4. Discussion
Depressive, ’ mental functioning (reduction, microbiota disorders, depression, LBP, depressive disorders
To the best of our knowledge, the study conducted is the first to address the possibility of reducing the severity of depressive disorders in people after bariatric surgery using diet and probiotic therapy.Depressive symptoms were observed in 45% of 200 patients who underwent bariatric surgery. The presence of depressive disorders was also noted in other studies. Alsubaie et al. [At present, there are lack of data in the literature examining the relationship between changes in the microbiota and the development of depression after bariatric surgery. Finding such marker bacteria in the future could be a very valuable predictor of the development of depression. In a previous paper, we published results that indicate a role for the gut microbiota and inflammatory processes in the development of depressive disorders in patients after bariatric surgery [In our study, after 5 weeks, we noted an improvement in patients’ mental functioning (reduction in BDI and HRSD), but it was not related to the probiotic used (In our study, the most important factor that contributed to the reduction in the severity of depressive disorders may have been the dietary intervention. Consumption of vegetables and whole grain cereals increased (DQI-I adequacy), consumption of simple sugars and SFA decreased (moderation DQI-I), and consumption of monounsaturated fatty acids derived mainly from olive oil increased (overall balance DQI-I). A Western-style diet, characterized by the consumption of highly processed products with a high content of sugars and saturated fatty acids and, at the same time, a low consumption of vegetables, fruits and fiber, favors the development of microbiota disorders [The original composition of the microbiota may be important for the functioning of the intestinal barrier and the effectiveness of its sealing. It seems that RYGB has a greater impact on the gut microbiota than restrictive surgery [In our study, we noted no significant differences in parameters assessing intestinal barrier integrity (LPS, LBP, zonulin, occludin) between the group taking the probiotic and the placebo. However, the study by Clemente-Postigo et al. [Due to significant limitations, this study should be considered a pilot study. Small study groups, short time of intervention, high heterogeneity and difficulties in compliance were the biggest limitations. However, the topic addressed is very interesting and requires further well-designed clinical and mechanistic studies.