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European Journal of Nutrition
Published in: European Journal of Nutrition 7/2021

Open Access 01-10-2021 | Obesity | Original Contribution

Mediterranean diet consumption affects the endocannabinoid system in overweight and obese subjects: possible links with gut microbiome, insulin resistance and inflammation

Authors: Silvia Tagliamonte, Manolo Laiola, Rosalia Ferracane, Marilena Vitale, Maria A. Gallo, Victoria Meslier, Nicolas Pons, Danilo Ercolini, Paola Vitaglione

Published in: European Journal of Nutrition | Issue 7/2021

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Abstract

Purpose

To investigate whether a Mediterranean diet (MD) affected the plasma concentrations of endocannabinoids (ECs), N-acylethanolamines (NAEs) and their specific ratios in subjects with lifestyle risk factors for metabolic diseases. To identify the relationship between circulating levels of these compounds and gut microbiome, insulin resistance and systemic inflammation.

Methods

A parallel 8-week randomised controlled trial was performed involving 82 overweight and obese subjects aged (mean ± SEM) 43 ± 1.4 years with a BMI of 31.1 ± 0.5 kg/m2, habitual Western diet (CT) and sedentary lifestyle. Subjects were randomised to consume an MD tailored to their habitual energy and macronutrient intake (n = 43) or to maintain their habitual diet (n = 39). Endocannabinoids and endocannabinoid-like molecules, metabolic and inflammatory markers and gut microbiome were monitored over the study period.

Results

The MD intervention lowered plasma arachidonoylethanolamide (AEA, p = 0.02), increased plasma oleoylethanolamide/palmitoylethanolamide (OEA/PEA, p = 0.009) and OEA/AEA (p = 0.006) and increased faecal Akkermansia muciniphila (p = 0.026) independent of body weight changes. OEA/PEA positively correlated with abundance of key microbial players in diet–gut–health interplay and MD adherence. Following an MD, individuals with low-plasma OEA/PEA at baseline decreased homeostatic model assessment of insulin resistance index (p = 0.01), while individuals with high-plasma OEA/PEA decreased serum high-sensitive C-reactive protein (p = 0.02).

Conclusions

We demonstrated that a switch from a CT to an isocaloric MD affects the endocannabinoid system and increases A. muciniphila abundance in the gut independently of body weight changes. Endocannabinoid tone and microbiome functionality at baseline drives an individualised response to an MD in ameliorating insulin sensitivity and inflammation.
Clinical Trial Registry number and website NCT03071718; www.​clinicaltrials.​gov
Appendix
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Metadata
Title
Mediterranean diet consumption affects the endocannabinoid system in overweight and obese subjects: possible links with gut microbiome, insulin resistance and inflammation
Authors
Silvia Tagliamonte
Manolo Laiola
Rosalia Ferracane
Marilena Vitale
Maria A. Gallo
Victoria Meslier
Nicolas Pons
Danilo Ercolini
Paola Vitaglione
Publication date
01-10-2021
Publisher
Springer Berlin Heidelberg
Published in
European Journal of Nutrition / Issue 7/2021
Print ISSN: 1436-6207
Electronic ISSN: 1436-6215
DOI
https://doi.org/10.1007/s00394-021-02538-8

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