrate diet protected against CDI

17. A High-Fat/High-Protein, Atkins-Type Diet
Worsens Clostridium Difficile Infection (CDI)
Study results, suggests popular
high-fat/high-protein weight-loss diets may enhance CDI risk
Especially during antibiotic treatment,
Possibly due to the additive effects of a loss of the
microorganisms in the microbiome that normally inhibit
C. difficile overgrowth &
INCREASED amino acids that promote C. difficile growth

18. Study Findings
Clostridium Difficile Infection was worsened by:
High-fat diet,
particularly a high-fat/high-protein,
“Atkins-like” diet.
And high-fat diet alone
also intensified CDI

19. Reference
• mSystems
• . 2020 Feb 11;5(1):e00765-19. doi:
10.1128/mSystems.00765-19.
• A High-Fat/High-Protein, Atkins-Type Diet Exacerbates
Clostridioides ( Clostridium) difficile Infection in Mice,
whereas a High-Carbohydrate Diet Protects
• Chrisabelle C Mefferd # 1, Shrikant S Bhute # 1,
Jacqueline R Phan 2, Jacob V Villarama 1, Dung M Do 2,
Stephanie Alarcia 1, Ernesto Abel-Santos 3 4, Brian P
Hedlund 5 4