We recently showed that adherence to the Mediterranean diet increased the proportion of plasma omega-3 polyunsaturated fatty acids (n-3 PUFAs), which was associated with an improved intestinal barrier integrity. In the present exploratory analysis, we assessed fecal fatty acids in the same cohort, aiming to investigate possible associations with intestinal barrier integrity. Women from the LIBRE randomized controlled trial, characterized by an impaired intestinal barrier integrity, followed either a Mediterranean diet (intervention group, IG, n=33) or a standard diet (control group, CG, n=35). At baseline (BL), month 3 (V1), and month 12 (V2), plasma lipopolysaccharide binding protein (LBP), fecal zonulin, and fecal fatty acids were measured. In the IG, fecal proportions of palmitoleic acid (16:1, n-7) and arachidonic acid (20:4, n-6) decreased, while the proportion of linoleic acid (18:2, n-6) and alpha linoleic acid (18:3, n-3) increased (BL-V1 and BL-V2, all P<0.08). In the CG, fecal proportions of palmitic acid and arachidic acid increased while the proportion of linoleic acid decreased (BL-V1, all P<0.05). The decrease in the proportion of palmitoleic acid correlated with the decrease in plasma LBP (∆V1-BL r=0.72, P<0.001; ∆V2-BL r=0.39, P<0.05) and correlated inversely with adherence to the Mediterranean diet (Mediterranean diet score; ∆V1-BL r=-0.42, P=0.03; ∆V2-BL r=-0.53, P=0.005) in the IG. Our data show that adherence to the Mediterranean diet induces distinct changes in the fecal fatty acid composition. Furthermore, our data indicate that the fecal proportion of palmitoleic acid, but not fecal n-3 PUFAs, are associated with intestinal barrier integrity in the IG.

Intestinal barrier integrity is a prerequisite for homeostasis of mucosal function, which is balanced to maximise absorptive capacity, while maintaining efficient defensive reactions against chemical and microbial challenges. Evidence is mounting that disruption of epithelial barrier integrity is one of the major aetiological factors associated with several gastrointestinal diseases, including infection by pathogens, obesity and diabetes, necrotising enterocolitis, irritable bowel syndrome and inflammatory bowel disease. The notion that specific probiotic bacterial strains can affect barrier integrity fuelled research in which in vitro cell lines, animal models and clinical trials are used to assess whether probiotics can revert the diseased state back to homeostasis and health. This review catalogues and categorises the lines of evidence available in literature for the role of probiotics in epithelial integrity and, consequently, their beneficial effect for the reduction of gastrointestinal disease symptoms.

Dairy products derived from the milk of cows fed in pastures are characterised by higher amounts of conjugated linoleic acid and α-linolenic acid (ALA), and several studies have shown their ability to reduce cardiovascular risk. However, their specific metabolic effects compared with standard dairy in a high-fat diet (HFD) context remain largely unknown; this is what we determined in the present study with a focus on the metabolic and intestinal parameters. The experimental animals were fed for 12 weeks a HFD containing 20 % fat in the form of a pasture dairy cream (PDC) or a standard dairy cream (SDC). Samples of plasma, liver, white adipose tissue, duodenum, jejunum and colon were analysed. The PDC mice, despite a higher food intake, exhibited lower fat mass, plasma and hepatic TAG concentrations, and inflammation in the adipose tissue than the SDC mice. Furthermore, they exhibited a higher expression of hepatic PPARα mRNA and adipose tissue uncoupling protein 2 mRNA, suggesting an enhanced oxidative activity of the tissues. These results might be explained, in part, by the higher amounts of ALA in the PDC diet and in the liver and adipose tissue of the PDC mice. Moreover, the PDC diet was found to increase the proportions of two strategic cell populations involved in the protective function of the intestinal epithelium, namely Paneth and goblet cells in the small intestine and colon, compared with the SDC diet. In conclusion, a PDC HFD leads to improved metabolic outcomes and to a stronger gut barrier compared with a SDC HFD. This may be due, at least in part, to the protective mechanisms induced by specific lipids.