Mediterranean diet intervention in overweight and obese subjects lowers plasma cholesterol and causes changes in the gut microbiome and metabolome independently of energy intake
Top Cited Papers
Open Access
- 19 February 2020
- Vol. 69 (7), 1258-1268
- https://doi.org/10.1136/gutjnl-2019-320438
Abstract
Objectives This study aimed to explore the effects of an isocaloric Mediterranean diet (MD) intervention on metabolic health, gut microbiome and systemic metabolome in subjects with lifestyle risk factors for metabolic disease. Design Eighty-two healthy overweight and obese subjects with a habitually low intake of fruit and vegetables and a sedentary lifestyle participated in a parallel 8-week randomised controlled trial. Forty-three participants consumed an MD tailored to their habitual energy intakes (MedD), and 39 maintained their regular diets (ConD). Dietary adherence, metabolic parameters, gut microbiome and systemic metabolome were monitored over the study period. Results Increased MD adherence in the MedD group successfully reprogrammed subjects’ intake of fibre and animal proteins. Compliance was confirmed by lowered levels of carnitine in plasma and urine. Significant reductions in plasma cholesterol (primary outcome) and faecal bile acids occurred in the MedD compared with the ConD group. Shotgun metagenomics showed gut microbiome changes that reflected individual MD adherence and increase in gene richness in participants who reduced systemic inflammation over the intervention. The MD intervention led to increased levels of the fibre-degrading Faecalibacterium prausnitzii and of genes for microbial carbohydrate degradation linked to butyrate metabolism. The dietary changes in the MedD group led to increased urinary urolithins, faecal bile acid degradation and insulin sensitivity that co-varied with specific microbial taxa. Conclusion Switching subjects to an MD while maintaining their energy intake reduced their blood cholesterol and caused multiple changes in their microbiome and metabolome that are relevant in future strategies for the improvement of metabolic health.Keywords
This publication has 68 references indexed in Scilit:
- Diet‐derived microbial metabolites in health and diseaseNutrition Bulletin, 2019
- Daily Sampling Reveals Personalized Diet-Microbiome Associations in HumansCell Host & Microbe, 2019
- The Mediterranean Diet and Cardiovascular HealthCirculation Research, 2019
- DASH Dietary Pattern and Cardiometabolic Outcomes: An Umbrella Review of Systematic Reviews and Meta-AnalysesNutrients, 2019
- Mediterranean diet and its components in relation to all-cause mortality: meta-analysisBritish Journal of Nutrition, 2018
- Human gut microbiome: hopes, threats and promisesGut, 2018
- Towards utilization of the human genome and microbiome for personalized nutritionCurrent Opinion in Biotechnology, 2018
- Central obesity and the Mediterranean diet: A systematic review of intervention trialsCritical Reviews in Food Science and Nutrition, 2017
- Healthy Dietary Patterns and Risk of Mortality and ESRD in CKD: A Meta-Analysis of Cohort StudiesClinical Journal of the American Society of Nephrology, 2016
- Diet rapidly and reproducibly alters the human gut microbiomeNature, 2013