Abstract

Non-communicable diseases (NCDs), including obesity, diabetes, cardiovascular disease, cancer, and chronic 
respiratory disorders, are the leading global causes of morbidity and mortality. Recent advances in microbiome 
research have revealed its central role in the onset, progression, and potential management of NCDs. The 
microbiome contributes to host metabolism, immune regulation, gut–brain signaling, and barrier integrity, with 
dysbiosis linked to systemic inflammation, metabolic dysfunction, and tumorigenesis. Mechanistic pathways 
include altered production of microbial metabolites such as short-chain fatty acids, bile acids, and trimethylamine
N-oxide, as well as disruption of immune tolerance and epithelial barrier functions. Diet is a major determinant of 
microbial composition and diversity, influencing NCD susceptibility and progression. Evidence supports that both 
Westernized and fiber-deficient diets promote dysbiosis, while plant-rich dietary patterns enhance microbial 
resilience and anti-inflammatory potential. Emerging therapeutic strategies, including probiotics, prebiotics, 
dietary modulation, and fecal microbiota transplantation (FMT), offer opportunities to restore microbial balance 
and improve health outcomes. However, methodological challenges, inter-individual variability, and limited 
longitudinal data complicate translation into clinical practice. This review synthesizes current evidence on the 
microbiome’s role in NCDs, highlighting mechanisms, dietary influences, and microbiome-targeted interventions, 
while outlining future directions for precision medicine.