Older adults and healthcare professionals have limited awareness of the link between the Mediterranean diet and the gut microbiome for healthy aging

Lauren O'Mahony; Emma O'Shea; Eibhlís M O'Connor; Audrey Tierney; Mary Harkin; Janas Harrington; Sharon Kennelly; Elke Arendt; Paul W O'Toole; Suzanne Timmons

doi:10.3389/fnut.2023.1104238

Older adults and healthcare professionals have limited awareness of the link between the Mediterranean diet and the gut microbiome for healthy aging

Front Nutr. 2023 Jan 27:10:1104238. doi: 10.3389/fnut.2023.1104238. eCollection 2023.

Authors

Lauren O'Mahony¹, Emma O'Shea¹, Eibhlís M O'Connor^{2

3

4}, Audrey Tierney^{5

6}, Mary Harkin⁷, Janas Harrington⁸, Sharon Kennelly⁹, Elke Arendt¹⁰, Paul W O'Toole^{4

11}, Suzanne Timmons^{1

4}

Affiliations

¹ Centre for Gerontology and Rehabilitation, School of Medicine, University College Cork, Cork, Ireland.
² Department of Biological Sciences, University of Limerick, Limerick, Ireland.
³ Health Research Institute, University of Limerick, Limerick, Ireland.
⁴ APC Microbiome Ireland, Alimentary Pharmabiotic Centre, University College Cork, Cork, Ireland.
⁵ School of Allied Health, University of Limerick, Limerick, Ireland.
⁶ Health Implementation Science and Technology Research Cluster, Health Research Institute, University of Limerick, Limerick, Ireland.
⁷ Age and Opportunity, Dublin, Ireland.
⁸ School of Public Health, University College Cork, Cork, Ireland.
⁹ National Primary Care Strategy and Planning, Health Service Executive, Dublin, Ireland.
¹⁰ School of Food and Nutritional Sciences, University College Cork, Cork, Ireland.
¹¹ School of Microbiology, University College Cork, Cork, Ireland.

Abstract

Objectives: Strategies to improve the gut microbiome through consuming an improved diet, including adopting the Mediterranean Diet (MD), may promote healthy aging. We explored older adults' and healthcare professionals' (HCPs) perspectives of the MD, gut health, and microbiome for their role in healthy aging.

Design: Phenomenological qualitative.

Setting: Community-dwelling older adults and HCPs in primary and secondary care in Ireland.

Participants: Older adults (aged 55 + years), recruited through social, retirement and disease-support groups. HCPs recruited through researcher networks and professional associations.

Measurements: Semi-structured 1:1 interviews and focus groups (FGs) conducted remotely with older adults and HCPs separately. Interviews/FGs were recorded, transcribed, and coded using inductive thematic analysis.

Results: Forty-seven older adults were recruited (50% male; 49% aged 60-69 years; 28% 70 +), and 26 HCPs including dietitians (n = 8); geriatricians (n = 6); clinical therapists (n = 4); nurses, pharmacists, catering managers, and meal-delivery service coordinators (n = 2 each). Older adults considered the MD "a nice way to enjoy food," good for cardiovascular health and longevity, but with accessibility and acceptability challenges (increased salads/fish, different food environments, socio-cultural differences). HCPs felt the MD is included in healthy eating advice, but not overtly, mostly through the promotion of mixed-fiber intake. Older adults considered "live" yogurt and probiotics, and to a lesser extent fiber, to maintain a "healthy gut," suggesting the gut has "something to do with" cognitive and digestive health. Overall, microbiota-health effects were considered "not common knowledge" among most older adults, but becoming more topical among both professionals and the public with advancing scientific communication.

Conclusion: While "gut health" was considered important, specific effects of the MD on gut microbiota, and the significance of this for healthy aging, was under-recognized. Future efforts should explain the importance to older adults of maintaining the gut microbiota through diet, while appreciating perspectives of probiotic products and supplements.

Keywords: Mediterranean diet; aging; gut microbiota; healthcare professionals; healthy aging; microbiome; older adults; science communication.

Grants and funding

This research, as part of a wider project, was funded by the Science Foundation of Ireland (SFI), via the Food Challenge Future Innovator Prize scheme (Grant no. 20/FIP/FD/8863). Funders had no role in the design, analysis or writing of this article.