One-Year Consumption of a Mediterranean-Like Dietary Pattern With Vitamin D3 Supplements Induced Small Scale but Extensive Changes of Immune Cell Phenotype, Co-receptor Expression and Innate Immune Responses in Healthy Elderly Subjects: Results From the United Kingdom Arm of the NU-AGE Trial

Abstract

Amongst the major features of aging are chronic low grade inflammation and a decline in immune function. The Mediterranean diet (MedDiet) is considered to be a valuable tool to improve health status, and although beneficial effects have been reported, to date, immunological outcomes have not been extensively studied. We aimed to test the hypothesis that 1 year of a tailored intervention based on the MedDiet with vitamin D (10 μg/day) would improve innate immune responses in healthy elderly subjects (65–79 years) from the English cohort (272 subjects recruited) of the NU-AGE randomized, controlled study (clinicaltrials.gov, NCT01754012). Of the 272 subjects forming the United Kingdom cohort a subgroup of 122 subjects (61 in the intervention group and 61 in the control group) was used to evaluate ex vivo innate immune response, phenotype of circulating immune cells, and levels of pro- and anti-inflammatory markers. Odds Ratio (OR) was calculated for all the parameters analyzed. After adjustment by gender, MedDiet-females with a BMI < 31 kg/m2 had a significant upregulation of circulating CD40+CD86+ cells (OR 3.44, 95% CI 1.01–11.75, P = 0.0437). Furthermore, in all MedDiet subjects, regardless of gender, we observed a MedDiet-dependent changes, although not statistically significant of immune-critical parameters including T cell degranulation, cytokine production and co-receptor expression. Overall, our study showed that adherence to an individually tailored Mediterranean-like dietary pattern with a daily low dose of vitamin D3 supplements for 1 year modified a large variety of parameters of immune function in healthy, elderly subjects. We interpreted these data as showing that the MedDiet in later life could improve aspects of innate immunity and thus it could aid the design of strategies to counteract age-associated disturbances.Clinical Trial Registration: clinicaltrials.gov, NCT01754012.

Adherence to a Mediterranean diet is associated with a lower risk of later-onset Crohn’s disease: results from two large prospective cohort studies

“…Specifically, in Healthy Lifestyle in Europe by Nutrition in Adolescence study, adherence to a Mediterranean diet was associated with an attenuation in oxidative stress response in adolescents 45. Similarly, in the randomised controlled trial of European Project on Nutrition in Elderly People, adherence to a Mediterranean diet for 1 year was associated with significant changes in innate and adaptive immunity as measured by T cell degranulation, cytokine production and co-receptor expression 8. These results are further supported by a number of cross-sectional analyses of patients with immune-mediated disorders including CD and psoriasis demonstrating an inverse relationship between adherence to a Mediterranean diet and disease activity 9 46.…”

“…Our findings have plausible biologic mechanisms. Several dietary intervention studies have demonstrated significant changes in inflammatory markers, immune cell populations and response to oxidative stress with Mediterranean diet 8 45. Specifically, in Healthy Lifestyle in Europe by Nutrition in Adolescence study, adherence to a Mediterranean diet was associated with an attenuation in oxidative stress response in adolescents 45.…”

“…First, ecologic studies have demonstrated lower incidence of IBD in Southern Europe where there is a higher consumption of a Mediterranean diet 6. Second, previous studies have shown that a Mediterranean diet reduces plasma levels of inflammatory markers such as high sensitivity C-reactive protein and tumour necrosis factor alpha and the risk of development and progression of other immune-mediated disorders including psoriasis and rheumatoid arthritis 7–10. Since IBD is characterised by a subclinical disease state marked by elevation in inflammatory and serological markers,11 12 adherence to a Mediterranean diet may have a plausible benefit in preventing development of clinically significant disease.…”

One-year Mediterranean diet promotes epigenetic rejuvenation with country- and sex-specific effects: a pilot study from the NU-AGE project

“…Probands were enrolled in five European countries (Italy, Poland, France, the Netherlands, and the UK), and a 1-year Mediterranean-like diet was administered to the intervention subgroup. A comprehensive clinical and molecular characterization was performed at baseline and after the 1-year intervention, and results achieved so far in the framework of this study have demonstrated a beneficial effect of the Mediterranean-like diet on global cognition and episodic memory (Marseglia et al 2018), osteoporosis , immune function (Maijo et al 2018), and cardiovascular health , as well as on the proteasomal proteolysis (Athanasopoulou et al 2018). The NU-AGE study design (different countries with different dietary traditions and habits) and the large number of collected data allowed to evaluate the impact of relevant variables usually poorly investigated (age, sex, and ethnicity/genetics, as well as individual characteristics) on different parameters at baseline and after the intervention (Konz et al 2018;Marseglia et al 2018;Ostan et al 2018;Pujos-Guillot et al 2018;Santoro et al 2018Santoro et al , 2019Jennings et al 2019).…”

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

“…A significant association was observed between increased adherence to the NU-AGE MedDiet and enhanced global cognitive ability and episodic memory 17. Moreover, higher adherence has been shown to reduce the rate of bone loss in individuals with osteoporosis18 and to improve innate immune function,19 blood pressure and arterial stiffness 20. In the current study we have profiled the effect of the NU-AGE MedDiet on the gut microbial community of a subset of participants from the NU-AGE trial comprising 612 individuals (289 controls (145 men and 144 women) and 323 with the NU-AGE MedDiet (141 men and 182 women)).…”