The influence of the microbial–mammalian metabolic axis is becoming increasingly important for human health. Bacterial fermentation of carbohydrates (CHOs) and proteins produces short-chain fatty acids (SCFA) and a range of other metabolites including those from aromatic amino acid (AAA) fermentation. SCFA influence host health as energy sources and via multiple signalling mechanisms. Bacterial transformation of fibre-related phytochemicals is associated with a reduced incidence of several chronic diseases. The ‘gut–liver axis’ is an emerging area of study. Microbial deconjugation of xenobiotics and release of aromatic moieties into the colon can have a wide range of physiological consequences. In addition, the role of the gut microbiota in choline deficiency in non-alcoholic fatty liver disease (NAFLD) and insulin resistance is receiving increased attention.