Abstract
BackgroundConsumption of a diet with high adherence to a Mediterranean diet pattern (MDP) has been associated with a favorable gastrointestinal tract (GIT) microbiome. A healthy GIT microbiome in pregnancy, as defined by increased alpha diversity, is associated with lower chance of adverse perinatal outcomes. This study aimed to evaluate the impact of adherence to an MDP on GIT microbial diversity longitudinally throughout pregnancy.MethodsAdherence to MDP was scored by the Alternate Mediterranean (aMED) Diet Quality Score, after being applied to a validated Food Frequency Questionnaire. Association of aMED Scores with GIT alpha diversity profiles were compared linearly and across time using a linear mixed model, including covariates of age, body mass index (BMI), ethnicity, and parity.ResultsForty-one participants of Filipino, Japanese, Native Hawaiian, and Non-Hispanic White descent provided dietary information and microbiome samples during each trimester of pregnancy. Alpha diversity profiles changed over gestation, with decreased microbial diversity in the third trimester. aMED scores positively correlated with Chao1 Index and Observed Species Number (r = 0.244, p = 0.017, and r = 0.233, p = 0.023, respectively). The strongest association was detected in the third trimester (Chao 1: r = 0.43, p = 0.020, Observed Species Number: r = 0.41, p = 0.026). Participants with higher aMED scores had higher relative abundance of Acidaminoacaeae at the family level (p = 0.0169), as well as higher abundance of several species known to increase production of short chain fatty acids within the GIT.ConclusionsAdherence to MDP pattern is associated with increased maternal GIT microbial diversity, and promotes the abundance of bacteria that produce short chain fatty acids. Increased consumption of fruits, vegetables and legumes with low red meat consumption were key components driving this association. The effect of nutrition however, was less of an effect than pregnancy itself. Further studies are needed to determine if adherence to a Mediterranean diet translates not only into microbial health, but also into reduced risk of adverse pregnancy outcomes.
Highlights
Consumption of a diet with high adherence to a Mediterranean diet pattern (MDP) has been associated with a favorable gastrointestinal tract (GIT) microbiome
There is a natural decline in butyrate-producing bacteria from the Firmicutes (Coprococci, Eubacterium, Roseburia, and Faecalibacterium genera) and Bacteroidetes (Odoribacter and Alistipes genera) phyla [2] at the end of gestation
Several studies demonstrate that at this point, the composition resembles that of an individual with metabolic syndrome, with increased Actinobacteria and Proteobacteria, and decreased Faecalibacterium [4, 5]
Summary
Consumption of a diet with high adherence to a Mediterranean diet pattern (MDP) has been associated with a favorable gastrointestinal tract (GIT) microbiome. A healthy GIT microbiome in pregnancy, as defined by increased alpha diversity, is associated with lower chance of adverse perinatal outcomes. GIT microbial dysbiosis, as defined as low alpha diversity and reduced levels of butyrate producing bacteria, is associated with bacterial translocation and the promotion of endotoxins, creating systemic inflammation. Such inflammation may lead to preterm labor [1], higher blood pressure [2], and increase the risk of developing gestational diabetes [3]. Bifidobacteria, Proteobacteria, and lactic acid–producing bacteria increase during the third trimester This process is thought to help facilitate the normally observed increase in inflammation and weight gain to increase energy supply for the fetus [4]. Manipulating microbial diversity over time may be possible with targeting maternal diet
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