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Nagasawa H, Suzuki S, Kobayashi T, Otsuka T, Okuma T, Matsushita S, Amano A, Shimizu Y, Suzuki Y, Ueda S. Effect of fruits granola (Frugra®) consumption on blood pressure reduction and intestinal microbiome in patients undergoing hemodialysis. Hypertens Res 2024:10.1038/s41440-024-01895-1. [PMID: 39300301 DOI: 10.1038/s41440-024-01895-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2024] [Revised: 08/06/2024] [Accepted: 09/02/2024] [Indexed: 09/22/2024]
Abstract
Cardiovascular diseases (CVDs) are a major cause of death in patients undergoing hemodialysis (HD). Blood pressure (BP) and uremic toxins are well-known risk factors for CVDs, which are influenced by diet. Dietary fiber supplementation in patients undergoing HD may reduce the risk of CVDs by improving lipid profiles and inflammatory status and lowering the levels of the uremic toxin indoxyl sulfate (IS). In this study, we investigated the relationship between the intestinal microbiota and risk factors for CVDs, such as BP and serum IS, in patients undergoing HD who consumed fruits granola (FGR). The study participants were selected from patients undergoing HD at the Izu Nagaoka Daiichi Clinic and consumed FGR for 2 months. Body composition and blood samples were tested at months 0, 1, 2 and fecal samples were collected at months 0 and 2 for intestinal microbiota analysis. FGR consumption decreased systolic and diastolic BP, estimated salt intake, and serum IS levels and improved the stool characteristics according to the Bristol Stool Form Scale (N = 24). Gut microbiota analysis showed an increase in the alpha diversity and abundance of Blautia and Neglecta. The abundance of lactic acid- and ethanol-producing bacteria also significantly increased, whereas the abundance of indole-producing bacteria significantly decreased. FGR consumption could be a useful tool for salt reduction, fiber supplementation, and improvement of the intestinal environment, thus contributing to improvement of BP and the reduction of other risk factors for CVDs in patients undergoing HD.
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Affiliation(s)
- Hajime Nagasawa
- Department of Nephrology, Juntendo University Faculty of Medicine, Tokyo, Japan
- Division of Nephrology, Department of Internal Medicine, Juntendo University Shizuoka Hospital, Shizuoka, Japan
- Department of Granola Health Care and Preventive Medicine, Juntendo University Faculty of Medicine, Tokyo, Japan
- Division of Kidney Health and Aging, the Center for Integrated Kidney Research and Advance, Shimane University Faculty of Medicine, Shimane, Japan
| | - Shogo Suzuki
- Department of Radiological Technology, Juntendo University Faculty of Health Science, Tokyo, Japan
| | - Takashi Kobayashi
- Department of Nephrology, Juntendo University Faculty of Medicine, Tokyo, Japan
- Department of Granola Health Care and Preventive Medicine, Juntendo University Faculty of Medicine, Tokyo, Japan
| | - Tomoyuki Otsuka
- Department of Nephrology, Juntendo University Faculty of Medicine, Tokyo, Japan
- Department of Granola Health Care and Preventive Medicine, Juntendo University Faculty of Medicine, Tokyo, Japan
| | - Teruyuki Okuma
- Department of Nephrology, Juntendo University Faculty of Medicine, Tokyo, Japan
- Department of Granola Health Care and Preventive Medicine, Juntendo University Faculty of Medicine, Tokyo, Japan
- Division of Kidney Health and Aging, the Center for Integrated Kidney Research and Advance, Shimane University Faculty of Medicine, Shimane, Japan
| | - Satoshi Matsushita
- Department of Granola Health Care and Preventive Medicine, Juntendo University Faculty of Medicine, Tokyo, Japan
- Department of Cardiovascular Surgery, Juntendo University Faculty of Medicine, Tokyo, Japan
| | - Atsushi Amano
- Department of Granola Health Care and Preventive Medicine, Juntendo University Faculty of Medicine, Tokyo, Japan
- Department of Cardiovascular Surgery, Juntendo University Faculty of Medicine, Tokyo, Japan
| | - Yoshio Shimizu
- Department of Nephrology, Juntendo University Faculty of Medicine, Tokyo, Japan
- Division of Nephrology, Department of Internal Medicine, Juntendo University Shizuoka Hospital, Shizuoka, Japan
| | - Yusuke Suzuki
- Department of Nephrology, Juntendo University Faculty of Medicine, Tokyo, Japan
| | - Seiji Ueda
- Department of Nephrology, Juntendo University Faculty of Medicine, Tokyo, Japan.
- Department of Granola Health Care and Preventive Medicine, Juntendo University Faculty of Medicine, Tokyo, Japan.
- Division of Kidney Health and Aging, the Center for Integrated Kidney Research and Advance, Shimane University Faculty of Medicine, Shimane, Japan.
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Byndloss M, Devkota S, Duca F, Hendrik Niess J, Nieuwdorp M, Orho-Melander M, Sanz Y, Tremaroli V, Zhao L. The Gut Microbiota and Diabetes: Research, Translation, and Clinical Applications-2023 Diabetes, Diabetes Care, and Diabetologia Expert Forum. Diabetes Care 2024; 47:1491-1508. [PMID: 38996003 PMCID: PMC11362125 DOI: 10.2337/dci24-0052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2024] [Accepted: 05/23/2024] [Indexed: 07/14/2024]
Abstract
This article summarizes the state of the science on the role of the gut microbiota (GM) in diabetes from a recent international expert forum organized by Diabetes, Diabetes Care, and Diabetologia, which was held at the European Association for the Study of Diabetes 2023 Annual Meeting in Hamburg, Germany. Forum participants included clinicians and basic scientists who are leading investigators in the field of the intestinal microbiome and metabolism. Their conclusions were as follows: 1) the GM may be involved in the pathophysiology of type 2 diabetes, as microbially produced metabolites associate both positively and negatively with the disease, and mechanistic links of GM functions (e.g., genes for butyrate production) with glucose metabolism have recently emerged through the use of Mendelian randomization in humans; 2) the highly individualized nature of the GM poses a major research obstacle, and large cohorts and a deep-sequencing metagenomic approach are required for robust assessments of associations and causation; 3) because single-time point sampling misses intraindividual GM dynamics, future studies with repeated measures within individuals are needed; and 4) much future research will be required to determine the applicability of this expanding knowledge to diabetes diagnosis and treatment, and novel technologies and improved computational tools will be important to achieve this goal.
