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Shafqat A, Masters MC, Tripathi U, Tchkonia T, Kirkland JL, Hashmi SK. Long COVID as a disease of accelerated biological aging: An opportunity to translate geroscience interventions. Ageing Res Rev 2024; 99:102400. [PMID: 38945306 DOI: 10.1016/j.arr.2024.102400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2024] [Revised: 06/12/2024] [Accepted: 06/27/2024] [Indexed: 07/02/2024]
Abstract
It has been four years since long COVID-the protracted consequences that survivors of COVID-19 face-was first described. Yet, this entity continues to devastate the quality of life of an increasing number of COVID-19 survivors without any approved therapy and a paucity of clinical trials addressing its biological root causes. Notably, many of the symptoms of long COVID are typically seen with advancing age. Leveraging this similarity, we posit that Geroscience-which aims to target the biological drivers of aging to prevent age-associated conditions as a group-could offer promising therapeutic avenues for long COVID. Bearing this in mind, this review presents a translational framework for studying long COVID as a state of effectively accelerated biological aging, identifying research gaps and offering recommendations for future preclinical and clinical studies.
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Affiliation(s)
- Areez Shafqat
- College of Medicine, Alfaisal University, Riyadh, Saudi Arabia.
| | - Mary Clare Masters
- Division of Infectious Diseases, Northwestern University, Chicago, IL, USA
| | - Utkarsh Tripathi
- Robert and Arlene Kogod Center on Aging, Mayo Clinic, Rochester, MN, USA
| | - Tamara Tchkonia
- Robert and Arlene Kogod Center on Aging, Mayo Clinic, Rochester, MN, USA; Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, MN, USA
| | - James L Kirkland
- Robert and Arlene Kogod Center on Aging, Mayo Clinic, Rochester, MN, USA; Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, MN, USA; Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA
| | - Shahrukh K Hashmi
- Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA; Research and Innovation Center, Department of Health, Abu Dhabi, UAE; College of Medicine and Health Sciences, Khalifa University, Abu Dhabi, United Arab Emirates
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Mostafa HK, El-Zayat AT, Abdullah A Alraddadi O, Abulaban M. Adherence to the Mediterranean Diet and Perceived Immunity Among the Saudi Population: A Cross-Sectional Study. Cureus 2023; 15:e34963. [PMID: 36938156 PMCID: PMC10019000 DOI: 10.7759/cureus.34963] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/14/2023] [Indexed: 02/16/2023] Open
Abstract
Background The Mediterranean diet (MedDiet) is a model of a sustainable dietary pattern. It has a protective role against coronary heart diseases, but nowadays it is hypothesized against many other diseases. Aim of the study This study aims to assess the prevalence of adherence to the Mediterranean diet and its association with immune status among the general Saudi population. Subjects and methods A cross-sectional study design was conducted over a sample size of 327 Saudi adults living in Jeddah. A self-administered online questionnaire was distributed in a digital Google Form via various social networks using the convenient sampling technique. The questionnaire had four major divisions: sociodemographic, general health characteristics, adherence to MedDiet, and immune status. The data were collected, validated, and subjected to statistical analysis. Results The study showed a statistically significant association between adherence to MedDiet and perceived immune status (p-value <0.05). However, the associations between adherence to MedDiet and having any chronic illness, and perceived general health were not statistically significant (p-value >0.05). Multivariable regression models showed that sex and occupation are significant predictors of adherence to MedDiet. Conclusion This study concluded that despite low adherence to MedDiet among Saudis, there was an association between adherence to MedDiet and immune status. This study recommends the implementation of MedDiet as an intervention for the management of chronic diseases to be considered by policymakers and guideline developers.
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Affiliation(s)
- Hany K Mostafa
- Histology and Cell Biology, Fakeeh College for Medical Sciences, Jeddah, SAU
- Medical Science, Ain Shams University, Cairo, EGY
| | - Ayat T El-Zayat
- Clinical Sciences, Fakeeh College for Medical Sciences, Jeddah, SAU
| | | | - Mohanad Abulaban
- Clinical Sciences, Fakeeh College for Medical Sciences, Jeddah, SAU
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3
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Nielsen JL, Bakula D, Scheibye-Knudsen M. Clinical Trials Targeting Aging. FRONTIERS IN AGING 2022; 3:820215. [PMID: 35821843 PMCID: PMC9261384 DOI: 10.3389/fragi.2022.820215] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Accepted: 01/18/2022] [Indexed: 01/07/2023]
Abstract
The risk of morbidity and mortality increases exponentially with age. Chronic inflammation, accumulation of DNA damage, dysfunctional mitochondria, and increased senescent cell load are factors contributing to this. Mechanistic investigations have revealed specific pathways and processes which, proposedly, cause age-related phenotypes such as frailty, reduced physical resilience, and multi-morbidity. Among promising treatments alleviating the consequences of aging are caloric restriction and pharmacologically targeting longevity pathways such as the mechanistic target of rapamycin (mTOR), sirtuins, and anti-apoptotic pathways in senescent cells. Regulation of these pathways and processes has revealed significant health- and lifespan extending results in animal models. Nevertheless, it remains unclear if similar results translate to humans. A requirement of translation are the development of age- and morbidity associated biomarkers as longitudinal trials are difficult and not feasible, practical, nor ethical when human life span is the endpoint. Current biomarkers and the results of anti-aging intervention studies in humans will be covered within this paper. The future of clinical trials targeting aging may be phase 2 and 3 studies with larger populations if safety and tolerability of investigated medication continues not to be a hurdle for further investigations.
