ESPEN 2022 Late Breaking Abstracts

Topic: Nutrition and chronic disease

Abstract Submission Identifier: ESPEN22-LB-2236

EFFECT OF THE MEDITERRANEAN DIET ON FECAL BILE ACIDS AND FECAL LONG-CHAIN FATTY ACIDS (LIBRE STUDY)

B. Seethaler^*, ¹, T. Stoll ¹, A. M. Neyrinck ², N. M. Delzenne ², M. Kiechle ³, S. C. Bischoff ¹

¹Institute of Nutritional Medicine, University of Hohenheim, Stuttgart, Germany, ²Metabolism and Nutrition Research Group, Louvain Drug Research Institute, UCLouvain, Université catholique de Louvain, Brussels, Belgium, ³Department of Gynecology, Center for Hereditary Breast and Ovarian Cancer, Klinikum Rechts der Isar, Technical University Munich and Comprehensive Cancer Center Munich, Munich, Germany

Rationale: Adherence to the Mediterranean diet (MedD) reduces the risk of breast cancer, yet the underlying mechanisms are largely unknown. LIBRE, a randomized controlled trial [1], assesses the effect of the MedD on breast cancer in an at-risk population. Here, we assess possible effects of the MedD on fecal bile acids (BAs) and fecal long-chain fatty acids (LCFAs), which are associated with cancer development.

Methods: 87 women were randomized to the intervention group (IG, n=45, repeated training on the MedD), or the control group (CG, n=42, lectured once on a standard healthy diet). Adherence to the MedD was assessed by the MedD Adherence Screener score (MEDAS) and the MedD-Score [2] at baseline (BL) and after 3 and 12 months (V1, V2). Fecal BAs were analyzed by mass spectrometry/HPLC; fecal LCFAs were analyzed by gas chromatography. Statistics: Wilcoxon tests, Spearman correlations.

Results: Adherence to the MedD increased markedly in the IG (MEDAS: BL-V1 +31%, BL-V2 +31%; MedD-Score: BL-V1 +33%, BL-V2 +67%; all p<0.001) and increased mildly in the CG solely after 3 months (MEDAS: BL-V1 +17%, p<0.01). After one year, fecal levels of the anti-carcinogenic ursodeoxycholic acid increased in the IG but not in the CG (IG: +66%, p<0.05). The carcinogenic LCFA C16:0 decreased by trend in the IG but not in the CG (IG: BL-V2 -8%, p=0.063). Accordingly, the MedD-Scores correlated inversely with C16:0 in the IG: BL: r=-0.330, p=0.027; V1: r=-0.303, p=0.043 (MEDAS); V1: r=-0.332, p=0.026; V2: r=-0.299, p=0.046 (MedD-Score). Furthermore, the anti-carcinogenic alpha-linolenic acid increased in the IG but not in the CG (IG: BL-V1 +155%, BL-V2 +221%, p<0.05).

Conclusion: Adherence to the MedD improved fecal BA and LCFA profiles, which may decrease breast cancer risk [3,4].

References: [1] Kiechle et al., Trials, 2016. [2] Trichopoulou et al., N Engl J Med, 2003. [3] Režen et al., Cell Mol Life Sci, 2022. [4] Liu & Ma, Nutrients, 2014.

Disclosure of Interest: None Declared

Keywords: Bile acids, Breast cancer, Mediterranean diet, Polyunsaturated fatty acids