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Affiliation(s)
- Mariana Byndloss
- Vanderbilt University Medical Center, Nashville, TN
- Howard Hughes Medical Institute, Vanderbilt University Medical Center, Nashville, TN
| | - Suzanne Devkota
- Human Microbiome Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA
| | | | - Jan Hendrik Niess
- Department of Biomedicine, University of Basel, Basel, Switzerland
- Department of Gastroenterology and Hepatology, University Digestive Healthcare Center, Clarunis, Basel, Switzerland
| | - Max Nieuwdorp
- Department of Internal and Vascular Medicine, Amsterdam University Medical Centers, Amsterdam, the Netherlands
- Amsterdam Diabeter Center, Amsterdam University Medical Centers, Amsterdam, the Netherlands
| | - Marju Orho-Melander
- Department of Clinical Sciences in Malmö, Lund University Diabetes Centre, Lund University, Malmö, Sweden
| | - Yolanda Sanz
- Institute of Agrochemistry and Food Technology, Spanish National Research Council (IATA-CSIC), Valencia, Spain
| | - Valentina Tremaroli
- Wallenberg Laboratory, Department of Molecular and Clinical Medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
| | - Liping Zhao
- Department of Biochemistry and Microbiology, School of Environmental and Biological Sciences, Rutgers University, New Brunswick, NJ
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3
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Byndloss M, Devkota S, Duca F, Niess JH, Nieuwdorp M, Orho-Melander M, Sanz Y, Tremaroli V, Zhao L. The gut microbiota and diabetes: research, translation, and clinical applications - 2023 Diabetes, Diabetes Care, and Diabetologia Expert Forum. Diabetologia 2024; 67:1760-1782. [PMID: 38910152 PMCID: PMC11410996 DOI: 10.1007/s00125-024-06198-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2024] [Accepted: 05/23/2024] [Indexed: 06/25/2024]
Abstract
This article summarises the state of the science on the role of the gut microbiota (GM) in diabetes from a recent international expert forum organised by Diabetes, Diabetes Care, and Diabetologia, which was held at the European Association for the Study of Diabetes 2023 Annual Meeting in Hamburg, Germany. Forum participants included clinicians and basic scientists who are leading investigators in the field of the intestinal microbiome and metabolism. Their conclusions were as follows: (1) the GM may be involved in the pathophysiology of type 2 diabetes, as microbially produced metabolites associate both positively and negatively with the disease, and mechanistic links of GM functions (e.g. genes for butyrate production) with glucose metabolism have recently emerged through the use of Mendelian randomisation in humans; (2) the highly individualised nature of the GM poses a major research obstacle, and large cohorts and a deep-sequencing metagenomic approach are required for robust assessments of associations and causation; (3) because single time point sampling misses intraindividual GM dynamics, future studies with repeated measures within individuals are needed; and (4) much future research will be required to determine the applicability of this expanding knowledge to diabetes diagnosis and treatment, and novel technologies and improved computational tools will be important to achieve this goal.
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Affiliation(s)
- Mariana Byndloss
- Vanderbilt University Medical Center, Nashville, TN, USA
- Howard Hughes Medical Institute, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Suzanne Devkota
- Cedars-Sinai Medical Center, Human Microbiome Research Institute, Los Angeles, CA, USA
| | | | - Jan Hendrik Niess
- Department of Biomedicine, University of Basel, Basel, Switzerland
- Department of Gastroenterology and Hepatology, University Digestive Healthcare Center, Clarunis, Basel, Switzerland
| | - Max Nieuwdorp
- Department of Internal and Vascular Medicine, Amsterdam University Medical Centers, Amsterdam, the Netherlands
- Amsterdam Diabeter Center, Amsterdam University Medical Centers, Amsterdam, the Netherlands
| | - Marju Orho-Melander
- Department of Clinical Sciences in Malmö, Lund University Diabetes Centre, Lund University, Malmö, Sweden
| | - Yolanda Sanz
- Institute of Agrochemistry and Food Technology, Spanish National Research Council (IATA-CSIC), Valencia, Spain.
