Mediterranean Diet and Probiotics

The Mediterranean diet and probiotics may be a match made in heaven. You have probably heard good things about the Mediterranean diet with its whole foods filled with plenty of fiber, vitamins, minerals, healthy fats and antioxidants. By reading this site, you already know about the wonderful things probiotics can do for you!

The Mediterranean diet is an eating plan focused on plant foods with: a high intake of vegetables, fruits, nuts, seeds, beans, tubers like sweet potatoes, peas and lentils, and herbs and spices; moderate amounts of whole grains, avocados and olive oil with optional red wine; and small amounts of cheese, yogurt, eggs and animal flesh (fish, poultry) from non-red meat. Red meat is seldom consumed. Processed and refined foods are avoided.

Details on what exactly this diet is may differ depending on who you talk to and which part of the Mediterranean region is considered. However, the basic premise is that the focus is on whole foods and positive lifestyle factors which include regular physical activity, sharing meals and enjoyment of life. In fact, the Mediterranean Diet Pyramid shows physical activity and enjoying time with others as the base of the pyramid. That is an important point because you can eat the cleanest diet on the planet, but if you are inactive and socially isolated you will not reap the full benefits of your choices.

This diet reduces the risk of heart disease, and reduces the incidences of cancer, Parkinson's and Alzheimer's diseases according to the Mayo Clinic. In 2018, a US News and World Report expert panel ranked the diet as tied with the DASH diet for the best diet overall and the best diet for healthy eating, plus it was ranked as the best diabetes diet, the best plant-based diet, and the easiest diet to follow, out of 40 diets.

What Do Mediterranean Diet and Probiotics Studies Show?

The Mediterranean diet can reduce gut-derived uremic toxins, as this page on TMAO reduction explains. Gut-derived uremic toxins, as the name suggests, are toxins that affect the kidneys. Additionally, they can also affect cardiovascular disease, neurological disorder, some cancers, and other conditions.

Also as the name suggests, these toxins are produced in the gut, specifically by certain gut bacteria. The Mediterranean diet reduces these toxins by affecting gut microbiota composition, including probiotics. The Mediterranean diet and probiotics are a good match for each other because one complements and promotes the beneficial effects of the other.

In a 2018 study by Nagpal et al. with monkeys that were socially housed but trained to eat their food in individual cages, diet differences caused gut microbiota differences, including differences in probiotic species.

The monkeys were fed two different diets for 2.5 years. Those fed a Mediterranean diet received fish oil, olive oil, fish meal, butter, egg, black and garbanzo bean flour, wheat flour, V8 vegetable juice, fruit puree and sucrose. This was not a whole foods diet, nor did it really compare to the human-based version of the diet.

The monkeys fed a Western diet  received lard, beef tallow, butter, egg, cholesterol, casein, lactalbumin, dextrin, high-fructose corn syrup and sucrose. This in no way resembled a whole-foods diet. The macronutrient percentages of protein, carbohydrate and fat were matched between the diets with 16% protein, 52-54% carbohydrate, and 31-32% fat. Cholesterol was also matched at 0.15-0.16 mg/Cal.

There was a relationship between the Mediterranean diet and probiotics. The microbiome diversity index from rectal/anal samples from Mediterranean diet monkeys was significantly higher by the Shannon diversity index compared to the Western diet monkeys. This is to be expected as a more diverse diet will support more diverse species. A higher Firmicutes-Bacteroides ratio and a significantly higher abundance of Clostridiacea and Lactobacillaceae families was found in the WD group compared to the MD group. Again, this is not surprising since Western diets are associated with higher Firmicutes and both of those families (which contain more than Clostridium and Lactobacillus species) are Firmicutes.

On a species level, the Mediterranean-diet monkeys boasted higher abundance of  Lactobacillus species. Lactobacillus salivarius was the most abundant Lactobacillus species. This also is not surprising because the Lactobacillus genus covers a wide range of species and strains that favor various food sources, and salivarius is a known commonly found probiotic species.

Why Did These Changes Occur between the Mediterranean Diet and Probiotics?

For one, the types of fat in a diet can affect gut populations. The Western diet had 39%, 35% and 25% saturated, monounsaturated and polyunsaturated fats, respectively, with an omega 6:omega3 ratio of 15:1. The Mediterranean diet had 25% saturated, 50% monounsaturated and 25% polyunsaturated fats with an omega 6:omega 3 ratio of 3:1. Monounsaturated fats, in particular, can act as prebiotics for beneficial bacteria, and olive oil is a great source. Omega-3 fatty acids are known to promote beneficial bacteria such as probiotic Lactobacillus.
A second major difference between the diets was fiber content. You may think that the Western diet had no fiber whatsoever, but in fact it was 9% of the diet. That is better than what many people today get, yet was low compared to 13% with the other diet. The fiber content difference in itself can affect gut microbial populations. Imagine what the differences between the diets could have been if whole foods were used instead of purees and juices!

The third major difference between the diets was the inclusion of plant compounds in the Mediterranean diet. Beyond fiber, plant compounds provide phytonutrients that can prebiotically act to stimulate beneficial bacteria such as probiotics. In turn, beneficial bacteria transform those plant compounds into active forms that our bodies can use and derive benefits from.

The Mediterranean Diet and Probiotics are Mutually Beneficial

The Mediterranean diet and probiotics are mutually beneficial. Abandoning the Western diet in favor of both can make significant positive changes in your health. Remember that other studies show the deleterious effects of the Western diet on diet-induced obesity, Type 2 diabetes, coronary artery disease and other conditions in monkeys and other animals. The Western diet is not healthy for any of us for many reasons.

If you'd like to learn more about eating in a way to benefit your gut microbiome and probiotics, please see "Probiotics: How to Use Them to Your Advantage."

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