Abstract
Accumulating literature is providing evidence that the gut microbiota is involved in metabolic disorders, but the question of how to effectively modulate it to restore homeostasis, especially in the elderly, is still under debate. In this study, we profiled the intestinal microbiota of 20 elderly obese women (EO) at the baseline (T0), after 15 days of hypocaloric Mediterranean diet administered as part of a nutritional-metabolic rehabilitation program for obesity (T1), and after a further 15 days of the same diet supplemented with a probiotic mix (T2). Fecal samples were characterized by Illumina MiSeq sequencing of the 16S rRNA gene. The EO microbiota showed the typical alterations found in obesity, namely, an increase in potential pro-inflammatory components (i.e., Collinsella) and a decrease in health-promoting, short-chain fatty acid producers (i.e., Lachnospiraceae and Ruminococcaceae members), with a tendency to reduced biodiversity. After 15 days of the rehabilitation program, weight decreased by (2.7 ± 1.5)% and the gut microbiota dysbiosis was partially reversed, with a decline of Collinsella and an increase in leanness-related taxa. During the next 15 days of diet and probiotics, weight dropped further by (1.2 ± 1.1)%, markers of oxidative stress improved, and Akkermansia, a mucin degrader with beneficial effects on host metabolism, increased significantly. These findings support the relevant role of a correct dietetic approach, even in the short term, to modulate the EO gut microbiota towards a metabolic health-related configuration, counteracting the increased risk of morbidity in these patients.
Highlights
Individuals aged 60 years and older are expected to nearly double from 12% to 22% of the global population between 2015 and 2050 [1]
Supporting patient compliance, after diet and probiotic supplementation, there was an increase in the relative abundances of bifidobacteria, lactobacilli and streptococci, i.e., the same bacterial genera included in the probiotic mixture (Supplementary Figure S4). In this short-term dietary intervention study in elderly obese women (EO), we showed that two weeks of balanced Mediterranean diet with mild caloric deficit, as a part of a metabolic-nutritional-psychological rehabilitation program, improved the patients’ metabolic picture, and that such an improvement was accompanied by the recovery of a balanced health-promoting configuration of the gut microbiota
This study demonstrated that two weeks of dietary intervention, as part of a metabolic-nutritional-psychological rehabilitation program, improved the metabolic picture and largely reversed the gut microbiota dysbiosis found in elderly obese women towards a profile typically associated with metabolic health
Summary
Individuals aged 60 years and older are expected to nearly double from 12% to 22% of the global population between 2015 and 2050 [1]. Subjects present a physiological reduction of several biological functions, one of the most common being the impairment of the gastrointestinal tract function. Masticatory function, taste and saliva production impair with age, and gastric acid secretion and gastrointestinal transit time slow down, leading to constipation [3]. The impairment of these biological functions is held responsible for the frequent adoption of an unbalanced diet with impaired nutritional status, and, together with this, believed to contribute to the typical age-related changes in the gut microbiota [4]. Given the multifaceted role of SCFAs in human physiology (e.g., maintenance of epithelial barrier integrity, metabolic regulation, immune functioning and modulation of neuronal activity) [6], this aged-type microbiota profile is supposed to variously contribute to the age-related functional decline, supporting inflammaging (i.e., the low-grade chronic inflammation characterizing the advancement of age) [7] and contributing to the pathophysiology of inflammation-related diseases frequently observed in the elderly [8,9,10,11]
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