Table 5.

Management strategies of dysbiosis.

Classification	Method	Mechanisms of action
Direct repopulation	Fecal microbiota transplant	A method of repopulating the gastrointestinal tract with beneficial bacteria directly (187)
Gut biotics	Probiotics	Live microorganisms that can provide health benefits and are designed to restore the beneficial bacteria of the gut (188, 189)
	Prebiotics	Compounds found in food designed to promote the growth of beneficial microorganisms of the human gut (190)
	Synbiotics	Refers to food or dietary supplements that consist of both probiotics and prebiotics (191)
Diet/Food modifications	Fermented foods	Fermented foods may play a role in health benefit through the nutritive alteration of the ingredients, modulation of the immune system, and the presence of bioactive compounds. By modulating the gut microbiota composition and activity they can affect intestinal and systemic function. Ingestion may help intestinal barrier function along with the production of metabolites inhibiting the uptake of pathogens (192)
	Fiber rich foods	High-fiber diets have the ability to positively alter the microbial intestinal composition by promoting the growth of more beneficial bacteria, such as Prevotella and Bacteroides, while shifting away from Firmicutes (193). Dietary fiber can also selectively increase SCFAs producing bacterium abundance (194)
	Mediterranean diet	This diet is generally described as having a greater focus on minimally processed fruits and vegetables with the inclusion of pulses (e.g., Chickpeas, lentils), nuts, seeds, and fish in relative abundance. The diet itself has also been associated with improvement in microbiome composition and diversity which can lead to lower risk of gut dysbiosis (195, 196)
	Ketogenic diet	This diet focused on a considerable limitation of carbohydrate sources to promote ketone body production. These ketones bodies may lead to an impact on energy metabolism and impact on the microbiome influencing bacteria taxa, richness and diversity (197)
Microbial by-products	Metabolite treatment	The byproducts of the gut microbiome or even probiotics are highly bioactive and are sometimes called “postbiotics” (198). Some common metabolites are SCFAs, which are a fuel source for colonocytes and can help maintain the gut barrier and inhibit pathogenic microorganism proliferation due to acidic pH condition. Specific SCFAs, such as resveratrol, a phytoalexin, can decrease plasma TMAO (which is a risk factor for CVD) (175)