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Page 14 of 22 Borrego-Ruiz et al. Microbiome Res Rep. 2025;4:20 https://dx.doi.org/10.20517/mrr.2024.78

[70]
Nutrition has been shown to play a crucial role in shaping microbial composition , making a diet rich in
essential nutrients, particularly balanced plant-based patterns, ideal for supporting microbial diversity. For
example, the adoption of a vegetarian diet, rich in indigestible fibers, facilitates fiber fermentation and alters
the intestinal microbial ecosystem, leading to the production of metabolites such as SCFAs and other
postbiotics. These metabolites exert beneficial effects on the intestinal immune system, the integrity of the
[189]
BBB, energy substrate supply, and defenses against microbial pathogens .
The modulation of the GM and its metabolites through the administration of psychobiotics also seems to be
a very promising approach for treating CNS alterations resulting from ELS . Psychobiotics, including
[190]
probiotics, synbiotics, and postbiotics, provide mental health benefits by modulating the GM, which in turn
[191]
influences the regulation of stress, anxiety, and depression symptoms . With respect to ELS, few studies
have investigated the use of probiotics to mitigate its effects on mental health and CNS function, through
the ability of probiotics to synthesize neuroactive compounds such as gamma-aminobutyric acid, serotonin,
children and adolescents to severely negative health and behavioral outcomes . Therefore, a
dopamine, norepinephrine, and acetylcholine . In addition, Borrego-Ruiz and Borrego reviewed the
[192]
application of FMT in various neurological and mental health disorders, highlighting overall positive
[193]
outcomes . However, the broader clinical implementation of this procedure is limited by multiple factors,
including the time and route of administration, the high cost of treatment, and concerns regarding its safety,
tolerability, efficacy, and potential side effects.

Within the context of Nutritional Psychiatry, the combined supplementation of psychobiotics and
nutraceuticals may offer a synergistic strategy for treating certain mental health conditions. However,
significant gaps remain between epidemiological findings and clinical evidence regarding the role of diet-
related factors in managing mental disorders. Future research should focus on exploring the mechanistic
[194]
pathways that involve the GM and its interaction with the CNS . Translating microbiota-related insights
into clinical practice presents considerable challenges, such as the inherent complexity of individual
microbiomes and the difficulty in establishing causal relationships between dietary interventions and
clinical outcomes. While dietary interventions can serve as a supportive measure, they should not be viewed
as a cure for severe mental illnesses. Instead, they should be considered part of a broader, comprehensive
[195]
treatment plan that includes approaches with more robust clinical validation .

Addressing psychosocial factors, such as the availability of mental health resources and supportive
environments, can further help mitigate the impact of stressors on gut integrity and overall health. In this
respect, interventions should not only focus on individual-level approaches but also on transforming the
prevailing adverse social dynamics. As individuals progress through life, several potentially disturbing and
distressing events, such as the emotional experience of humiliation due to bullying victimization, can lead
[196]
multidisciplinary approach aimed at addressing the factors that can induce ELS is essential for promoting
optimal development and overall well-being for all individuals, including initiatives directed at advancing
the understanding of the influence of the microbiome and the potential interventions derived from it, which
to date appear to show promising results.

Future research should focus on investigating the causal relationship between microbiota and stress using
more rigorous research approaches. Specific experimental designs, such as longitudinal studies and
randomized controlled trials, are essential for establishing stronger evidence of causality. Furthermore,
advanced analytical techniques, including multivariate analysis, should be employed to better understand
the complex interactions involved. It is also crucial to address potential confounding variables, including
diet, lifestyle factors, and other environmental influences, to ensure the validity and accuracy of the