Impact of personalized diet and probiotic supplementation on inflammation, nutritional parameters and intestinal microbiota - The "RISTOMED project": Randomized controlled trial in healthy older people

Clin Nutr. 2015 Aug;34(4):593-602. doi: 10.1016/j.clnu.2014.09.023. Epub 2014 Oct 8.

Abstract

Objectives: To assess the impact of a personalized diet, with or without addition of VSL#3 preparation, on biomarkers of inflammation, nutrition, oxidative stress and intestinal microbiota in 62 healthy persons aged 65-85 years.

Design: Open label, randomized, multicenter study.

Primary endpoint: High-sensitivity C-reactive protein.

Setting: Community.

Interventions: Eight week web-based dietary advice (RISTOMED platform) alone or with supplementation of VSL#3 (2 capsules per day). The RISTOMED diet was optimized to reduce inflammation and oxidative stress.

Measurements: Blood and stool samples were collected on days 1 and 56.

Results: Diet alone reduced ESR (p = 0.02), plasma levels of cholesterol (p < 0.01) and glucose (p = 0.03). Addition of VSL#3 reduced ESR (p = 0.05) and improved folate (p = 0.007), vitamin B12 (p = 0.001) and homocysteine (p < 0.001) plasma levels. Neither intervention demonstrated any further effects on inflammation. Subgroup analysis showed 40 participants without signs of low-grade inflammation (hsCRP<3 mg/l, subgroup 1) and 21 participants with low-grade inflammation at baseline (hsCRP≥3 mg/l, subgroup 2). In subgroup 2 addition of VSL#3 increased bifidobacteria (p = 0.005) in more participants and improved both folate (p = 0.015) and vitamin B12 (p = 0.035) levels compared with subgroup 1. The increases were positively correlated to the change in the bifidobacteria concentration for folate (p = 0.023) and vitamin B12 (p = 0.001). As expected change in homocysteine correlated negatively to change in folate (r = -0.629, p = 0.002) and vitamin B12 (r = -0.482, p = 0.026).

Conclusions: Addition of VSL#3 increased bifidobacteria and supported adequate folate and vitamin B12 concentrations in subjects with low-grade inflammation. Decrease in homocysteine with VSL#3 was clinically relevant. suggesting protective potentials for aging-associated conditions, e.g. cardiovascular or neurological diseases. ClinicalTrials.gov: NCT01069445-NCT01179789.

Keywords: Aging; Inflammation; Internet; Nutritional software; Oxidative stress; VSL#3.

Publication types

  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Biological Products / metabolism
  • Biomarkers / blood
  • Blood Glucose / metabolism
  • C-Reactive Protein / metabolism
  • Cholesterol / blood
  • Diet
  • Dietary Supplements*
  • Feeding Behavior*
  • Female
  • Folic Acid / blood
  • Gastrointestinal Microbiome*
  • Homocysteine / blood
  • Humans
  • Inflammation / therapy*
  • Intestines / microbiology*
  • Lactobacillus / metabolism
  • Lactobacillus delbrueckii / metabolism
  • Lactobacillus plantarum / metabolism
  • Male
  • Oxidative Stress / physiology
  • Probiotics / administration & dosage*
  • Streptococcus thermophilus / metabolism
  • Vitamin B 12 / blood

Substances

  • Biological Products
  • Biomarkers
  • Blood Glucose
  • Homocysteine
  • bifidobacterin
  • C-Reactive Protein
  • Folic Acid
  • Cholesterol
  • Vitamin B 12

Associated data

  • ClinicalTrials.gov/NCT01069445
  • ClinicalTrials.gov/NCT01179789