Abstract
Objective
To evaluate the effect of a low-carbohydrate, high-protein (LC/HP) diet that includes
healthy dietary components (eg, lean meat, whole grains, fruits and vegetables, fiber,
etc) on the gut microbiome composition in individuals with chronic spinal cord injury
(SCI).
Design
A single-center randomized parallel controlled trial.
Setting
Research University.
Participants
Adult participants with chronic SCI (N=19, 3 years or more after the injury, C2-L2,
American Spinal Injury Association Impairment Scale A-D). Participants were insulin
resistant and had not received antibiotics within 4 weeks before enrolling in the
study.
Interventions
Participants were randomized to the LC/HP diet group (40% energy from carbohydrates,
30% energy from protein, and 30% energy from fat and met dietary guideline recommendations)
or the control group for 8 weeks. Participants assigned to the LC/HP group were provided
with all meals delivered weekly to their homes. Participants assigned to the control
group were asked to continue their usual diet.
Main Outcome Measures
Stool samples were collected at baseline and the end of week 8. The gut microbiome
16S ribosomal RNA V4 region was sequenced, and gut microbiome diversity and taxonomical
abundance were computed using the QIIME2 suite.
Results
Participants in the LC/HP group had significant changes in alpha-diversity (reduced
operational taxonomic unit and Faith's phylogenetic diversity) and beta-diversity
(unweighted UniFrac), while no significant differences were observed among participants
in the control group after the intervention. Moreover, several taxa changed differently
over time between groups, including increased Bacteroides thetaiotaomicron, Coprococcus 3, Fusicatenibacter, Tannerellaceae, and decreased Tyzzerella, Phascolarctobacterium, Romboutsia, Clostridium sensu stricto 1, Hungatella,
Ruminococcus gauvreauii, family XI, and Bacillales among participants in the diet group, while these taxa
did not change in the control group.
Conclusions
An LC/HP diet with healthy dietary components improved gut microbiome composition
in individuals with SCI, including increased bacteria implicated in fiber metabolism
and reduced bacteria communities linked to cardiometabolic disorders.
Keywords
List of abbreviations:
ANCOM (analysis of composition of microbiomes), ASV (amplicon sequence variant), GD (gut dysbiosis), LC/HP (low-carbohydrate/high-protein diet), OGTT (oral glucose tolerance test), OTU (operational taxonomic unit), QIIME2 (Quantitative Insights Into Microbial Ecology 2), SCFA (short-chain fatty acid), SCI (spinal cord injury)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: April 10, 2022
Accepted:
March 7,
2022
Received in revised form:
March 2,
2022
Received:
October 22,
2021
Footnotes
Work in the laboratory of C. Yarar-Fisher was supported by The National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR UAB Spinal Cord Injury Model Systems Grant: NIDILRR-90SI5019).
Clinical Trial Registration No.: NCT03207841.
Disclosures: none
Identification
Copyright
© 2022 by the American Congress of Rehabilitation Medicine.
