Gut Microbiome-Hormone Axis and Precision Fermentation Prevent Adolescent Cardiovascular Risk

Adolescence is a critical period where interactions between diet, the gut microbiome, and endocrine maturation significantly influence long-term cardiovascular health. Early metabolic disturbances during this stage can rapidly escalate into chronic cardiovascular vulnerability. Current preventive strategies often fall short in addressing the intricate interplay of these factors. This review addresses the gap by exploring how microbial metabolites impact host physiology and how emerging biotechnologies like precision fermentation could offer targeted interventions to mitigate cardiometabolic risk in this susceptible population.

This narrative review synthesized the latest research on the diet-microbiome-hormone axis in adolescents. It focused on identifying metabolic pathways through which microbial metabolites influence host physiology, specifically examining their impact on enteroendocrine communication, insulin sensitivity, vascular function, and inflammatory tone. A key aspect of the review was the integration of precision fermentation (PF) into the adolescent cardiometabolic framework, exploring its potential to produce bioactive compounds that modulate relevant regulatory pathways for cardiovascular risk prevention.

The review highlights that microbial metabolites, including short-chain fatty acids (SCFAs), microbially transformed bile acids, and postbiotic signaling molecules, are crucial regulators of enteroendocrine communication, insulin sensitivity, vascular function, and inflammatory tone. These metabolites directly link dietary exposures to early cardiometabolic alterations. Dysbiosis, often driven by ultra-processed diets and low fiber intake, promotes metabolic endotoxemia, neuroendocrine imbalance, and endothelial impairment—all recognized as early indicators of cardiovascular disease.

Precision fermentation (PF) offers a novel approach by enabling controlled production of structurally defined bioactive compounds, such as ACE inhibitory peptides, targeted prebiotic oligosaccharides, SCFA-promoting substrates, microbially derived EPA and DHA, phytosterols, and purified postbiotics.

These PF-derived compounds modulate several key regulatory pathways, including the renin-angiotensin-aldosterone system, lipid and bile acid metabolism, gut barrier stability, inflammatory signaling, and endocrine axes involving glucagon-like peptide-1 (GLP-1), peptide YY (PYY), leptin, insulin sensitivity, and growth hormone/insulin-like growth factor-1 (GH/IGF-1) dynamics. This comprehensive modulation positions PF as a promising strategy to address adolescent metabolic susceptibility.