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Affiliation(s)
- Johannes Leth Nielsen
- Center for Healthy Aging, Department of Cellular and Molecular Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Daniela Bakula
- Center for Healthy Aging, Department of Cellular and Molecular Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Morten Scheibye-Knudsen
- Center for Healthy Aging, Department of Cellular and Molecular Medicine, University of Copenhagen, Copenhagen, Denmark
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Koppula S, Akther M, Haque ME, Kopalli SR. Potential Nutrients from Natural and Synthetic Sources Targeting Inflammaging-A Review of Literature, Clinical Data and Patents. Nutrients 2021; 13:nu13114058. [PMID: 34836313 PMCID: PMC8617641 DOI: 10.3390/nu13114058] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Revised: 11/06/2021] [Accepted: 11/11/2021] [Indexed: 12/16/2022] Open
Abstract
Inflammaging, the steady development of the inflammatory state over age is an attributable characteristic of aging that potentiates the initiation of pathogenesis in many age-related disorders (ARDs) including neurodegenerative diseases, arthritis, cancer, atherosclerosis, type 2 diabetes, and osteoporosis. Inflammaging is characterized by subclinical chronic, low grade, steady inflammatory states and is considered a crucial underlying cause behind the high mortality and morbidity rate associated with ARDs. Although a coherent set of studies detailed the underlying pathomechanisms of inflammaging, the potential benefits from non-toxic nutrients from natural and synthetic sources in modulating or delaying inflammaging processes was not discussed. In this review, the available literature and recent updates of natural and synthetic nutrients that help in controlling inflammaging process was explored. Also, we discussed the clinical trial reports and patent claims on potential nutrients demonstrating therapeutic benefits in controlling inflammaging and inflammation-associated ARDs.
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Affiliation(s)
- Sushruta Koppula
- Department of Integrated Biosciences, College of Biomedical & Health Science, Konkuk University, Chungju 27381, Korea; (S.K.); (M.A.)
| | - Mahbuba Akther
- Department of Integrated Biosciences, College of Biomedical & Health Science, Konkuk University, Chungju 27381, Korea; (S.K.); (M.A.)
| | - Md Ezazul Haque
- Department of Applied Life Science, Graduate School, BK21 Program, Konkuk University, Chungju 27381, Korea;
| | - Spandana Rajendra Kopalli
- Department of Bioscience and Biotechnology, Sejong University, Gwangjin-gu, Seoul 05006, Korea
- Correspondence: ; Tel.: +82-2-6935-2619
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Wu PY, Chen KM, Tsai WC. The Mediterranean Dietary Pattern and Inflammation in Older Adults: A Systematic Review and Meta-analysis. Adv Nutr 2021; 12:363-373. [PMID: 33002104 PMCID: PMC8009747 DOI: 10.1093/advances/nmaa116] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Revised: 06/23/2020] [Accepted: 08/26/2020] [Indexed: 01/19/2023] Open
Abstract
This systematic review and meta-analysis aimed to explore the association between the Mediterranean dietary pattern and inflammation in older adults. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed. A search of the literature was conducted up to June 2020 in 7 electronic databases, namely PubMed, Embase, Web of Science, Scopus, Cochrane Library, Cumulative Index to Nursing and Allied Health Literature (CINAHL), and ProQuest. The Joanna Briggs Institute Critical Appraisal Checklists and the Newcastle-Ottawa Scale were used to assess the methodological quality. The overall standardized mean difference (SMD) and 95% CIs were estimated in random-effects meta-analyses. Thirteen studies were identified as having acceptable quality and were included in this systematic review: 3 randomized controlled trials (RCTs), 1 quasi-experimental study, 1 cohort study, and 8 cross-sectional studies. The circulating C-reactive protein (CRP) concentration was the most common inflammation indicator used. Results of the meta-analysis on 5 cross-sectional studies revealed a significant inverse association between the Mediterranean dietary pattern and inflammation as assessed by CRP (SMD = -0.26; 95% CI: -0.41, -0.11; P < 0.001). Other studies that investigated a variety of inflammation indicators other than CRP showed mixed results with regard to the relation between the Mediterranean dietary pattern and inflammation in older adults. Our findings suggest that the Mediterranean dietary pattern may be associated with lower inflammation in older adults. However, more long-term RCTs are required to demonstrate the effects of the Mediterranean dietary pattern on multiple inflammation parameters in older adults. The study has been registered on PROSPERO (#CRD42020140145).
