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It is likely that the larger number of statistically significant changes to the microbiome observed in the groups switched from WD to LD reflects their more numerous exposures to different diets, longitudinal changes in dietary exposure, the stress associated with diet switch, the negative energy state achieved by treatment and/or diet-driven weight loss, or a combination of these factors, but it may also be related to differences in terminal body weight and fat mass since both adiposity and diet composition have been shown to modulate the mouse gut microbiome profile

In turn, substance use typically worsens mental health over time