| | - Valentina Tremaroli
- Wallenberg Laboratory, Department of Molecular and Clinical Medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
| | - Liping Zhao
- Department of Biochemistry and Microbiology, School of Environmental and Biological Sciences, Rutgers University, New Brunswick, NJ, USA
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Byndloss M, Devkota S, Duca F, Niess JH, Nieuwdorp M, Orho-Melander M, Sanz Y, Tremaroli V, Zhao L. The Gut Microbiota and Diabetes: Research, Translation, and Clinical Applications-2023 Diabetes, Diabetes Care, and Diabetologia Expert Forum. Diabetes 2024; 73:1391-1410. [PMID: 38912690 PMCID: PMC11333376 DOI: 10.2337/dbi24-0028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2024] [Accepted: 05/23/2024] [Indexed: 06/25/2024]
Abstract
This article summarizes the state of the science on the role of the gut microbiota (GM) in diabetes from a recent international expert forum organized by Diabetes, Diabetes Care, and Diabetologia, which was held at the European Association for the Study of Diabetes 2023 Annual Meeting in Hamburg, Germany. Forum participants included clinicians and basic scientists who are leading investigators in the field of the intestinal microbiome and metabolism. Their conclusions were as follows: 1) the GM may be involved in the pathophysiology of type 2 diabetes, as microbially produced metabolites associate both positively and negatively with the disease, and mechanistic links of GM functions (e.g., genes for butyrate production) with glucose metabolism have recently emerged through the use of Mendelian randomization in humans; 2) the highly individualized nature of the GM poses a major research obstacle, and large cohorts and a deep-sequencing metagenomic approach are required for robust assessments of associations and causation; 3) because single-time point sampling misses intraindividual GM dynamics, future studies with repeated measures within individuals are needed; and 4) much future research will be required to determine the applicability of this expanding knowledge to diabetes diagnosis and treatment, and novel technologies and improved computational tools will be important to achieve this goal.
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Affiliation(s)
- Mariana Byndloss
- Vanderbilt University Medical Center, Nashville, TN
- Howard Hughes Medical Institute, Vanderbilt University Medical Center, Nashville, TN
| | - Suzanne Devkota
- Human Microbiome Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA
| | | | - Jan Hendrik Niess
- Department of Biomedicine, University of Basel, Basel, Switzerland
- Department of Gastroenterology and Hepatology, University Digestive Healthcare Center, Clarunis, Basel, Switzerland
| | - Max Nieuwdorp
- Department of Internal and Vascular Medicine, Amsterdam University Medical Centers, Amsterdam, the Netherlands
- Amsterdam Diabeter Center, Amsterdam University Medical Centers, Amsterdam, the Netherlands
| | - Marju Orho-Melander
- Department of Clinical Sciences in Malmö, Lund University Diabetes Centre, Lund University, Malmö, Sweden
| | - Yolanda Sanz
- Institute of Agrochemistry and Food Technology, Spanish National Research Council (IATA-CSIC), Valencia, Spain
| | - Valentina Tremaroli
- Wallenberg Laboratory, Department of Molecular and Clinical Medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
| | - Liping Zhao
- Department of Biochemistry and Microbiology, School of Environmental and Biological Sciences, Rutgers University, New Brunswick, NJ
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Martinez TM, Wachsmuth HR, Meyer RK, Weninger SN, Lane AI, Kangath A, Schiro G, Laubitz D, Stern JH, Duca FA. Differential effects of plant-based flours on metabolic homeostasis and the gut microbiota in high-fat fed rats. Nutr Metab (Lond) 2023; 20:44. [PMID: 37858106 PMCID: PMC10585811 DOI: 10.1186/s12986-023-00767-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Accepted: 10/13/2023] [Indexed: 10/21/2023] Open
Abstract
BACKGROUND The gut microbiome is a salient contributor to the development of obesity, and diet is the greatest modifier of the gut microbiome, which highlights the need to better understand how specific diets alter the gut microbiota to impact metabolic disease. Increased dietary fiber intake shifts the gut microbiome and improves energy and glucose homeostasis. Dietary fibers are found in various plant-based flours which vary in fiber composition. However, the comparative efficacy of specific plant-based flours to improve energy homeostasis and the mechanism by which this occurs is not well characterized. METHODS In experiment 1, obese rats were fed a high fat diet (HFD) supplemented with four different plant-based flours for 12 weeks. Barley flour (BF), oat bran (OB), wheat bran (WB), and Hi-maize amylose (HMA) were incorporated into the HFD at 5% or 10% total fiber content and were compared to a HFD control. For experiment 2, lean, chow-fed rats were switched to HFD supplemented with 10% WB or BF to determine the preventative efficacy of flour supplementation. RESULTS In experiment 1, 10% BF and 10% WB reduced body weight and adiposity gain and increased cecal butyrate. Gut microbiota analysis of WB and BF treated rats revealed increases in relative abundance of SCFA-producing bacteria. 10% WB and BF were also efficacious in preventing HFD-induced obesity; 10% WB and BF decreased body weight and adiposity, improved glucose tolerance, and reduced inflammatory markers and lipogenic enzyme expression in liver and adipose tissue. These effects were accompanied by alterations in the gut microbiota including increased relative abundance of Lactobacillus and LachnospiraceaeUCG001, along with increased portal taurodeoxycholic acid (TDCA) in 10% WB and BF rats compared to HFD rats. CONCLUSIONS Therapeutic and preventative supplementation with 10%, but not 5%, WB or BF improves metabolic homeostasis, which is possibly due to gut microbiome-induced alterations. Specifically, these effects are proposed to be due to increased concentrations of intestinal butyrate and circulating TDCA.
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Affiliation(s)
- Taylor M Martinez
- Physiological Sciences Graduate Interdisciplinary Program, University of Arizona, Tucson, AZ, USA
| | - Hallie R Wachsmuth
- Physiological Sciences Graduate Interdisciplinary Program, University of Arizona, Tucson, AZ, USA
| | - Rachel K Meyer
- School of Nutritional Science and Wellness, University of Arizona, Tucson, AZ, USA
| | - Savanna N Weninger
- Physiological Sciences Graduate Interdisciplinary Program, University of Arizona, Tucson, AZ, USA
| | - Adelina I Lane
- Physiological Sciences Graduate Interdisciplinary Program, University of Arizona, Tucson, AZ, USA
| | - Archana Kangath
- School of Animal and Comparative Biomedical Sciences, University of Arizona, ACBS Building, 1117 E Lowell St., Tucson, AZ, 85711, USA
| | - Gabriele Schiro
- The PANDA Core for Genomics and Microbiome Research, Department of Pediatrics, University of Arizona, Tucson, AZ, USA
| | - Daniel Laubitz
- The PANDA Core for Genomics and Microbiome Research, Department of Pediatrics, University of Arizona, Tucson, AZ, USA
| | - Jennifer H Stern
- Division of Endocrinology, University of Arizona College of Medicine, Tucson, AZ, USA
| | - Frank A Duca
- School of Animal and Comparative Biomedical Sciences, University of Arizona, ACBS Building, 1117 E Lowell St., Tucson, AZ, 85711, USA.
