Dietary Patterns Affect the Gut Microbiome-The Link to Risk of Cardiometabolic Diseases

Abstract

Clusters of bacterial species within the gut microenvironment, or gut enterotype, have been correlated with cardiometabolic disease risk. The metabolic products and metabolites that bacteria produce, such as short-chain fatty acids, secondary bile acids, and trimethylamine, may also affect the microbial community and disease risk. Diet has a direct impact on the gut microenvironment by providing substrates to and promoting the colonization of resident bacteria. To date, few dietary patterns have been evaluated for their effect on the gut microbiome, but the Mediterranean diet and Vegetarian diets have shown favorable effects for both the gut microbiome and cardiometabolic disease risk. This review examines the gut microbiome as a mediator between these dietary patterns and cardiometabolic disease risk.

FIGURE 1

Schematic of known and proposed interactions between diet and cardiometabolic risk illustrates the known risk-reducing properties of Vegetarian and Mediterranean diets on cardiometabolic diseases and the proposed interactions between the Vegetarian and Mediterranean diets with the gut microbiome and gut-derived metabolites that can reduce cardiovascular disease risk. The thick, solid-black arrows represent a large pool of evidence to support a pathway; narrow, solid-black arrows represent an intermediate amount of evidence to support a pathway; narrow, dotted black lines represent emerging evidence to support a pathway; and narrow, dotted black lines with a question mark represent other possible mechanistic pathways. Vegetarian and Mediterranean diets can alter the presence or absence of various bacteria and, in turn, also alter the gut metabolome. The direct effect of the gut microbial environment on cardiovascular disease risk is unknown. Vegetarian and Mediterranean diets can also affect the production of gut metabolites by serving as substrate for the resident bacteria.