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Article

A Pilot Study on the Metabolic Impact of Mediterranean Diet in Type 2 Diabetes: Is Gut Microbiota the Key?

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Nutrition and Metabolism, NOVA Medical School, Faculdade de Ciências, Universidade NOVA de Lisboa, 1169-056 Lisboa, Portugal
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CINTESIS—Center for Health Technology Services Research, NOVA Medical School, Faculdade de Ciências, Universidade NOVA de Lisboa, 1169-056 Lisboa, Portugal
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Unidade Universitária Lifestyle Medicine José de Mello Saúde by NOVA Medical School, 1169-056 Lisboa, Portugal
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Endocrinology Department, Centro Hospitalar e Universitário Lisboa Central, 1069-166 Lisboa, Portugal
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CHRC—Comprehensive Health Research Center, CEDOC—Chronic Diseases Research Center, NOVA Medical School, Faculdade de Ciências, Universidade NOVA de Lisboa, 1169-056 Lisboa, Portugal
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Ophiomics-Precision Medicine, 1600-513 Lisboa, Portugal
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Laboratory Medicine Center Germano de Sousa, 1600-513 Lisboa, Portugal
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Author to whom correspondence should be addressed.
Academic Editor: Emilio Ros
Nutrients 2021, 13(4), 1228; https://doi.org/10.3390/nu13041228
Received: 26 February 2021 / Revised: 31 March 2021 / Accepted: 4 April 2021 / Published: 8 April 2021
(This article belongs to the Special Issue Nutrition and Metabolic Dysfunction)
The Mediterranean diet (MD) has been recommended for type 2 diabetes (T2D) treatment. The impact of diet in shaping the gut microbiota is well known, particularly for MD. However, the link between MD and diabetes outcome improvement is not completely clear. This study aims to evaluate the role of microbiota modulation by a nonpharmacological intervention in patients with T2D. In this 12-week single-arm pilot study, nine participants received individual nutritional counseling sessions promoting MD. Gut microbiota, biochemical parameters, body composition, and blood pressure were assessed at baseline, 4 weeks, and 12 weeks after the intervention. Adherence to MD [assessed by Mediterranean Diet Adherence Screener (MEDAS) score] increased after the intervention. Bacterial richness increased after 4 weeks of intervention and was negatively correlated with fasting glucose levels and Homeostatic Model Assessment for Insulin Resistance (HOMA-IR). Prevotella to Bacteroides ratio also increased after 4 weeks. In contrast, glycated haemoglobin (HbA1c) and HOMA-IR were only decreased at the end of study. Alkaline phosphatase activity was assessed in fecal samples and was negatively correlated with HbA1c and positively correlated with bacterial diversity. The results of this study reinforce that MD adherence results in a better glycemic control in subjects with T2D. Changes in gut bacterial richness caused by MD adherence may be relevant in mediating the metabolic impact of this dietary intervention. View Full-Text
Keywords: gut microbiota; Mediterranean diet; type 2 diabetes gut microbiota; Mediterranean diet; type 2 diabetes
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MDPI and ACS Style

Ismael, S.; Silvestre, M.P.; Vasques, M.; Araújo, J.R.; Morais, J.; Duarte, M.I.; Pestana, D.; Faria, A.; Pereira-Leal, J.B.; Vaz, J.; Ribeiro, P.; Teixeira, D.; Marques, C.; Calhau, C. A Pilot Study on the Metabolic Impact of Mediterranean Diet in Type 2 Diabetes: Is Gut Microbiota the Key? Nutrients 2021, 13, 1228. https://doi.org/10.3390/nu13041228

AMA Style

Ismael S, Silvestre MP, Vasques M, Araújo JR, Morais J, Duarte MI, Pestana D, Faria A, Pereira-Leal JB, Vaz J, Ribeiro P, Teixeira D, Marques C, Calhau C. A Pilot Study on the Metabolic Impact of Mediterranean Diet in Type 2 Diabetes: Is Gut Microbiota the Key? Nutrients. 2021; 13(4):1228. https://doi.org/10.3390/nu13041228

Chicago/Turabian Style

Ismael, Shámila, Marta P. Silvestre, Miguel Vasques, João R. Araújo, Juliana Morais, Maria Inês Duarte, Diogo Pestana, Ana Faria, José B. Pereira-Leal, Joana Vaz, Pedro Ribeiro, Diana Teixeira, Cláudia Marques, and Conceição Calhau. 2021. "A Pilot Study on the Metabolic Impact of Mediterranean Diet in Type 2 Diabetes: Is Gut Microbiota the Key?" Nutrients 13, no. 4: 1228. https://doi.org/10.3390/nu13041228

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