- BIO 5 Institute, University of Arizona, Tucson, AZ, USA.
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6
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McClements IF, McClements DJ. Designing healthier plant-based foods: Fortification, digestion, and bioavailability. Food Res Int 2023; 169:112853. [PMID: 37254427 DOI: 10.1016/j.foodres.2023.112853] [Citation(s) in RCA: 15] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Revised: 04/12/2023] [Accepted: 04/14/2023] [Indexed: 06/01/2023]
Abstract
Many consumers are incorporating more plant-based foods into their diets as a result of concerns about the environmental, ethical, and health impacts of animal sourced foods like meat, seafood, egg, and dairy products. Foods derived from animals negatively impact the environment by increasing greenhouse gas emissions, land use, water use, pollution, deforestation, and biodiversity loss. The livestock industry confines and slaughters billions of livestock animals each year. There are concerns about the negative impacts of some animal sourced foods, such as red meat and processed meat, on human health. The livestock industry is a major user of antibiotics, which is leading to a rise in the resistance of several pathogenic microorganisms to antibiotics. It is often assumed that a plant-based diet is healthier than one containing more animal sourced foods, but this is not necessarily the case. Eating more fresh fruits, vegetables, nuts, and whole grain cereals has been linked to improved health outcomes but it is unclear whether next-generation plant-based foods, such as meat, seafood, egg, and dairy analogs are healthier than the products they are designed to replace. Many of these new products are highly processed foods that contain high levels of saturated fat, sugar, starch, and salt, and low levels of micronutrients, nutraceuticals, and dietary fibers. Moreover, they are often rapidly digested in the gastrointestinal tract because processing disrupts plant tissues and releases the macronutrients. Consequently, it is important to formulate plant-based foods to reduce the levels of nutrients linked to adverse health effects and increase the levels linked to beneficial health effects. Moreover, it is important to design the food matrix so that the macronutrients are not digested and absorbed too quickly, but the micronutrients are highly bioavailable. In this article, we discuss how next-generation plant-based foods can be made healthier by controlling their nutrient profile, digestibility, and bioavailability.
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Chew HSJ, Heng FKX, Tien SA, Thian JY, Chou HS, Loong SSE, Ang WHD, Chew NWS, Lo KHK. Effects of Plant-Based Diets on Anthropometric and Cardiometabolic Markers in Adults: An Umbrella Review. Nutrients 2023; 15:2331. [PMID: 37242214 PMCID: PMC10222061 DOI: 10.3390/nu15102331] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Revised: 05/05/2023] [Accepted: 05/11/2023] [Indexed: 05/28/2023] Open
Abstract
We conducted an umbrella review to consolidate the evidence of adopting plant-based diets on anthropometric and cardiometabolic outcomes. Six electronic databases (CINAHL, EMBASE, PubMed, Scopus, the Cochrane Library, and Web of Science) were searched for systematic reviews with meta-analysis (SRMAs) published from each journal's inception until 1 October 2022. Effect sizes from SRMAs and primary studies were pooled separately using random effects models. Overlapping primary studies were removed for primary studies' analyses. Seven SRMAs representing 51 primary studies were included, suggesting significant benefits of plant-based diets on weight (-2.09 kg, 95% CI: -3.56, -0.62 kg, p = 0.01, I2 = 95.6%), body mass index (-0.95 kg/m2, 95% CI: -1.26, -0.63 kg/m2, p = 0.002; I2 = 45.1%), waist circumference (-2.20 cm, 95% CI: -0.08, 0.00 cm, p = 0.04; I2 = 88.4%), fasting blood glucose (-0.11 mmol/L, 95% CI: -0.13, -0.09 mmol/L, p < 0.001, I2 = 18.2%), and low-density lipoprotein cholesterol (-0.31 mmol/L, 95% CI: -0.41, -0.20 mmol/L, p < 0.001, I2 = 65.6%). Changes in high-density lipoprotein cholesterol, triglycerides, and blood pressure were not statistically significant. Generally, plant-based diets were recommended to improve anthropometry, lipid profile, and glucose metabolism. However, findings should be interpreted with caution, because most of the reviews were rated to be of low credibility of evidence and were largely based on Western eating habits and traditions, which may limit the generalizability of findings.
