The composition of the gut microbiome differs among community dwelling older people with good and poor appetite

Cox, Natalie and Roberts, Helen (2021) The composition of the gut microbiome differs among community dwelling older people with good and poor appetite. Journal of Cachexia, Sarcopenia and Muscle, 12 (2), 368-377. (doi:10.1002/jcsm.12683).

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Abstract

Background: Anorexia of ageing is common and important in the development of sarcopenia in older individuals. Links have been proposed between the gut microbiota and sarcopenia. Disordered gut function is also recognized in anorexia of ageing, but how this may relate to resident gut microbiota is unexplored. Understanding this relationship may provide a basis for novel interventions for anorexia of ageing and sarcopenia. This study explores compositional differences of the gut microbiota between community dwelling healthy older adults with good or poor appetite, and associated differences in sarcopenia. Methods: We assessed appetite by the Simplified Nutritional Appetite Questionnaire (SNAQ) in members of the TwinsUK cohort aged ≥65 years. Using a pool of 776 individuals with existing microbiome data estimated from 16S rRNA sequencing data, we identified 102 cases (SNAQ score < 14) (95% female, mean age 68 years) matched to controls (SNAQ > 14) on body mass index, gender, age, diet, calorie consumption, frailty, antibiotic use, socio-economic status, and technical variables to minimize confounding microbiota associations. Species abundance and diversity, compositional differences, and paired differences in taxa abundance were compared between cases and controls. Additionally, we compared case and controls for sarcopenia as measured by muscle mass (appendicular lean mass/height ²) and strength (chair stand time in seconds). Results: Cases with poor appetite had reduced species richness and diversity of their gut microbiome (adjusted OBSERVED: beta = −0.2, P < 0.001; adjusted SHANNON: beta = −0.17, P = 0.0135), significant compositional differences (adjusted non-parametric multivariate analysis of variance, P = 0.0095), and significant differences in taxa abundance including reduction of genus Lachnospira (logFC = −1.015, q = 0.023). In all-female subgroup analysis, cases with poor appetite demonstrated reduction in muscle strength (11.03 s vs. 9.26 s, P = 0.02). Conclusions: This study is the first to observe differences in the composition of gut microbiota between healthy community dwelling older individuals with good and poor appetite. We found female individuals with reduced muscle strength had poor appetite compared with those with normal strength. These associations require further examination to understand causality and mechanisms of interaction, to inform potential strategies targeting the gut microbiota as a novel intervention for anorexia of ageing and sarcopenia.

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Accepted/In Press date: 10 January 2021

e-pub ahead of print date: 13 February 2021

Published date: April 2021

Additional Information: Funding Information: N.J.C and H.C.R receive support from the National Institute of Health Research (NIHR) Southampton Biomedical Research Centre. H.C.R receives support from the NIHR Applied Research Collaboration (ARC) Wessex. M.N.L is funded by an NIHR Doctoral Fellowship (RE160685). TwinsUK is funded by the Wellcome Trust (WT081878MA), Medical Research Council, European Union, the NIHR-funded BioResource, Clinical Research Facility and Biomedical Research Centre based at Guy's and St Thomas' NHS Foundation Trust in partnership with King's College London. This work was also supported by the Chronic Disease Research Foundation. The views expressed are those of the authors and not necessarily those of the NHS, the NIHR or the Department of Health and Social Care. The authors of this paper wish to express our sincere appreciation and gratitude to all of the hard working support staff at TwinsUK and the study participants of the cohort for donating their samples and time and make what we do possible. We thank Dr Julia K. Goodrich, Dr Ruth E. Ley, and the Cornell technical team for generating the microbial sequence data. The authors of this manuscript certify that they comply with the ethical guidelines for authorship and publishing in the Journal of Cachexia, Sarcopenia, and Muscle.53 The study was performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments. Favourable ethical opinion was granted by the formerly known St Thomas' Hospital Research Ethics Committee (REC). Following restructure and merging of REC, subsequent amendments were approved by the NRES Committee London?Westminster (TwinsUK, REC ref: EC04/015, 1 November 2011); use of microbiota samples was granted NRES Committee London?Westminster (The Flora Twin Study, REC ref.: 12/LO/0227, 1 November 2011). Publisher Copyright: © 2021 The Authors. Journal of Cachexia, Sarcopenia and Muscle published by John Wiley & Sons Ltd on behalf of Society on Sarcopenia, Cachexia and Wasting Disorders

Keywords: Appetite, Gut microbiome, Nutrition, Older people, Sarcopenia