Carbohydrate quality, fecal microbiota and cardiometabolic health in older adults: a cohort study

ABSTRACT

The impact of carbohydrate quality, measured by the carbohydrate quality index (CQI), on gut microbiota and health has been scarcely investigated. The aim of this study was to cross-sectionally and longitudinally explore the relationships between CQI, fecal microbiota, and cardiometabolic risk factors in an elderly Mediterranean population at high cardiovascular risk. At baseline and 1-year, CQI was assessed from food frequency questionnaires data, cardiometabolic risk factors were measured, and fecal microbiota profiled from 16S sequencing. Multivariable-adjusted linear regression models were fitted to assess the associations between tertiles of baseline CQI, fecal microbiota, and cardiometabolic risk factors at baseline, and between tertiles of 1-year change in CQI, 1-year change in fecal microbiota and cardiometabolic risk factors. Cross-sectionally, higher CQI was positively associated with Shannon alpha diversity index, and abundance of genera Faecalibacterium and Christensenellaceae R7 group, and negatively associated with the abundance of Odoribacter, and uncultured Rhodospirillales genera. Some of these genera were associated with higher glycated hemoglobin and lower body mass index. In addition, we observed a positive association between CQI, and some pathways related with the metabolism of butyrate precursors and plants-origin molecules. Longitudinally, 1-year improvement in CQI was associated with a concurrent increase in the abundance of genera Butyrivibrio. Increased abundance of this genera was associated with 1-year improvement in insulin status. These observations suggest that a better quality of carbohydrate intake is associated with improved metabolic health, and this improvement could be modulated by greater alpha diversity and abundance of specific genera linked to beneficial metabolic outcomes.

KEYWORDS:

• Carbohydrate quality
• fecal microbiota
• cardiovascular disease
• Mediterranean diet

Acknowledgments

We thank all PREDIMED-Plus participants and investigators. CIBEROBN is, an initiative of the Instituto de Salud Carlos III (ISCIII), Madrid, Spain. The Hojiblanca (Lucena, Spain) and Patrimonio Comunal Olivarero (Madrid, Spain) food companies donated extra-virgin olive oil. The Almond Board of California (Modesto, CA), American Pistachio Growers (Fresno, CA), and Paramount Farms (Wonderful Company, LLC, Los Angeles, CA) donated nuts for the PREDIMED-Plus pilot study. The authors also thank the PREDIMED-Plus Biobank Network as a part of the National Biobank Platform of the ISCIII for storing and managing the PREDIMED-Plus biological samples. JSS senior author of this study gratefully acknowledges the financial support by ICREA under the ICREA Academia programme. The research groups want to thank Jasper Koehorst and Bart Nijsse from the Unlock platform for their support in processing the data with the NG-tax pipeline. We also want to thank Athanasia Ioannou for her work with the stool samples preparation.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Authors’ contributions

All the principal PREDIMED-Plus investigators contributed to study concept and design and to data extraction from the participants. AA performed the statistical analyses. AA and SKN drafted the manuscript. All authors reviewed the manuscript for important intellectual content and approved the final version to be published.

Data sharing

The datasets generated and analyzed during the current study are not publicly available due to data regulations and for ethical reasons, considering that this information might compromise research participants’ consent because our participants only gave their consent for the use of their data by the original team of investigators. However, collaboration for data analyses can be requested by sending a letter to the PREDIMED-Plus steering Committee ([email protected]). The request will then be passed to all the members of the PREDIMED-Plus Steering Committee for deliberation.

Supplementary material

Supplemental data for this article can be accessed online at https://doi.org/10.1080/19490976.2023.2246185

Additional information

Funding

This work was supported by the official Spanish Institutions for funding scientific biomedical research, CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN) and Instituto de Salud Carlos III (ISCIII), through the Fondo de Investigación para la Salud (FIS), which is co-funded by the European Regional Development Fund (six coordinated FIS projects leaded by JSS and JVi, including the following projects: PI13/00233, PI13/00728, PI13/00462, PI14/01206, PI14/00696, PI16/00533, PI16/00366, PI16/00501, PI17/01441, PI17/00855, PI19/00017, PI19/00781, PI19/00576, PI20/00557, PI21/0046; the Especial Action Project entitled: Implementación y evaluación de una intervención intensiva sobre la actividad física Cohorte PREDIMED-Plus grant to JSS; the Recercaixa (number 2013ACUP00194) grant to JSS; grants from the Consejería de Salud de la Junta de Andalucía (PI0458/2013, PS0358/2016, PI0137/2018); the PROMETEO/2017/017 and PROMETEO/2021/21 grants from the Conselleria de Innovación, Universidades, Ciencia y Sociedad Digital from the Generalitat Valenciana; and by and by NIH grant R01DK127601. This research was also partially funded by the Eat2beNICE/H2020-SFS-2016-2 EU-H2020 European grant). SKN is supported by a postdoctoral fellowship from the Canadian Institutes of Health Research (CIHR, MFE-171207). JSS, a senior author of this paper, was partially supported by ICREA under the ICREA Academia program.