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Affiliation(s)
- Pei-Yu Wu
- Center for Long-term Care Research, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Kuei-Min Chen
- Center for Long-term Care Research, Kaohsiung Medical University, Kaohsiung, Taiwan
- College of Nursing, Kaohsiung Medical University, Kaohsiung, Taiwan
- Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Wan-Chi Tsai
- Department of Medical Laboratory Science and Biotechnology, Kaohsiung Medical University, Kaohsiung, Taiwan
- Department of Laboratory Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
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6
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Pellanda P, Ghosh TS, O'Toole PW. Understanding the impact of age-related changes in the gut microbiome on chronic diseases and the prospect of elderly-specific dietary interventions. Curr Opin Biotechnol 2020; 70:48-55. [PMID: 33279732 DOI: 10.1016/j.copbio.2020.11.001] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Revised: 09/22/2020] [Accepted: 11/02/2020] [Indexed: 12/17/2022]
Abstract
Ageing is associated with characteristic changes including a gradual decline of physiological functions, inflamm-aging, sarcopenia, and the associated onset of multiple diseases. Another factor potentially contributing to enhanced susceptibility to multiple diseases is aging-associated alteration in the gut microbiome. These alterations include a loss of commensals and gain of disease-associated pathobionts, and are accelerated by lifestyle factors like medication, reduced mobility and restricted diet. Several studies suggest that supplementation or modification of the habitual diet may help to address age-related frailty and comorbidities, aided by microbiota modulation. In this review, we comprehensively summarize recent investigations of microbiota alterations during aging and age-related diseases and the possibilities for altering the microbiome as a therapeutic approach.
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Affiliation(s)
- Paola Pellanda
- APC Microbiome Institute, Bioscience Building, University College Cork, Ireland; School of Microbiology, Food Science & Technology Building, University College Cork, Ireland
| | - Tarini Shankar Ghosh
- APC Microbiome Institute, Bioscience Building, University College Cork, Ireland; School of Microbiology, Food Science & Technology Building, University College Cork, Ireland
| | - Paul W O'Toole
- APC Microbiome Institute, Bioscience Building, University College Cork, Ireland; School of Microbiology, Food Science & Technology Building, University College Cork, Ireland.
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Sharma R, Padwad Y. Nutraceuticals-Based Immunotherapeutic Concepts and Opportunities for the Mitigation of Cellular Senescence and Aging: A Narrative Review. Ageing Res Rev 2020; 63:101141. [PMID: 32810647 DOI: 10.1016/j.arr.2020.101141] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Revised: 07/29/2020] [Accepted: 08/07/2020] [Indexed: 02/06/2023]
Abstract
The role of increased tissue senescent cell (SC) burden in driving the process of ageing and associated disorders is rapidly gaining attention. Amongst various plausible factors, impairment in immune functions is emerging as a critical regulator of known age-associated accumulation of SC. Immune cells dysfunctions with age are multi-faceted and are uniquely attributed to the independent processes of immunosenescence and cellular senescence which may collectively impair immune system mediated clearance of SC. Moreover, being functionally and phenotypically heterogenic, immune cells are also liable to be affected by senescence microenvironment in other tissues. Therefore, strategies aimed at improving immunosenescence and cellular senescence in immune cells can have pleiotropic effects on ageing physiology including the accumulation of SC. In this regard, nutraceutical's immunomodulatory attributes are well documented which may have implications in developing nutrition-oriented immunotherapeutic approaches against SC. In particular, the three diverse sources of bioactive ingredients, viz., phytochemicals, probiotic bacteria and omega-3-fatty acids have shown promising anti-immunosenescence and anti-cellular senescence potential in immune cells influencing aging and immunity in ways beyond modest stimulation of immune responses. The present narrative review describes the preventive and therapeutic attributes of phytochemicals such as polyphenols, probiotic microbes and omega-3-fatty acids in influencing the emerging nexus of immunosenescence, cellular senescence and SC during aging. Outstanding questions and nutraceuticals-based pro-longevity and niche research areas have been deliberated. Further research using integrative approaches is recommended for developing nutrition-based holistic immunotherapeutic strategies for 'healthy ageing'.
