BackgroundAssociations between dietary patterns, metabolic and inflammatory markers and gut microbiota are yet to be elucidated.ObjectivesWe aimed to characterize dietary patterns in overweight and obese subjects and evaluate the different dietary patterns in relation to metabolic and inflammatory variables as well as gut microbiota.DesignDietary patterns, plasma and adipose tissue markers, and gut microbiota were evaluated in a group of 45 overweight and obese subjects (6 men and 39 women). A group of 14 lean subjects were also evaluated as a reference group.ResultsThree clusters of dietary patterns were identified in overweight/obese subjects. Cluster 1 had the least healthy eating behavior (highest consumption of potatoes, confectionary and sugary drinks, and the lowest consumption of fruits that was associated also with low consumption of yogurt, and water). This dietary pattern was associated with the highest LDL cholesterol, plasma soluble CD14 (p = 0.01) a marker of systemic inflammation but the lowest accumulation of CD163+ macrophages with anti-inflammatory profile in adipose tissue (p = 0.05). Cluster 3 had the healthiest eating behavior (lower consumption of confectionary and sugary drinks, and highest consumption of fruits but also yogurts and soups). Subjects in this Cluster had the lowest inflammatory markers (sCD14) and the highest anti-inflammatory adipose tissue CD163+ macrophages. Dietary intakes, insulin sensitivity and some inflammatory markers (plasma IL6) in Cluster 3 were close to those of lean subjects. Cluster 2 was in-between clusters 1 and 3 in terms of healthfulness. The 7 gut microbiota groups measured by qPCR were similar across the clusters. However, the healthiest dietary cluster had the highest microbial gene richness, as evaluated by quantitative metagenomics.ConclusionA healthier dietary pattern was associated with lower inflammatory markers as well as greater gut microbiota richness in overweight and obese subjects.Trial RegistrationClinicalTrials.gov NCT01314690

KeywordsDietary patterns, digestive symptoms, health-related quality of life, women Running title Dietary patterns and digestive symptomsAuthorship BH was involved in the dietary analysis, interpretation of the results and preparation of the manuscript. DP, DG and BT designed the study and were involved in the analysis and the preparation of the manuscript. FHR and PR were responsible for the statistical analysis and commented on the manuscript. KW and BF advised on the analysis and interpretation of the results and preparation of the manuscript. All authors read and approved the final manuscript.Digestive symptoms are reported to result from a wide range of dietary components. Dietary 4 pattern analysis is a useful method of considering the entire diet, rather than individual foods or 5 nutrients, providing an opportunity to take interactions into account. The objective was to 6 investigate the relationship between diet, digestive symptoms and health-related quality of life 7 (HRQoL) in women reporting minor digestive symptoms, using a dietary pattern approach. 8 9 Research methods 10Analysis was performed on dietary and digestive symptoms data collected in France. Females 11 (n=308, aged 18-60yrs) reporting a bowel movement frequency within the normal range (3-21 12 stools/week) but with minor digestive symptoms in the previous month were investigated. 13Dietary data was collected using three 24-hr recalls. K-means was used to divide the dietary data 14 into clusters. The frequency of digestive symptoms (abdominal discomfort or pain, bloating, 15 flatulence, borborygmi) and bowel movements were evaluated over a two week period. HRQoL 16 was also assessed. Our results demonstrate that even within a relatively homogeneous sample of French women, 27 distinct dietary patterns can be identified but without significant differences in digestive 28 symptoms (except for flatulence), and HRQoL. 29