Alterations in the Oral Microbiome Associated With Diabetes, Overweight, and Dietary Components

Abeer Shaalan, Sunjae Lee, Catherine Feart, Esther Garcia-Esquinas, David Gomez-Cabrero, Esther Lopez-Garcia, Martine Morzel, Eric Neyraud, Fernando Rodriguez-Artalejo, Ricarda Streich, Gordon Proctor

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9 Scopus citations


The Mediterranean diet (MedDiet) represents the traditional food consumption patterns of people living in countries bordering the Mediterranean Sea and is associated with a reduced incidence of obesity and type-2 diabetes mellitus (T2DM). The objective of this study was to examine differences in the composition of the oral microbiome in older adults with T2DM and/or high body mass index (BMI) and whether the microbiome was influenced by elements of a MedDiet. Using a nested case-control design individuals affected by T2DM were selected from the Seniors-ENRICA-2 cohort concurrently with non-diabetic controls. BMI was measured, a validated dietary history taken, and adherence to a Mediterranean diet calculated using the MEDAS (Mediterranean Diet Adherence Screener) index. Oral health status was assessed by questionnaire and unstimulated whole mouth saliva was collected, and salivary flow rate calculated. Richness and diversity of the salivary microbiome were reduced in participants with T2DM compared to those without diabetes. The bacterial community structure in saliva showed distinct “signatures” or “salivatypes,” characterized by predominance of particular bacterial genera. Salivatype 1 was more represented in subjects with T2DM, whilst those with obesity (BMI ≥ 30 kg/m2) had a predominance of salivatype 2, and control participants without T2DM or obesity had an increased presence of salivatype 3. There was an association of salivatype 1 with increased consumption of sugary snacks combined with reduced consumption of fish/shellfish and nuts. It can be concluded that the microbial community structure of saliva is altered in T2DM and obesity and is associated with altered consumption of particular food items. In order to further substantiate these observations a prospective study should be undertaken to assess the impact of diets aimed at modifying diabetic status and reducing weight.
Original languageEnglish (US)
JournalFrontiers in Nutrition
StatePublished - Jul 6 2022

Bibliographical note

KAUST Repository Item: Exported on 2022-09-14
Acknowledgements: This work was initiated by the Joint Programming Initiative, A Healthy Diet for a Healthy Life (HDHL). The SALAMANDER project was funded by Agence Nationale de la Recherche, France (grant no. ANR16-HDHL-0005-01), Biotechnology and Biological Sciences Research Council, United Kingdom (grant no. BB/R000891/1), and the Ministry of Economy and Competitiveness, Spain (APCIN grant no. 2016-145). SL was supported by a GIST Research Institute (GRI) GIST-MIT research Collaboration grant by the GIST in 2022; the “2020 Joint Research Project of Institutes of Science and Technology” at South Korea; the KHIDI-AZ Diabetes Research Program, South Korea; and the Basic Science Research Program (2021R1C1C1006336) of the Ministry of Science, ICT through the National Research Foundation, South Korea. We are grateful to Erica Prosdocimi and William Wade for advice and discussions.


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