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Papadaki A, Nolen-Doerr E, Mantzoros CS. The Effect of the Mediterranean Diet on Metabolic Health: A Systematic Review and Meta-Analysis of Controlled Trials in Adults. Nutrients 2020; 12:nu12113342. [PMID: 33143083 PMCID: PMC7692768 DOI: 10.3390/nu12113342] [Citation(s) in RCA: 110] [Impact Index Per Article: 27.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Revised: 10/27/2020] [Accepted: 10/28/2020] [Indexed: 12/20/2022] Open
Abstract
The Mediterranean diet (MD) may provide metabolic benefits but no systematic review to date has examined its effect on a multitude of outcomes related to metabolic health. This systematic review with meta-analysis (International Prospective Register of Systematic Reviews, PROSPERO; number CRD42019141459) aimed to examine the MD’s effect on metabolic syndrome (MetSyn) incidence, components and risk factors (primary outcomes), and incidence and/or mortality from MetSyn-related comorbidities and receipt of pharmacologic treatment for MetSyn components and comorbidities (secondary outcomes). We searched Pubmed, Embase, Cumulative Index to Nursing and Allied Health Literature (CINAHL), and Web of Science for controlled trials published until June 2019, comparing the MD with no treatment, usual care, or different diets in adults. Studies not published in English and not promoting the whole MD were excluded. Two authors independently extracted data and assessed risk of bias using the Cochrane Collaboration’s and Risk of Bias in non-randomised studies (ROBINS-I) tools. Reporting followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Random-effects meta-analyses, subgroup analyses and meta-regressions were performed, and heterogeneity was quantified using the I2 statistic. We identified 2654 reports and included 84 articles reporting 57 trials (n = 36,983). In random effects meta-analyses, the MD resulted in greater beneficial changes in 18 of 28 MetSyn components and risk factors (body weight, body mass index, waist circumference, systolic and diastolic blood pressure, glucose, insulin, homeostatic model assessment of insulin resistance (HOMA-IR) index, total-, low-density lipoprotein (LDL)- and high-density lipoprotein (HDL)-cholesterol, triglycerides, alanine transaminase, hepatic fat mass, C-reactive protein, interleukin-6, tumour necrosis factor-a, and flow-mediated dilatation) and lower risk of cardiovascular disease incidence (risk ratio (RR) = 0.61, 95% confidence intervals (CI) 0.42–0.80; I2 = 0%), and stroke (RR = 0.67, 95% CI 0.35–0.98; I2 = 0%). Only six studies reported effects on pharmacotherapy use, and pooled analysis indicated no differences between diet groups. Lack of consistency in comparator groups and other study characteristics across studies resulted in high heterogeneity for some outcomes, which could not be considerably explained by meta-regressions. However, a consistent direction of beneficial effect of the MD was observed for the vast majority of outcomes examined. Findings support MD’s beneficial effect on all components and most risk factors of the MetSyn, in addition to cardiovascular disease and stroke incidence. More studies are needed to establish effects on other clinical outcomes and use of pharmacotherapy for MetSyn components and comorbidities. Despite the high levels of heterogeneity for some outcomes, this meta-analysis enabled the comparison of findings across studies and the examination of consistency of effects. The consistent direction of effect, suggesting the MD’s benefits on metabolic health, supports the need to promote this dietary pattern to adult populations.
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Affiliation(s)
- Angeliki Papadaki
- Centre for Exercise, Nutrition and Health Sciences, School for Policy Studies, University of Bristol, Bristol BS8 1TZ, UK;
- Division of Endocrinology, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA;
| | - Eric Nolen-Doerr
- Division of Endocrinology, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA;
- Department of Endocrinology, Boston VA Healthcare System, Boston, MA 02130, USA
| | - Christos S. Mantzoros
- Division of Endocrinology, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA;
- Department of Endocrinology, Boston VA Healthcare System, Boston, MA 02130, USA
- Correspondence: ; Tel.: +1-(0)617-667-8636
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Khalili H, Håkansson N, Chan SS, Chen Y, Lochhead P, Ludvigsson JF, Chan AT, Hart AR, Olén O, Wolk A. Adherence to a Mediterranean diet is associated with a lower risk of later-onset Crohn's disease: results from two large prospective cohort studies. Gut 2020; 69:1637-1644. [PMID: 31900290 DOI: 10.1136/gutjnl-2019-319505] [Citation(s) in RCA: 115] [Impact Index Per Article: 28.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2019] [Revised: 12/16/2019] [Accepted: 12/17/2019] [Indexed: 02/06/2023]
Abstract
OBJECTIVE To examine the relationship between Mediterranean diet and risk of later-onset Crohn's disease (CD) or ulcerative colitis (UC). DESIGN We conducted a prospective cohort study of 83 147 participants (age range: 45-79 years) enrolled in the Cohort of Swedish Men and Swedish Mammography Cohort. A validated food frequency questionnaire was used to calculate an adherence score to a modified Mediterranean diet (mMED) at baseline in 1997. Incident diagnoses of CD and UC were ascertained from the Swedish Patient Register. We used Cox proportional hazards modelling to calculate HRs and 95% CI. RESULTS Through December of 2017, we confirmed 164 incident cases of CD and 395 incident cases of UC with an average follow-up of 17 years. Higher mMED score was associated with a lower risk of CD (Ptrend=0.03) but not UC (Ptrend=0.61). Compared with participants in the lowest category of mMED score (0-2), there was a statistically significant lower risk of CD (HR=0.42, 95% CI 0.22 to 0.80) but not UC (HR=1.08, 95% CI 0.74 to 1.58). These associations were not modified by age, sex, education level, body mass index or smoking (all Pinteraction >0.30). The prevalence of poor adherence to a Mediterranean diet (mMED score=0-2) was 27% in our cohorts, conferring a population attributable risk of 12% for later-onset CD. CONCLUSION In two prospective studies, greater adherence to a Mediterranean diet was associated with a significantly lower risk of later-onset CD.
