关键词: 肥胖, 肠道菌群, 短链脂肪酸, 益生菌, 饮食干预

Abstract: Childhood obesity has become a major global public health issue. Conventional prevention and treatment strategies usually have poor long-term outcomes. The studies in recent years have shown that the gut microbiota is a key mediator between the environment and the host metabolism，and the composition and dysbiosis of gut microbiota contribute to childhood obesity， affecting energy harvest，dietary metabolism，low-grade inflammation，insulin sensitivity，and appetite regulation. Microbiota-targeted interventions，such as specific diets and pre/probiotics，have shown promise as adjuncts to lifestyle changes，but the clinical use is hampered by the microbiota’s complexity，individual variability，uncertain causality，and limited technological efficacy and insufficient data of long-term safety. Fecal microbiota transplantation requires extreme caution in the treatment of pediatric obesity due to unclear risk-benefit. Clinicians should take a rational perspective on gut microbiota intervention，and consider healthy lifestyles as the cornerstone of management. Optimizing diet with high-fiber and diversity remains the most fundamental，safe and effective strategy for modulation of gut microbiota and prevention and treatment of obesity. Future research on gut microbiota should focus on causal mechanisms，developing multi-omics-guided personalized interventions and exploring preciser and safer microecological agents.

Key words: obesity, gut microbiota, short-chain fatty acids, probiotics, dietary intervention