RT Journal Article SR Electronic T1 Mediterranean diet intervention alters the gut microbiome in older people reducing frailty and improving health status: the NU-AGE 1-year dietary intervention across five European countries JF Gut JO Gut FD BMJ Publishing Group Ltd and British Society of Gastroenterology SP 1218 OP 1228 DO 10.1136/gutjnl-2019-319654 VO 69 IS 7 A1 Tarini Shankar Ghosh A1 Simone Rampelli A1 Ian B Jeffery A1 Aurelia Santoro A1 Marta Neto A1 Miriam Capri A1 Enrico Giampieri A1 Amy Jennings A1 Marco Candela A1 Silvia Turroni A1 Erwin G Zoetendal A1 Gerben D A Hermes A1 Caumon Elodie A1 Nathalie Meunier A1 Corinne Malpuech Brugere A1 Estelle Pujos-Guillot A1 Agnes M Berendsen A1 Lisette C P G M De Groot A1 Edith J M Feskins A1 Joanna Kaluza A1 Barbara Pietruszka A1 Marta Jeruszka Bielak A1 Blandine Comte A1 Monica Maijo-Ferre A1 Claudio Nicoletti A1 Willem M De Vos A1 Susan Fairweather-Tait A1 Aedin Cassidy A1 Patrizia Brigidi A1 Claudio Franceschi A1 Paul W O'Toole YR 2020 UL http://gut.bmj.com/content/69/7/1218.abstract AB Objective Ageing is accompanied by deterioration of multiple bodily functions and inflammation, which collectively contribute to frailty. We and others have shown that frailty co-varies with alterations in the gut microbiota in a manner accelerated by consumption of a restricted diversity diet. The Mediterranean diet (MedDiet) is associated with health. In the NU-AGE project, we investigated if a 1-year MedDiet intervention could alter the gut microbiota and reduce frailty.Design We profiled the gut microbiota in 612 non-frail or pre-frail subjects across five European countries (UK, France, Netherlands, Italy and Poland) before and after the administration of a 12-month long MedDiet intervention tailored to elderly subjects (NU-AGE diet).Results Adherence to the diet was associated with specific microbiome alterations. Taxa enriched by adherence to the diet were positively associated with several markers of lower frailty and improved cognitive function, and negatively associated with inflammatory markers including C-reactive protein and interleukin-17. Analysis of the inferred microbial metabolite profiles indicated that the diet-modulated microbiome change was associated with an increase in short/branch chained fatty acid production and lower production of secondary bile acids, p-cresols, ethanol and carbon dioxide. Microbiome ecosystem network analysis showed that the bacterial taxa that responded positively to the MedDiet intervention occupy keystone interaction positions, whereas frailty-associated taxa are peripheral in the networks.Conclusion Collectively, our findings support the feasibility of improving the habitual diet to modulate the gut microbiota which in turn has the potential to promote healthier ageing.