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Affiliation(s)
- Hamed Khalili
- Division of Gastroenterology, Massachusetts General Hospital, Boston, Massachusetts, USA .,Department of Medicine, Harvard Medical School, Boston, Massachusetts, USA
| | - Niclas Håkansson
- Nutritional Epidemiology Unit, Institution of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Simon S Chan
- Department of Medicine, Norwich Medical School, Norwich, UK.,Department of Gastroenterology, Norfolk and Norwich University Hospitals NHS Trust, Norwich, UK
| | - Ye Chen
- Clinical and Translational Epidemiology Unit, Massachusetts General Hospital, Boston, Massachusettss, USA
| | - Paul Lochhead
- Clinical and Translational Epidemiology Unit, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Jonas F Ludvigsson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.,Department of Pediatrics, Örebro, Sweden
| | - Andrew T Chan
- Gastrointestinal Unit, Massachusetts General Hospital, Boston, Massachusetts, USA.,Harvard Medical School, Boston, Massachusetts, USA
| | - Andrew R Hart
- Department of Gastroenterology, University of East Anglia, Norwich, UK
| | - Ola Olén
- Clinical Epidemiology Unit, Karolinska Institutet, Stockholm, Sweden
| | - Alicja Wolk
- Nutritional Epidemiology Unit, Institution of Environmental Medicine, Karolinska Institutet, Stockholms, Sweden
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Ghosh TS, Rampelli S, Jeffery IB, Santoro A, Neto M, Capri M, Giampieri E, Jennings A, Candela M, Turroni S, Zoetendal EG, Hermes GDA, Elodie C, Meunier N, Brugere CM, Pujos-Guillot E, Berendsen AM, De Groot LCPGM, Feskins EJM, Kaluza J, Pietruszka B, Bielak MJ, Comte B, Maijo-Ferre M, Nicoletti C, De Vos WM, Fairweather-Tait S, Cassidy A, Brigidi P, Franceschi C, O'Toole PW. Mediterranean diet intervention alters the gut microbiome in older people reducing frailty and improving health status: the NU-AGE 1-year dietary intervention across five European countries. Gut 2020; 69:1218-1228. [PMID: 32066625 PMCID: PMC7306987 DOI: 10.1136/gutjnl-2019-319654] [Citation(s) in RCA: 421] [Impact Index Per Article: 105.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2019] [Revised: 12/29/2019] [Accepted: 12/31/2019] [Indexed: 12/12/2022]
Abstract
OBJECTIVE Ageing is accompanied by deterioration of multiple bodily functions and inflammation, which collectively contribute to frailty. We and others have shown that frailty co-varies with alterations in the gut microbiota in a manner accelerated by consumption of a restricted diversity diet. The Mediterranean diet (MedDiet) is associated with health. In the NU-AGE project, we investigated if a 1-year MedDiet intervention could alter the gut microbiota and reduce frailty. DESIGN We profiled the gut microbiota in 612 non-frail or pre-frail subjects across five European countries (UK, France, Netherlands, Italy and Poland) before and after the administration of a 12-month long MedDiet intervention tailored to elderly subjects (NU-AGE diet). RESULTS Adherence to the diet was associated with specific microbiome alterations. Taxa enriched by adherence to the diet were positively associated with several markers of lower frailty and improved cognitive function, and negatively associated with inflammatory markers including C-reactive protein and interleukin-17. Analysis of the inferred microbial metabolite profiles indicated that the diet-modulated microbiome change was associated with an increase in short/branch chained fatty acid production and lower production of secondary bile acids, p-cresols, ethanol and carbon dioxide. Microbiome ecosystem network analysis showed that the bacterial taxa that responded positively to the MedDiet intervention occupy keystone interaction positions, whereas frailty-associated taxa are peripheral in the networks. CONCLUSION Collectively, our findings support the feasibility of improving the habitual diet to modulate the gut microbiota which in turn has the potential to promote healthier ageing.