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Affiliation(s)
- Han Shi Jocelyn Chew
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117597, Singapore
| | - Felicia Kai Xin Heng
- Department of Nursing, Ng Teng Fong General Hospital, Singapore 609606, Singapore
| | - Si Ai Tien
- Department of Nursing, Khoo Teck Puat Hospital, Singapore 768828, Singapore
| | - Jie Yun Thian
- Department of Nursing, Tan Tock Seng Hospital, Singapore 308433, Singapore
| | - Hui Shan Chou
- Department of Nursing, Singapore General Hospital, Singapore 169608, Singapore
| | - Shaun Seh Ern Loong
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117597, Singapore
| | - Wei How Darryl Ang
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117597, Singapore
| | - Nicholas W. S. Chew
- Department of Cardiology, National University Heart Centre, Singapore 119074, Singapore
| | - Ka-Hei Kenneth Lo
- Department of Food Science and Nutrition, The Hong Kong Polytechnic University, Hong Kong
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Li C, Dhital S, Gidley MJ. High amylose wheat foods: A new opportunity to improve human health. Trends Food Sci Technol 2023. [DOI: 10.1016/j.tifs.2023.03.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/29/2023]
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Cichońska P, Kowalska E, Ziarno M. The Survival of Psychobiotics in Fermented Food and the Gastrointestinal Tract: A Review. Microorganisms 2023; 11:microorganisms11040996. [PMID: 37110420 PMCID: PMC10142889 DOI: 10.3390/microorganisms11040996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2023] [Revised: 04/04/2023] [Accepted: 04/10/2023] [Indexed: 04/29/2023] Open
Abstract
In recent years, scientists have been particularly interested in the gut-brain axis, as well as the impact of probiotics on the nervous system. This has led to the creation of the concept of psychobiotics. The present review describes the mechanisms of action of psychobiotics, their use in food products, and their viability and survival during gastrointestinal passage. Fermented foods have a high potential of delivering probiotic strains, including psychobiotic ones. However, it is important that the micro-organisms remain viable in concentrations ranging from about 106 to 109 CFU/mL during processing, storage, and digestion. Reports indicate that a wide variety of dairy and plant-based products can be effective carriers for psychobiotics. Nonetheless, bacterial viability is closely related to the type of food matrix and the micro-organism strain. Studies conducted in laboratory conditions have shown promising results in terms of the therapeutic properties and viability of probiotics. Because human research in this field is still limited, it is necessary to broaden our understanding of the survival of probiotic strains in the human digestive tract, their resistance to gastric and pancreatic enzymes, and their ability to colonize the microbiota.
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Affiliation(s)
- Patrycja Cichońska
- Department of Food Technology and Assessment, Institute of Food Science, Warsaw University of Life Sciences-SGGW (WULS-SGGW), Nowoursynowska 159c St., 02-776 Warsaw, Poland
| | - Ewa Kowalska
- Department of Food Technology and Assessment, Institute of Food Science, Warsaw University of Life Sciences-SGGW (WULS-SGGW), Nowoursynowska 159c St., 02-776 Warsaw, Poland
| | - Małgorzata Ziarno
- Department of Food Technology and Assessment, Institute of Food Science, Warsaw University of Life Sciences-SGGW (WULS-SGGW), Nowoursynowska 159c St., 02-776 Warsaw, Poland
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Arroyo MC, Laurie I, Rotsaert C, Marzorati M, Risso D, Karnik K. Age-Dependent Prebiotic Effects of Soluble Corn Fiber in M-SHIME ® Gut Microbial Ecosystems. PLANT FOODS FOR HUMAN NUTRITION (DORDRECHT, NETHERLANDS) 2023; 78:213-220. [PMID: 36694053 PMCID: PMC9947079 DOI: 10.1007/s11130-023-01043-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 01/08/2023] [Indexed: 06/17/2023]
Abstract
Soluble corn fiber (SCF) has demonstrated prebiotic effects in clinical studies. Using an in vitro mucosal simulator of the human intestinal microbial ecosystem (M-SHIME®) model, the effects of SCF treatment on colonic microbiota composition and metabolic activity and on host-microbiome interactions were evaluated using fecal samples from healthy donors of different ages (baby [≤ 2 years], n = 4; adult [18-45 years], n = 2; elderly [70 years], n = 1). During the 3-week treatment period, M-SHIME® systems were supplemented with SCF daily (baby, 1.5, 3, or 4.5 g/d; adult, 3 or 8.5 g/d; and elderly, 8.5 g/d). M-SHIME® supernatants were evaluated for their effect on the intestinal epithelial cell barrier and inflammatory responses in lipopolysaccharide. (LPS)-stimulated cells. Additionally, short-chain fatty acid (SCFA) production and microbial community composition were assessed. In the baby and adult models, M-SHIME® supernatants from SCF treated vessels protected Caco-2 membrane integrity from LPS-induced damage. SCF treatment resulted in the expansion of Bacteroidetes, Firmicutes, and Bifidobacterial, as well as increased SCFA production in all age groups. SCF tended to have the greatest effect on propionate production. These findings demonstrate the prebiotic potential of SCF in babies, adults, and the elderly and provide insight into the mechanisms behind the observed prebiotic effects.
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Affiliation(s)
- Marta Calatayud Arroyo
- ProDigest, Technologiepark 82, 9052, Zwijnaarde, Belgium
- Center for Microbial Ecology and Technology (CMET), Faculty of Bioscience Engineering, Ghent University, Coupure Links 653, 9000, Ghent, Belgium
| | - Ieva Laurie
- Tate & Lyle PLC, 5 Marble Arch, W1H 7EJ, London, UK.
