Microbiota healing: Mediterranean style always among the best choices

Aging is an inevitable process, but the associated loss of bodily functions and increased inflammatory conditions cause increased frailty in older people. The importance of this diet is that it appears to modulate the gut bacteria in a way that is beneficial to prevent the loss of physical vigor and cognitive impairment with advancing age. Earlier studies show that a poor diet with a restricted variety of foods is both a common pattern with older people and one which accelerates the onset of physical frailty because it narrows the range of bacteria found in the gut. This is especially so when it comes to older people who are living in long-term nursing homes and other residential facilities. A new study published in the journal Gut, reports the striking health-promoting effects of switching to a Mediterranean diet for just one year. The results were due to an increase in the health and number of gut bacteria that favor a healthy diet. A Mediterranean diet is one that is rich in fruits, vegetables, nuts, legumes, olive oil, and fish but has small amounts of red meat and saturated fats. The current study focused on the benefits that a Mediterranean diet might produce in terms of healthier gut microbiome, whether it might shift the gut bacterial population and subtypes in a direction that is favorable to retaining and increasing the number of bacteria that are associated with healthy aging.

In the study, which spanned five countries (France, Italy, Netherlands, Poland, and the UK), the researchers examined the gut microbiome of about 600 people aged 65 to 79 years, with one sample at baseline and a second sample after 12 months on a typical Western diet or a Mediterranean diet that was adapted to fit the needs of older people. The first group contained about 290 people, and the second about 320 people. All the participants were classified as physically frail or on the edge of frailty (about 180 people), or not frail (about 430 people) at baseline. At the beginning of the study, the participants fell into three subgroups based on their dietary profiles as well as their gut microbiomes – the Italians, the French and English, and the Dutch and Polish subjects. The Mediterranean diet was found to be linked to beneficial changes in the gut microbiome when followed for 12 months. The loss of bacterial diversity was reduced, while the types of bacteria that are found to mark clinical features that accompany less frailty went up. These indicators include walking speed and strength of handgrip, as well as better brain function, including memory. They are also associated with lower levels of inflammatory proteins that could harm the individual’s health. These include C-reactive protein (CRP) and Interleukin-17.

A closer look shows that these changes are also linked to a higher number of good bacteria, those that produce short-chain fatty acids that contribute to health. Concurrently, there is a lower number of bacteria that are known to produce specific bile acids, p-cresols, ethanol, and carbon dioxide. These chemicals can harm the person if produced in excess, by increasing the risk of colon cancer, and metabolic damage like insulin resistance, fatty liver, and cell damage. The bacteria whose numbers increased were also found to be what is called ‘keystone’ species. In other words, their presence in adequate quantities is essential to maintaining the stability of the gut microbiome. On the other hand, the other species that are known to be linked to the markers of increased frailty are not vital to the gut ecosystem. The findings remained constant even after controlling for age, body mass index, and the presence of multiple disease conditions, also though these factors modulate the composition of the gut microbiome. Secondly, even though the participants came from different countries with obviously different dietary practices, the findings showed that despite the fundamental difference in gut microbiome composition, the final response at 12 months of following this diet remained strikingly similar across national borders.

Again, the time frame of the change in the diet and the microbiome seems to show that the latter is more important in its association with health improvement markers. The researchers say the microbiome changes are most closely linked to the increase in dietary fiber, which includes additional vitamins and minerals. The micronutrients they found to be increased included vitamins C, B1, B6, B9, iron, copper, potassium, manganese, and magnesium. On the other hand, the controls showed a higher level of saturated fat intake compared to the Mediterranean diet group. Researchers computed a “microbiome index” and examined its associations with the earlier measures of frailty, cognitive function, and inflammation. They found that 10 of the 11 associations in the positive direction (improved health) and many negative associations were replicated or newly discovered. The team inferred that the changes in the microbiome were probably more important in improving the health of the participants on the Mediterranean diet than the diet itself, which may have served as the agent. The study, therefore, adds support to a principle that microbiomes of healthy individuals are similar and the unhealthy individuals are each aberrant in their way. They feel that this shows that the microbiome components are not just indirect reflections of the diet, but independently associated factors linked to indicators of improved health.

Though this study doesn’t prove that the gut microbiome changes cause the reduction in frailty, it does emphasize the role played by the diet in the microbiome composition, which in turn affects the health of the human host. Anyway, by stabilizing the gut microbial community, adherence to the diet could facilitate the retention of an healthy microbiome, providing resilience and protecting from changes to alternative states that are found in unhealthy people. Scientists paid attention to elders and weaker people: a slice of them may not be able to chew or swallow firm foods like vegetables and some fruits. In such a scenario, the study could help develop useful treatments in the form of live bacterial formulation for ingestion by identifying the bacteria that are associated with healthy aging. This could perhaps serve to delay the onset or the progress of senile frailty.

  • Edited by Dr. Gianfrancesco Cormaci, PhD, specialist in Clinical Biochemistry.

Scientific references

Ghosh TS, Rampelli S et al., O’Toole PW. Gut 2020 Feb 17. 

Luisi MLE et al. Front Pharmacol. 2019 Nov 15; 10:1366. 

McGrattan AM et al. Curr Nutr Rep. 2019 Jun; 8(2):53-65. 

Tosti V et al. J Gerontol A Biol Sci Med Sci. 2018; 73(3):318.

Informazioni su Dott. Gianfrancesco Cormaci 2450 Articoli
- Laurea in Medicina e Chirurgia nel 1998 (MD Degree in 1998) - Specialista in Biochimica Clinica nel 2002 (Clinical Biochemistry specialty in 2002) - Dottorato in Neurobiologia nel 2006 (Neurobiology PhD in 2006) - Ha soggiornato negli Stati Uniti, Baltimora (MD) come ricercatore alle dipendenze del National Institute on Drug Abuse (NIDA/NIH) e poi alla Johns Hopkins University, dal 2004 al 2008. - Dal 2009 si occupa di Medicina personalizzata. - Detentore di un brevetto sulla preparazione di prodotti gluten-free a partire da regolare farina di frumento immunologicamente neutralizzata (owner of a patent concerning the production of bakery gluten-free products, starting from regular wheat flour). - Responsabile del reparto Ricerca e Sviluppo per la società CoFood s.r.l. (leader of the R&D for the partnership CoFood s.r.l.) - Autore di un libro riguardante la salute e l'alimentazione, con approfondimenti su come questa condizioni tutti i sistemi corporei. - Autore di articoli su informazione medica, salute e benessere sui siti web salutesicilia.com e medicomunicare.it