A simple dietary approach to increase plant diversity improves gut microbiome and gut symptoms in healthy adults: The ZOE BIOME study
A.C. Creedon 1, 2, H. Bernard1,  F. Amati1,3, M. Wallace1, A. Arrè1, A. Platts1, F. Giordano1, J. Capdevila1, F. Asnicar3, T.D. Spector 1, 4, S.E. Berry1, 2
1. Zoe Ltd, London, UK.
2. Department of Nutritional Sciences, School of Life Course Sciences, King’s College London, London, UK
3. Department CIBIO, University of Trento, Trento, Italy
4. Department of Twin Research and Genetic Epidemiology, King’s College London, London, UK
Diets low in fibre-rich plant foods are a major contributing factor to the increasing prevalence of diet-related diseases globally(1). Associations between diets higher in fibre and decreased mortality from circulatory and digestive diseases(2) highlights the potential public health benefits of dietary interventions aimed at increasing fibre intakes. Increasing both the amount and diversity of plant foods may improve health via modulation of gut microbiome composition and function. We designed a simple dietary intervention to address low intakes of diverse plant foods and fibre, to potentially improve microbiome composition  and gut health.
The ZOE BIOME trial (NCT06231706) was a 6-week, parallel design randomised controlled trial conducted in 399 healthy adults in the UK, investigating the health effects of a simple dietary approach consisting of 30 whole-food ingredients high in plant polyphenolic compounds, fibre and micronutrients. Participants were randomised to the primary intervention (15g twice/day) or control group (bread croutons; 14g twice/day; isocaloric functional equivalent). The primary outcome was change in microbiome species, reported based on ranking of species associated with either favourable or unfavourable cardiometabolic health markers(3). Secondary outcomes were gut symptoms (gastrointestinal symptoms ratings scale), self reported hunger, energy and mood (visual analogue scales) assessed at baseline and 6 weeks.
A total of 352 (female, 266 (75.6%); mean age 50.7y (SD 7.9)) participants were included in the primary intention to treat analysis. In the intervention group, 132 microbiome species were significantly different between baseline and endpoint, compared to 37 species in the control. Of species identified in the intervention group, more favourable species (associated with favourable health measures(3) ) increased, while less favourable species decreased (p = 0.046), an effect not seen in the control group (p = 0.39). There were significant improvements in self reported outcomes in the intervention group (vs. control) for indigestion domain (-14% vs. -3%; p = 0.006), constipation domain (-12% vs 1%; p = 0.02), energy (18% vs 0%; p = 0.004) and happiness (5% vs -4%; p = 0.02). Adherence was high in both the intervention and control groups (98.3% vs 99.1%). There were no significant differences in hunger between groups.
This single whole food dietary approach to increase plant diversity and fibre is a simple strategy that we have shown benefits gut microbiome composition, gut symptoms and self-reported mood and energy over 6 weeks.

**A simple dietary approach to increase plant diversity improves gut microbiome and gut symptoms in healthy adults: The ZOE BIOME study**
A.C. Creedon 1, 2, H. Bernard1,  F. Amati1,3, M. Wallace1, A. Arrè1, A. Platts1, F. Giordano1, J. Capdevila1, F. Asnicar3, T.D. Spector 1, 4, S.E. Berry1, 2
1. Zoe Ltd, London, UK.
2. Department of Nutritional Sciences, School of Life Course Sciences, King’s College London, London, UK
3. Department CIBIO, University of Trento, Trento, Italy
4. Department of Twin Research and Genetic Epidemiology, King’s College London, London, UK
Diets low in fibre-rich plant foods are a major contributing factor to the increasing prevalence of diet-related diseases globally(1). Associations between diets higher in fibre and decreased mortality from circulatory and digestive diseases(2) highlights the potential public health benefits of dietary interventions aimed at increasing fibre intakes. Increasing both the amount and diversity of plant foods may improve health via modulation of gut microbiome composition and function. We designed a simple dietary intervention to address low intakes of diverse plant foods and fibre, to potentially improve microbiome composition  and gut health.
The ZOE BIOME trial (NCT06231706) was a 6-week, parallel design randomised controlled trial conducted in 399 healthy adults in the UK, investigating the health effects of a simple dietary approach consisting of 30 whole-food ingredients high in plant polyphenolic compounds, fibre and micronutrients. Participants were randomised to the primary intervention (15g twice/day) or control group (bread croutons; 14g twice/day; isocaloric functional equivalent). The primary outcome was change in microbiome species, reported based on ranking of species associated with either favourable or unfavourable cardiometabolic health markers(3). Secondary outcomes were gut symptoms (gastrointestinal symptoms ratings scale), self reported hunger, energy and mood (visual analogue scales) assessed at baseline and 6 weeks.
A total of 352 (female, 266 (75.6%); mean age 50.7y (SD 7.9)) participants were included in the primary intention to treat analysis. In the intervention group, 132 microbiome species were significantly different between baseline and endpoint, compared to 37 species in the control. Of species identified in the intervention group, more favourable species (associated with favourable health measures(3) ) increased, while less favourable species decreased (_p_ = 0.046), an effect not seen in the control group (_p_ = 0.39). There were significant improvements in self reported outcomes in the intervention group (vs. control) for indigestion domain (-14% vs. -3%; _p_ = 0.006), constipation domain (-12% vs 1%; _p_ = 0.02), energy (18% vs 0%; _p_ = 0.004) and happiness (5% vs -4%; _p_ = 0.02). Adherence was high in both the intervention and control groups (98.3% vs 99.1%). There were no significant differences in hunger between groups.
This single whole food dietary approach to increase plant diversity and fibre is a simple strategy that we have shown benefits gut microbiome composition, gut symptoms and self-reported mood and energy over 6 weeks.

LB15 - A simple dietary approach to increase plant diversity improves gut microbiome and gut symptoms in healthy adults: The ZOE BIOME study.

Unique to the new Congress (previously the Summer Conference) is that you will have greater opportunity to engage with more nutrition science than ever before. In 2024 the core programme will be delivered by the Irish Section of The Nutrition Society, supported by the Science Committee. The theme of these symposia will be ‘new data – focused approaches and challenges’. Outside of the core programme you will have the chance to hear the latest research from the Society’s partner organisations, universities, the private sector and more, on a diverse range of research.