Cited by 325Gut microbiota and healthNutritional Studies and DietProbiotics and Fermented Foods

Adherence to the Mediterranean diet is associated with the gut microbiota pattern and gastrointestinal characteristics in an adult population

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Mitsou, Evdokia K., Kakali, Aimilia, Antonopoulou, Smaragdi, Mountzouris, Konstantinos C., Yannakoulia, Mary, Panagiotakos, Demosthenes B., Kyriacou, Adamantini·2017·British Journal of Nutrition

Abstract

This study aimed to explore the potential associations of adherence to the Mediterranean diet with gut microbiota characteristics and gastrointestinal symptomatology in an adult population. Other long-term dietary habits (e.g. consumption of snacks and junk food or stimulant intake) were also evaluated in terms of the gut microbiota profile. Participants ( n 120) underwent anthropometric, dietary, physical activity and lifestyle evaluation. Adherence to the Mediterranean diet was assessed using a Mediterranean diet score, the MedDietScore, and subjects were classified into three tertiles according to individual adherence scoring. Gut microbiota composition was determined using quantitative PCR and plate-count techniques, and faecal SCFA were analysed using GC. Gastrointestinal symptoms were also evaluated. Participants with a high adherence to the Mediterranean diet had lower Escherichia coli counts ( P =0·022), a higher bifidobacteria: E. coli ratio ( P =0·025), increased levels and prevalence of Candida albicans ( P =0·039 and P =0·050, respectively), greater molar ratio of acetate ( P =0·009), higher defaecation frequency ( P =0·028) and a more pronounced gastrointestinal symptomatology compared with those reporting low adherence. A lower molar ratio of valerate was also observed in the case of high adherence to the Mediterranean diet compared with the other two tertiles ( P for trend =0·005). Positive correlations of MedDietScore with gastrointestinal symptoms, faecal moisture, total bacteria, bifidobacteria: E. coli ratio, relative share of Bacteroides, C. albicans and total SCFA, as well as negative associations with cultivable E. coli levels and valerate were indicated. Fast food consumption was characterised by suppressed representation of lactobacilli and butyrate-producing bacteria. In conclusion, our findings support a link between adherence to the Mediterranean diet and gut microbiota characteristics.

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  • A Mediterranean diet results in distinctive and identifiable gut microbiota characteristics.

    “and results in distinctive and identifiable gut microbiota characteristics (Mitsou et al., 2017).”

    From The Microbiota-Gut-Brain Axis (2019) · cites this paper as Mitsou et al., 2017

    The Discussion (page not available in our copy) reports identifiable gut microbiota characteristics associated with higher Mediterranean-diet adherence, including lower E. coli counts and a higher bifidobacteria:E. coli ratio. But it also says the cross-sectional design undermines causal inference. The claim’s “results in” wording therefore goes beyond what this study establishes. (LLM, conf=0.90)

    Experimental — accuracy not yet measured
  • The Mediterranean diet reduces oxidative stress and inflammation and regulates gut microbiota eubiosis, contributing to improved immune responses.

    “This particular diet results in a reduction in both oxidative stress and inflammation and regulation of eubiosis of the gut microbiota, which in turn all contribute to an improvement in immune responses189.”

    From SARS-CoV-2, COVID-19 and the aging immune system (2021) · cites this paper as [189]

  • The efficacy of the Mediterranean diet results as an attenuation of inflammation and oxidative stress, and from the maintenance of a condition of eubiosis of the microbiota, involved in the general improvement of immune response in these populations.

    “The efficacy of this diet results as an attenuation of inflammation and oxidative stress, and from the maintenance of a condition of eubiosis of the microbiota, involved in the general improvement of immune response in these populations (68, 83–86).”
  • The high rate of long living people and the low incidence of cardiovascular disease in many Mediterranean countries suggest the importance of a diet rich in fruits, vegetables, whole grains, legumes, and olive oil.

    “The high rate of long living people and the low incidence of cardiovascular disease in many Mediterranean countries suggest the importance of a diet rich in fruits, vegetables, whole grains, legumes, and olive oil (probably the main anti-aging food in this area).”
  • The reduced consumption of animal proteins, in particular red and cured meat, is also important.

    “The reduced consumption of animal proteins, in particular red and cured meat, is also important.”

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Authors
Mitsou, E. K., Kakali, A., Antonopoulou, S., Mountzouris, K. C., Yannakoulia, M., Panagiotakos, D. B., & Kyriacou, A.
Affiliations
  • Harokopio University of Athens (GR)
  • Agricultural University of Athens (GR)
Corresponding author
Kyriacou, Adamantini
Venue
British Journal of Nutrition
Published
2017-06-28
Volume
117
Issue
12
Pages
1645-1655
ISSN
  • 0007-1145 (ISSN-L)
  • 1475-2662
OpenAlex
W2744805498
Cited by
325
References
64
Citations by year
2026: 20 · 2025: 46 · 2024: 31 · 2023: 34 · 2022: 43 · 2021: 66 · 2020: 35 · 2019: 37 · 2018: 9 · 2017: 3
FWCI
9.39
Type
journal article
Language
en
Open access
Locations
  • British Journal Of Nutrition (publishedVersion)
  • PubMed (publishedVersion)
Funders
Harokopio University
Topics
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Gut microbiota and health
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Nutritional Studies and Diet
  • Life Sciences › Agricultural and Biological Sciences › Food Science › Probiotics and Fermented Foods
Keywords
Mediterranean diet, dietary adherence, gut microbiota, gastrointestinal symptoms, short-chain fatty acids, Escherichia coli, Bifidobacterium, Candida albicans, Bacteroides, butyrate-producing bacteria, lactobacilli, fast food consumption
MeSH terms
Gastrointestinal Microbiome, Adolescent, Adult, Aged, Bacteroides, Bifidobacterium, Candida albicans, Cross-Sectional Studies, Diet, Escherichia coli, Fatty Acids, Feces, Female, Gastrointestinal Diseases, Humans, Hydrogen-Ion Concentration, Male, Middle Aged, Patient Compliance, Surveys and Questionnaires, Socioeconomic Factors, Colony Count, Microbial, Exercise, Nutrition Assessment, Body Mass Index, Diet, Mediterranean, Gastrointestinal Tract, Young Adult

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