Although epidemiological studies indicate that polyphenol-rich foods can have a relevant role in maintaining health, the demonstration of the effects in clinical trials has been rather vague. In many studies some volunteers respond to the intervention while others do not. For ellagitannins it is known that after their intake they are only absorbed in small amounts if at all, and they are metabolized in the colon by the gut microbiota leading to metabolites that have smaller size and that are much better absorbed than the precursors. Therefore, the metabolites produced in each individual depend on the gut microbiota composition and function. Three different and consistent metabotypes for the metabolism of ellagitannins have been reported (1). This means that in each individual, the ellagic acid metabolites that circulate in plasma depend on their metabotype, and therefore, they can show different health effects after the intervention. In a recent study on the effect of pomegranate extract on cardiovascular disease biomarkers in overweight-obese individuals, it was shown that the effect was not significant for the whole studied population. The significance, however, was reached when the volunteers were stratified according to their metabotype. In particular, the individuals of metabotype B responded better to the intervention taken the values of the biomarkers from a relevant risk at the beginning of the study, to normal values after 6 weeks of pomegranate polyphenol extract intake (2), while showed no relevant changes for those volunteers of metabotype A and metabotype 0. Something similar was previously reported for soybean isoflavones, as the equol producer metabotype (phenotype) responded improving cardiovascular disease biomarkers, while the equol non-producer metabotype did not show a response. Further studies have questioned the bioactivity of the metabolites produced (3), and suggest that they can also be biomarkers of the gut microbiota composition that is also known to be associated with the health status (4).<br/>

Stratification by gut microbiota metabotypes can explain differences in response to polyphenol dietary interventions

256th National Meeting (2018)

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