Influence of a 3-month low-calorie Mediterranean diet compared to the vegetarian diet on human gut microbiota and SCFA: the CARDIVEG Study

  • Giuditta Pagliai
  • Edda Russo
  • Elena Niccolai
  • Monica Dinu
  • Vincenzo Di Pilato
  • Alessandro Magrini
  • Gianluca Bartolucci
  • Simone Baldi
  • Marta Menicatti
  • Betti Giusti
  • Rossella Marcucci
  • Gian Maria Rossolini
  • Alessandro Casini
  • Francesco Sofi
  • Amedeo AmedeiEmail author
Original Contribution



We evaluated the effect of low-calorie mediterranean (MD) and vegetarian (VD) diets on gut microbiome (GM) composition and short-chain-fatty acids (SCFA) production.


We performed next generation sequencing (NGS) of 16S rRNA and SCFA analysis on fecal samples of 23 overweight omnivores (16 F; 7 M) with low-to-moderate cardiovascular risk. They were randomly assigned to a VD or MD, each lasting 3 months, with a crossover study design.


Dietary interventions did not produce significant diversity in the GM composition at higher ranks (family and above), neither between nor within MD and VD, but they did it at genus level. MD significantly changed the abundance of Enterorhabdus, Lachnoclostridium and Parabacteroides, while VD significantly affected the abundance of Anaerostipes, Streptococcus, Clostridium sensu stricto, and Odoribacter. Comparison of the mean variation of each SCFA between MD and VD showed an opposite and statistically significant trend for propionic acid (+ 10% vs − 28%, respectively, p = 0.034). In addition, variations of SCFA were negatively correlated with changes of some inflammatory cytokines such as VEGF, MCP-1, IL-17, IP-10 and IL-12, only after MD. Finally, correlation analyses showed a potential relationship—modulated by the two diets—between changes of genera and changes of clinical and biochemical parameters.


A short-term dietary intervention with MD or VD does not induce major change in the GM, suggesting that a diet should last longer than 3 months for scratching the microbial resilience. Changes in SCFA production support their role in modulating the inflammatory response, thus mediating the anti-inflammatory and protective properties of MD.


Microbiota SCFA Cardiovascular diseases Cytokines Mediterranean diet Vegetarian diet 



The research was founded with a grant from the regional contribution of “The Programma Attuativo Regionale (Toscana) funded by FAS (now FSC), Grant number 4042.16092014.066000029, the Italian Ministry of University and Research (MIUR) and the Foundation ‘Ente Cassa di Risparmio di Firenze’.

Author contributions

AA and FS conceived the study, participated in the design of the study, wrote the study protocol, and prepared the final version of the manuscript. FS has been responsible for recruitment and clinical evaluations. GP, ER and MD, participated in the design of the study. ER and SB conducted microbiota experiments. GB, SB and MM performed SCFA analysis. AM, EN and VP performed the statistical analysis. RM participated in the writing of the study protocol. AC, GMR and BG participated in the design of the study and critical revision of the manuscript for important intellectual content. EN, GP, ER wrote the manuscript. All authors read and approved the final manuscript. All authors read and commented on the manuscript.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Supplementary material

394_2019_2050_MOESM1_ESM.pdf (1.9 mb)
Supplementary material 1 (PDF 1975 kb)


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  • Giuditta Pagliai
    • 1
  • Edda Russo
    • 1
  • Elena Niccolai
    • 1
  • Monica Dinu
    • 1
  • Vincenzo Di Pilato
    • 1
  • Alessandro Magrini
    • 1
  • Gianluca Bartolucci
    • 2
  • Simone Baldi
    • 1
  • Marta Menicatti
    • 2
  • Betti Giusti
    • 1
    • 3
  • Rossella Marcucci
    • 1
    • 3
  • Gian Maria Rossolini
    • 1
  • Alessandro Casini
    • 1
    • 4
  • Francesco Sofi
    • 1
    • 4
    • 5
  • Amedeo Amedei
    • 1
    • 6
    Email author
  1. 1.Department of Experimental and Clinical MedicineUniversity of FlorenceFlorenceItaly
  2. 2.Department of Neurosciences, Psychology, Drug Research and Child Health Section of Pharmaceutical and Nutraceutical SciencesUniversity of FlorenceFlorenceItaly
  3. 3.Atherothrombotic Diseases UnitCareggi University HospitalFlorenceItaly
  4. 4.Clinical Nutrition UnitCareggi University HospitalFlorenceItaly
  5. 5.IRCCS Don Carlo Gnocchi FoundationFlorenceItaly
  6. 6.Department of BiomedicineCareggi University HospitalFlorenceItaly

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