| | - Chloë Rotsaert
- ProDigest, Technologiepark 82, 9052, Zwijnaarde, Belgium
| | - Massimo Marzorati
- ProDigest, Technologiepark 82, 9052, Zwijnaarde, Belgium
- Center for Microbial Ecology and Technology (CMET), Faculty of Bioscience Engineering, Ghent University, Coupure Links 653, 9000, Ghent, Belgium
| | - Davide Risso
- Tate & Lyle PLC, 5 Marble Arch, W1H 7EJ, London, UK
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11
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Khalili L, Centner AM, Salazar G. Effects of Berries, Phytochemicals, and Probiotics on Atherosclerosis through Gut Microbiota Modification: A Meta-Analysis of Animal Studies. Int J Mol Sci 2023; 24:ijms24043084. [PMID: 36834497 PMCID: PMC9960548 DOI: 10.3390/ijms24043084] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 01/28/2023] [Accepted: 01/30/2023] [Indexed: 02/09/2023] Open
Abstract
Atherosclerosis is a major cause of death and disability. The beneficial effects of phytochemicals and probiotics on atherosclerosis have gained significant interest since these functional foods can improve inflammation, oxidative stress, and microbiome dysbiosis. The direct effect of the microbiome in atherosclerosis, however, needs further elucidation. The objective of this work was to investigate the effects of polyphenols, alkaloids, and probiotics on atherosclerosis using a meta-analysis of studies with mouse models of atherosclerosis. Identification of eligible studies was conducted through searches on PubMed, Embase, Web of Science, and Science Direct until November 2022. The results showed that phytochemicals reduced atherosclerosis, which was significant in male mice, but not in females. Probiotics, on the other hand, showed significant reductions in plaque in both sexes. Berries and phytochemicals modulated gut microbial composition by reducing the Firmicutes/Bacteroidetes (F/B) ratio and by upregulating health-promoting bacteria, including Akkermansia muciniphila. This analysis suggests that phytochemicals and probiotics can reduce atherosclerosis in animal models, with a potentially greater effect on male animals. Thus, consumption of functional foods rich in phytochemicals as well as probiotics are viable interventions to improve gut health and reduce plaque burden in patients suffering from cardiovascular disease (CVD).
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Affiliation(s)
- Leila Khalili
- Department of Nutrition and Integrative Physiology, College of Health and Human Sciences, Florida State University, Tallahassee, FL 32306, USA
| | - Ann Marie Centner
- Department of Nutrition and Integrative Physiology, College of Health and Human Sciences, Florida State University, Tallahassee, FL 32306, USA
| | - Gloria Salazar
- Department of Nutrition and Integrative Physiology, College of Health and Human Sciences, Florida State University, Tallahassee, FL 32306, USA
- Center for Advancing Exercise and Nutrition Research on Aging (CAENRA), Florida State University, Tallahassee, FL 32306, USA
- Correspondence:
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Raza MA, Saeed F, Afzaal M, Imran A, Niaz B, Hussain M, Rasheed A, Kashif Mukhtar M, Waleed M, Al Jbawi E. Comparative study of cross- and uncross-linked arabinoxylans extracted from maize bran with special reference to their structural and antioxidant potential. INTERNATIONAL JOURNAL OF FOOD PROPERTIES 2022. [DOI: 10.1080/10942912.2022.2143524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
| | - Farhan Saeed
- Department of Food Science, Government College University Faisalabad, Pakistan
| | - Muhammad Afzaal
- Department of Food Science, Government College University Faisalabad, Pakistan
| | - Ali Imran
- Department of Food Science, Government College University Faisalabad, Pakistan
| | - Bushra Niaz
- Department of Food Science, Government College University Faisalabad, Pakistan
| | - Muzzamal Hussain
- Department of Food Science, Government College University Faisalabad, Pakistan
| | - Amara Rasheed
- Department of Food Science, Government College University Faisalabad, Pakistan
| | - Muhammad Kashif Mukhtar
- National Institute of Food Science and Technology (NIFSAT), University of Agriculture Faisalabad, Pakistan
| | - Muhammad Waleed
- Department of Food Science, Government College University Faisalabad, Pakistan
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13
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Pectin in Metabolic Liver Disease. Nutrients 2022; 15:nu15010157. [PMID: 36615814 PMCID: PMC9824118 DOI: 10.3390/nu15010157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 12/02/2022] [Accepted: 12/08/2022] [Indexed: 12/31/2022] Open
Abstract
Alterations in the composition of the gut microbiota (dysbiosis) are observed in nutritional liver diseases, including non-alcoholic fatty liver disease (NAFLD) and alcoholic liver disease (ALD) and have been shown to be associated with the severity of both. Editing the composition of the microbiota by fecal microbiota transfer or by application of probiotics or prebiotics/fiber in rodent models and human proof-of-concept trials of NAFLD and ALD have demonstrated its possible contribution to reducing the progression of liver damage. In this review, we address the role of a soluble fiber, pectin, in reducing the development of liver injury in NAFLD and ALD through its impact on gut bacteria.
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Anti-Obesity Effects of Formulated Biscuits Supplemented with Date's Fiber; Agro-Waste Products Used as a Potent Functional Food. Nutrients 2022; 14:nu14245315. [PMID: 36558474 PMCID: PMC9783991 DOI: 10.3390/nu14245315] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Revised: 11/23/2022] [Accepted: 12/10/2022] [Indexed: 12/23/2022] Open
Abstract
Superabundant date fruit production in Al-Qassim in the Kingdom of Saudi Arabia (KSA), a plentiful region for producing date syrup resulting in massive amounts of date fiber (DF), causes environmental issues with what is considered dietary waste. However, no food producer or researcher has thought of the valorization of DF by extracting the crude polysaccharides that can be converted to nanoparticles (flours) to increase its functional group and enhance its functionality. Using the DF was the primary goal, with the new biscuits used within the current study investigated as a potent integrated approach for controlling obesity levels and its effects. Obesity is one of the most important human problems worldwide, connected to many metabolic diseases, e.g., diabetes mellitus and cardiovascular disease. Its prevalence has recently increased among Saudi children and adolescents. An investigation of the biological effects of the formulated products was carried out by feeding the formulated biscuits with different DF levels (5, 10 and 15%) to obese albino rats, in addition to positive and negative control groups, to evaluate the effect of a reduced calorie product on controlling their body weight and health stats (lipid profile, blood sugars, kidney and liver functions). The collected data showed that the most positive results were obtained from rats fed diets supplemented with 10% DF biscuits. All TCHO, TrGs, HDL, and HDL were decreased to the best levels in this group compared to the positive control group (148.23, 145.30, 37.50, and 81.67 vs. 238.37, 199.07, 62.57, and 135.99, respectively). To conclude, DF supplementation presented anti-obesity properties in animal models; however, more epidemiological trials are needed.
