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Variability in metabolizable energy, measured between individuals on the MBD, is partially attributable to the levels of fecal short-chain fatty acids and microbial biomass present in the gut. The host-diet-microbiome interaction, as demonstrated by our results, has a profound effect on energy balance. While a global rise in overweight and obesity poses a significant public health challenge, the relationship between body mass index (BMI) and treatment efficacy in neoadjuva