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Affiliation(s)
- Tarini Shankar Ghosh
- School of Microbiology, University College Cork, Cork, Ireland
- APC Microbiome Ireland, University College Cork, Cork, Ireland
| | - Simone Rampelli
- Unit of Microbial Ecology of Health, Department of Pharmacy and Biotechnology, University of Bologna, Bologna, Italy
| | - Ian B Jeffery
- School of Microbiology, University College Cork, Cork, Ireland
- APC Microbiome Ireland, University College Cork, Cork, Ireland
| | - Aurelia Santoro
- Department of Experimental, Diagnostic and Speciality Medicine, Alma Mater Studiorum, University of Bologna, Bologna, Italy
- CIG Interdepartmental Centre "L Galvani", Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | - Marta Neto
- School of Microbiology, University College Cork, Cork, Ireland
- APC Microbiome Ireland, University College Cork, Cork, Ireland
| | - Miriam Capri
- Unit of Microbial Ecology of Health, Department of Pharmacy and Biotechnology, University of Bologna, Bologna, Italy
| | - Enrico Giampieri
- Department of Experimental, Diagnostic and Speciality Medicine, Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | - Amy Jennings
- Norwich Medical School, University of East Anglia Faculty of Medicine and Health Sciences, Norwich, Norfolk, UK
| | - Marco Candela
- Unit of Microbial Ecology of Health, Department of Pharmacy and Biotechnology, University of Bologna, Bologna, Italy
| | - Silvia Turroni
- Unit of Microbial Ecology of Health, Department of Pharmacy and Biotechnology, University of Bologna, Bologna, Italy
| | - Erwin G Zoetendal
- Laboratory of Microbiology, Wageningen University and Research, Wageningen, Netherlands
| | - Gerben D A Hermes
- Laboratory of Microbiology, Wageningen University and Research, Wageningen, Netherlands
| | - Caumon Elodie
- CRNH Auvergne, F-63000 Clermont-Ferrand, CHU Clermont-Ferrand, Clermont-Ferrand, France
| | - Nathalie Meunier
- CRNH Auvergne, F-63000 Clermont-Ferrand, CHU Clermont-Ferrand, Clermont-Ferrand, France
| | | | - Estelle Pujos-Guillot
- Plateforme d'Exploration du Métabolisme, MetaboHUB Clermont, Clermont-Ferrand, Université Clermont Auvergne, Clermont-Ferrand, Auvergne, France
| | - Agnes M Berendsen
- Division of Human Nutrition and Health, Wageningen University and Research, Wageningen, Netherlands
| | - Lisette C P G M De Groot
- Division of Human Nutrition and Health, Wageningen University and Research, Wageningen, Netherlands
| | - Edith J M Feskins
- Division of Human Nutrition and Health, Wageningen University and Research, Wageningen, Netherlands
| | - Joanna Kaluza
- Department of Human Nutrition, Warsaw University of Life Sciences, Warszawa, Poland
| | - Barbara Pietruszka
- Department of Human Nutrition, Warsaw University of Life Sciences, Warszawa, Poland
| | | | - Blandine Comte
- Plateforme d'Exploration du Métabolisme, MetaboHUB Clermont, Clermont-Ferrand, Université Clermont Auvergne, Clermont-Ferrand, Auvergne, France
| | - Monica Maijo-Ferre
- Gut Health Institute Strategic Programme, Quadram Institute Bioscience, Norwich, Norfolk, UK
| | - Claudio Nicoletti
- Gut Health Institute Strategic Programme, Quadram Institute Bioscience, Norwich, Norfolk, UK
- Department of Experimental and Clinical Medicine, Section of Anatomy, University of Florence, Firenze, Toscana, Italy
| | - Willem M De Vos
- Laboratory of Microbiology, Wageningen University and Research, Wageningen, Netherlands
- Human Microbiome Research Program, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Susan Fairweather-Tait
- Department of Nutrition and Preventive Medicine, Norwich Medical School, University of East Anglia, Norwich, Norfolk, UK
| | - Aedin Cassidy
- The Institute of Global Food Security, Queen's University Belfast, Belfast, UK
| | - Patrizia Brigidi
- Unit of Microbial Ecology of Health, Department of Pharmacy and Biotechnology, University of Bologna, Bolognas, Italy
| | - Claudio Franceschi
- Department of Experimental, Diagnostic and Speciality Medicine, Alma Mater Studiorum, University of Bologna, Bologna, Emilia-Romagna, Italy
- Department of Applied Mathematics, Institute of Information Technology, Mathematics and Mechanics (ITMM), Lobachevsky State University of Nizhny Novgorod-National Research University (UNN), Nizhny Novgorod, Russian Federation
| | - Paul W O'Toole
- School of Microbiology, University College Cork, Cork, Ireland
- APC Microbiome Ireland, University College Cork, Cork, Ireland
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One-year Mediterranean diet promotes epigenetic rejuvenation with country- and sex-specific effects: a pilot study from the NU-AGE project. GeroScience 2020; 42:687-701. [PMID: 31981007 PMCID: PMC7205853 DOI: 10.1007/s11357-019-00149-0] [Citation(s) in RCA: 59] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2019] [Accepted: 12/13/2019] [Indexed: 12/12/2022] Open
Abstract
Mediterranean diet has been proposed to promote healthy aging, but its effects on aging biomarkers have been poorly investigated. We evaluated the impact of a 1-year Mediterranean-like diet in a pilot study including 120 elderly healthy subjects from the NU-AGE study (60 Italians, 60 Poles) by measuring the changes in their epigenetic age, assessed by Horvath's clock. We observed a trend towards epigenetic rejuvenation of participants after nutritional intervention. The effect was statistically significant in the group of Polish females and in subjects who were epigenetically older at baseline. A genome-wide association study of epigenetic age changes after the intervention did not return significant (adjusted p value < 0.05) loci. However, we identified small-effect alleles (nominal p value < 10-4), mapping in genes enriched in pathways related to energy metabolism, regulation of cell cycle, and of immune functions. Together, these findings suggest that Mediterranean diet can promote epigenetic rejuvenation but with country-, sex-, and individual-specific effects, thus highlighting the need for a personalized approach to nutritional interventions.