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Saini P, Islam M, Das R, Shekhar S, Sinha ASK, Prasad K. Wheat Bran as Potential Source of Dietary Fiber: Prospects and Challenges. J Food Compost Anal 2022. [DOI: 10.1016/j.jfca.2022.105030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Ahmad SR. Plant-based diet for obesity treatment. Front Nutr 2022; 9:952553. [PMID: 36159462 PMCID: PMC9493195 DOI: 10.3389/fnut.2022.952553] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Accepted: 07/13/2022] [Indexed: 11/13/2022] Open
Abstract
Obesity rates continue to rise, resulting in a global epidemic that shows no sign of slowing down. Our understanding of this complex disease is also constantly evolving, requiring healthcare providers to stay up to date with best practices. The application of plant-based diets (PBDs) may hold the key to a successful weight-control strategy. PBD refers to any dietary pattern that emphasizes the consumption of plant foods while excluding the consumption of most or all animal products. The purpose of this mini-review is to report on the application of PBDs as a potential treatment for obesity. PBDs have also been shown to be beneficial in the treatment of other non-communicable diseases, such as the prevention and treatment of type 2 diabetes. Many of the reported RCTs were of short duration. Longer-term studies, as well as studies focusing on strict adherence to the PBD regime, are needed. PBD is a beneficial approach to improving health, particularly in obese patients. Benefits include weight loss, improved cardiovascular health, lower blood pressure, and improved glucose metabolism.
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Schipke J, Brandenberger C, Vital M, Mühlfeld C. Starch and Fiber Contents of Purified Control Diets Differentially Affect Hepatic Lipid Homeostasis and Gut Microbiota Composition. Front Nutr 2022; 9:915082. [PMID: 35873446 PMCID: PMC9301012 DOI: 10.3389/fnut.2022.915082] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Accepted: 06/07/2022] [Indexed: 01/04/2023] Open
Abstract
Background Interpretation of results from diet-induced-obesity (DIO) studies critically depends on control conditions. Grain-based chows are optimized for rodent nutrition but do not match the defined composition of purified diets used for DIO, severely limiting the comparability. Purified control diets are recommended but often contain high starch and only minor fiber amounts. It is unknown whether this composition leads to metabolic alterations compared with chow and whether the addition of refined fibers at the expense of starch affects these changes. Methods In this experiment, 6-week-old C57BL/6N mice were fed (i) a conventional purified control diet (high-starch, low-fiber; Puri-starch), (ii) an alternative, custom-made purified control diet containing pectin and inulin (medium-starch, higher-fiber; Puri-fiber), or (iii) grain-based chow for 30 weeks (N = 8–10). Results Puri-starch feeding resulted in significantly elevated levels of plasma insulin (p = 0.004), cholesterol (p < 0.001), and transaminases (AST p = 0.002, ALT p = 0.001), hepatic de novo lipogenesis and liver steatosis, and an altered gut microbiota composition compared with chow-fed mice. In contrast, Puri-fiber exerted only minor effects on systemic parameters and liver lipid homeostasis, and promoted a distinct gut microbiota composition. Conclusion Carbohydrate-rich purified diets trigger a metabolic status possibly masking pathological effects of nutrients under study, restricting its use as control condition. The addition of refined fibers is suited to create purified, yet physiological control diets for DIO research.
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Affiliation(s)
- Julia Schipke
- Hannover Medical School, Institute of Functional and Applied Anatomy, Hannover, Germany
- Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), Member of the German Center for Lung Research (DZL), Hannover, Germany
- *Correspondence: Julia Schipke
| | - Christina Brandenberger
- Hannover Medical School, Institute of Functional and Applied Anatomy, Hannover, Germany
- Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), Member of the German Center for Lung Research (DZL), Hannover, Germany
| | - Marius Vital
- Hannover Medical School, Institute for Medical Microbiology and Hospital Epidemiology, Hannover, Germany
| | - Christian Mühlfeld
- Hannover Medical School, Institute of Functional and Applied Anatomy, Hannover, Germany
- Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), Member of the German Center for Lung Research (DZL), Hannover, Germany
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Prebiotics and the Human Gut Microbiota: From Breakdown Mechanisms to the Impact on Metabolic Health. Nutrients 2022; 14:nu14102096. [PMID: 35631237 PMCID: PMC9147914 DOI: 10.3390/nu14102096] [Citation(s) in RCA: 31] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Revised: 05/11/2022] [Accepted: 05/14/2022] [Indexed: 12/13/2022] Open
Abstract
The colon harbours a dynamic and complex community of microorganisms, collectively known as the gut microbiota, which constitutes the densest microbial ecosystem in the human body. These commensal gut microbes play a key role in human health and diseases, revealing the strong potential of fine-tuning the gut microbiota to confer health benefits. In this context, dietary strategies targeting gut microbes to modulate the composition and metabolic function of microbial communities are of increasing interest. One such dietary strategy is the use of prebiotics, which are defined as substrates that are selectively utilised by host microorganisms to confer a health benefit. A better understanding of the metabolic pathways involved in the breakdown of prebiotics is essential to improve these nutritional strategies. In this review, we will present the concept of prebiotics, and focus on the main sources and nature of these components, which are mainly non-digestible polysaccharides. We will review the breakdown mechanisms of complex carbohydrates by the intestinal microbiota and present short-chain fatty acids (SCFAs) as key molecules mediating the dialogue between the intestinal microbiota and the host. Finally, we will review human studies exploring the potential of prebiotics in metabolic diseases, revealing the personalised responses to prebiotic ingestion. In conclusion, we hope that this review will be of interest to identify mechanistic factors for the optimization of prebiotic-based strategies.