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Neutrophil-to-Lymphocyte Ratio, Mediterranean Diet, and Bone Health in Coeliac Disease Patients: A Pilot Study. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2019; 2019:7384193. [PMID: 31320984 PMCID: PMC6610747 DOI: 10.1155/2019/7384193] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/24/2019] [Revised: 04/10/2019] [Accepted: 04/18/2019] [Indexed: 12/18/2022]
Abstract
Neutrophil-to-lymphocyte ratio (NLR) has been proposed as a bone loss index in postmenopausal women and as a marker of inflammation in coeliac patients. The aims of this work were to evaluate the effect of gluten-free diet (GFD) on NLR retrospectively and study the relationship between NLR and Mediterranean diet adherence and selected food groups (fruits, vegetables, red meat, potatoes, and unrefined and refined cereals). Adult individuals (n = 50), who had been on a strict GFD by at least 6 months, were recruited. The degree of adherence to the Mediterranean diet was calculated with two different scores: the Mediterranean Diet Score (MDS-14), assessed through the validated 14-item questionnaire of the PREDIMED study, and the MEDScore (Score-55) proposed by Panagiotakos. The latter includes the consumption of unrefined cereals (UC). High percentages of osteopenia and osteoporosis were found within the recruited subjects, who furnished the reports of bone mineral density (BMD), in particular in postmenopausal (Post-M) women. Recent NLR was higher in subjects with osteoporosis compared to osteopenia and normal BMD. However, retrospective analysis showed both increase and decrease in NLR after GFD, with no significant differences between Marsh grade, anemia, and BMD status. Moreover, premenopausal previous pregnancy (Pre-MPP) and Post-M had higher NLR at diagnosis compared to Men and premenopausal (Pre-M), but higher differences were observed in recent NLR between Pre-MPP and Men only. Chocolate consumption was associated with lower recent NLR, whereas the latter was correlated with Score-55, but not with MDS-14. Moreover, refined cereal consumption was correlated with recent NLR. Although large prospective studies are needed in order to clarify the relationship between UC and NLR in coeliac patients, in this pilot study, we have investigated for the first time the relationship between NLR, dietary habit, and osteoporosis in coeliac disease.
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The Prevalence and Determinants of Vitamin D Status in Community-Dwelling Older Adults: Results from the English Longitudinal Study of Ageing (ELSA). Nutrients 2019; 11:nu11061253. [PMID: 31159411 PMCID: PMC6627050 DOI: 10.3390/nu11061253] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Revised: 05/14/2019] [Accepted: 05/29/2019] [Indexed: 01/01/2023] Open
Abstract
Vitamin D deficiency is often associated with adverse health outcomes in older adults. The circulating 25-hydroxyvitamin D (25(OH)D) status predominately relies on UV exposure. However, the extent of which northerly latitude exasperates deficiency is less explored in ageing. We aimed to investigate vitamin D deficiency in community-dwelling, older adults, residing at latitudes 50–55° north. This study was comprised of 6004 adults, aged >50 years from wave 6 (2012–2013) of the English Longitudinal Study of Ageing (ELSA). Deficiency was categorised by two criteria: Institute of Medicine (IOM) (<30 nmol/L) and Endocrine Society (ES) (<50 nmol/L). The overall prevalence of Institute of Medicine (IOM) and Endocrine Society (ES) definitions of deficiency were 26.4% and 58.7%, respectively. Females (odds ratio (OR) 1.23; CI: 1.04–1.44), those aged 80+ (OR: 1.42; CI: 1.01–1.93), smoking (OR: 1.88; CI: 1.51–2.34); of non-white ethnicity (OR: 3.8; CI:2.39–6.05); being obese (OR: 1.32; CI:1.09–1.58), and of poor self-reported health (OR:1.99; CI:1.33, 2.96), were more likely to be vitamin D deficient (by IOM). Residents in the south of England had a reduced risk of deficiency (OR: 0.78; CI:0.64–0.95), even after adjustment for socioeconomic and traditional predictors (obesity, age, lifestyle, etc.) of vitamin D status. Other factors, such as being retired, having a normal BMI, engaging in regular vigorous physical activity, vitamin D supplement use, sun travel, and summer season were also significantly positive correlates of deficiency. Similar results were observed for the ES cut-off definition. Importantly, more than half of adults aged >50 years had 25(OH)D concentrations <50 nmol/L. These findings demonstrate that low vitamin D status is highly prevalent in older English adults and the crucial importance of public health strategies throughout midlife and older age to achieve optimal vitamin D status.