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Cook TM, Mansuy-Aubert V. Communication between the gut microbiota and peripheral nervous system in health and chronic disease. Gut Microbes 2022; 14:2068365. [PMID: 35482894 PMCID: PMC9067538 DOI: 10.1080/19490976.2022.2068365] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Trillions of bacteria reside within our gastrointestinal tract, ideally forming a mutually beneficial relationship between us. However, persistent changes in diet and lifestyle in the western diet and lifestyle contribute to a damaging of the gut microbiota-host symbiosis leading to diseases such as obesity and irritable bowel syndrome. Many symptoms and comorbidities associated with these diseases stem from dysfunctional signaling in peripheral neurons. Our peripheral nervous system (PNS) is comprised of a variety of sensory, autonomic, and enteric neurons which coordinate key homeostatic functions such as gastrointestinal motility, digestion, immunity, feeding behavior, glucose and lipid homeostasis, and more. The composition and signaling of bacteria in our gut dramatically influences how our peripheral neurons regulate these functions, and we are just beginning to uncover the molecular mechanisms mediating this communication. In this review, we cover the general anatomy and function of the PNS, and then we discuss how the molecules secreted or stimulated by gut microbes signal through the PNS to alter host development and physiology. Finally, we discuss how leveraging the power of our gut microbes on peripheral nervous system signaling may offer effective therapies to counteract the rise in chronic diseases crippling the western world.
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Affiliation(s)
- Tyler M. Cook
- Department of Cell and Molecular Physiology, Loyola University Chicago, Maywood, IL, USA
| | - Virginie Mansuy-Aubert
- Department of Cell and Molecular Physiology, Loyola University Chicago, Maywood, IL, USA,CONTACT Virginie Mansuy-Aubert Loyola University Chicago, Maywood, IL, USA
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Rodríguez-Lara A, Plaza-Díaz J, López-Uriarte P, Vázquez-Aguilar A, Reyes-Castillo Z, Álvarez-Mercado AI. Fiber Consumption Mediates Differences in Several Gut Microbes in a Subpopulation of Young Mexican Adults. Nutrients 2022; 14:1214. [PMID: 35334871 PMCID: PMC8954685 DOI: 10.3390/nu14061214] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Revised: 03/09/2022] [Accepted: 03/11/2022] [Indexed: 12/15/2022] Open
Abstract
Diet is a determinant for bodyweight and gut microbiota composition. Changes in dietary patterns are useful for the prevention and management of overweight and obesity. We aim to evaluate diet behavior and its potential association with selected gut bacteria and body weight among Mexican young adults. Mexican college students aged between 18 and 25 (normal-weight, overweight, and obese) were recruited. Anthropometric variables were recorded. A validated food frequency questionnaire was applied to all the participants. The percentages of macronutrients, fiber, and energy were calculated, and fecal samples were analyzed by real-time-qPCR to quantify selected gut bacteria. All the participants showed an unbalanced dietary pattern. However, the consumption of fruits, non-fat cereals, and oils and fats without protein were higher in the normal-weight individuals. In the overweight/obese participants, fiber intake did not correlate with the microbial variables, while Kcal from protein and Clostridium leptum correlated positively with Lactobacillus. Similarly, Clostridium coccoides-Eubacterium rectale correlated with Akkermansia muciniphila. In the normal-weight participants, Clostridium leptum and Lactobacillus correlated positively with Clostridium coccoides-Eubacterium rectale and Bifidobacterium, respectively, and Bacteroidetes negatively with Akkermansia muciniphila. In conclusion, a higher fiber intake had a positive impact on body weight and bacterial gut composition in this Mexican population of college students.
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Affiliation(s)
- Avilene Rodríguez-Lara
- Institute of Nutrition and Food Technology, Biomedical Research Center, University of Granada, 18016 Armilla, Spain; (A.R.-L.); (A.V.-A.)
| | - Julio Plaza-Díaz
- Department of Biochemistry and Molecular Biology II, School of Pharmacy, University of Granada, 18071 Granada, Spain
- Children’s Hospital of Eastern Ontario Research Institute, Ottawa, ON K1H 8L1, Canada
| | - Patricia López-Uriarte
- Departamento de Ciencias Exactas y Metodologías del Centro Universitario del Sur, Universidad de Guadalajara, Ciudad Guzmán 49000, Mexico;
| | - Alejandra Vázquez-Aguilar
- Institute of Nutrition and Food Technology, Biomedical Research Center, University of Granada, 18016 Armilla, Spain; (A.R.-L.); (A.V.-A.)
- Department of Biochemistry and Molecular Biology II, School of Pharmacy, University of Granada, 18071 Granada, Spain
| | - Zyanya Reyes-Castillo
- Instituto de Investigaciones en Comportamiento Alimentario y Nutrición, Universidad de Guadalajara, Ciudad Guzmán 49000, Mexico;
| | - Ana I. Álvarez-Mercado
- Institute of Nutrition and Food Technology, Biomedical Research Center, University of Granada, 18016 Armilla, Spain; (A.R.-L.); (A.V.-A.)
- Department of Biochemistry and Molecular Biology II, School of Pharmacy, University of Granada, 18071 Granada, Spain
- Instituto de Investigación Biosanitaria IBS.GRANADA, Complejo Hospitalario Universitario de Granada, 18014 Granada, Spain
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