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Nutritional Modulation of Immune and Central Nervous System Homeostasis: The Role of Diet in Development of Neuroinflammation and Neurological Disease. Nutrients 2019; 11:nu11051076. [PMID: 31096592 PMCID: PMC6566411 DOI: 10.3390/nu11051076] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2019] [Revised: 05/02/2019] [Accepted: 05/13/2019] [Indexed: 02/06/2023] Open
Abstract
The gut-microbiome-brain axis is now recognized as an essential part in the regulation of systemic metabolism and homeostasis. Accumulating evidence has demonstrated that dietary patterns can influence the development of metabolic alterations and inflammation through the effects of nutrients on a multitude of variables, including microbiome composition, release of microbial products, gastrointestinal signaling molecules, and neurotransmitters. These signaling molecules are, in turn, implicated in the regulation of the immune system, either promoting or inhibiting the production of pro-inflammatory cytokines and the expansion of specific leukocyte subpopulations, such as Th17 and Treg cells, which are relevant in the development of neuroinflammatory and neurodegenerative conditions. Metabolic diseases, like obesity and type 2 diabetes mellitus, are related to inadequate dietary patterns and promote variations in the aforementioned signaling pathways in patients with these conditions, which have been linked to alterations in neurological functions and mental health. Thus, maintenance of adequate dietary patterns should be an essential component of any strategy aiming to prevent neurological pathologies derived from systemic metabolic alterations. The present review summarizes current knowledge on the role of nutrition in the modulation of the immune system and its impact in the development of neuroinflammation and neurological disease.
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van Splunter M, Perdijk O, Fick-Brinkhof H, Feitsma AL, Floris-Vollenbroek EG, Meijer B, Brugman S, Savelkoul HFJ, van Hoffen E, van Neerven RJJ. Bovine Lactoferrin Enhances TLR7-Mediated Responses in Plasmacytoid Dendritic Cells in Elderly Women: Results From a Nutritional Intervention Study With Bovine Lactoferrin, GOS and Vitamin D. Front Immunol 2018; 9:2677. [PMID: 30515164 PMCID: PMC6255898 DOI: 10.3389/fimmu.2018.02677] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2018] [Accepted: 10/30/2018] [Indexed: 01/15/2023] Open
Abstract
During aging the immune system is dysregulated. Especially plasmacytoid dendritic cells (pDCs) and myeloid DCs (mDCs) have reduced Toll like receptor (TLR)-mediated responses resulting in increased susceptibility to infections. Consumption of bovine lactoferrin (bLF) has been shown to reduce infections with viruses. Galacto-oligosacharides (GOS) and vitamin D are associated with reduced pro-inflammatory cytokine levels in serum, and increased TLR7/8 responses, respectively. A double-blind placebo-controlled nutritional intervention study in elderly women was performed, to investigate the potential of bLF, GOS, and vitamin D to restore TLR responsiveness of pDCs and mDCs and to reduce inflammatory markers in serum. The nutritional intervention group (n = 15) received bLF for 3 weeks, followed by 3 weeks of bLF + GOS, and subsequently 3 weeks of bLF + GOS + vitamin D. The placebo group (n = 15) received maltodextrin for 9 weeks. Every 3 weeks, blood was collected and TLR responses of pDCs and mDCs, and inflammation-related markers in serum were measured. After 3 weeks of bLF supplementation, increased TLR7/8 and TLR1/2 responses were observed in pDCs of the nutritional intervention group compared to the placebo group. When the effects of the entire nutritional intervention were investigated, increased TLR1/2 mediated responses in mDCs were observed, and in serum sVCAM tended to decrease. Finally, based on the RAND-36 questionnaire physical function tended to improve in the intervention group. Since especially TLR7-mediated responses in pDCs were enhanced after bLF supplementation compared to placebo, this suggests that bLF may contribute to antiviral responses mediated by pDC in elderly women.Clinical trial registry number: NCT03026244, clinicaltrials.gov:
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Affiliation(s)
| | - Olaf Perdijk
- Cell Biology and Immunology, Wageningen University, Wageningen, Netherlands
| | | | | | | | - Ben Meijer
- Cell Biology and Immunology, Wageningen University, Wageningen, Netherlands
| | - Sylvia Brugman
- Cell Biology and Immunology, Wageningen University, Wageningen, Netherlands
| | - Huub F J Savelkoul
- Cell Biology and Immunology, Wageningen University, Wageningen, Netherlands
| | | | - R J Joost van Neerven
- Cell Biology and Immunology, Wageningen University, Wageningen, Netherlands.,FrieslandCampina, Amersfoort, Netherlands
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