Association between dietary intake of foods estimated to contain live microbes and health indicators in Australian adults: An exploratory analysis

The goal of this article was to develop a database for estimating and categorizing live microbe (LM) content in common foods and beverages, compatible with data from the Australian Eating Survey food frequency questionnaire (AES-FFQ). A secondary aim was to apply these data to examine the relationship between estimated live dietary microbe intake (derived from self-reported LM-containing food consumption), cardiometabolic health indicators, and inflammatory markers. We hypothesized that greater consumption of foods with higher estimated live microbe content would be associated with better cardiometabolic health in adults. Foods were categorized by potential viable microorganism concentration based on published methods: low (<10⁴ CFU/g), medium (10⁴-10⁷ CFU/g), or high (>10⁷ CFU/g). These LM categories were mapped to a subset of AUStralian Food and NUTrient database food codes corresponding to AES-FFQ items. Using cross-sectional baseline data from healthy adults, estimated live dietary microbe intakes were calculated, and relationships with demographic, anthropometric, and clinical chemistry data were analyzed using adjusted weighted least-squares regression. Foods were assigned to LM categories for more than 200 foods from the AUStralian Food and NUTrient database corresponding with AES-FFQ food items. Dietary data from 58 adults were analyzed to assess associations between estimated live dietary microbe intake and health outcomes. Higher self-reported dietary intake of foods with estimated medium-to-high live dietary microbe content was inversely associated with body weight (P = .008), body mass index (P = .005), waist circumference (P < .001), and plasma insulin concentration (P = .001), and positively associated with high-density lipoprotein cholesterol (P < .001). No significant associations were observed with fasting plasma glucose, total, low-density lipoprotein and non-high-density lipoprotein cholesterol, triglycerides or tumor necrosis factor-alpha. Findings from this exploratory analysis suggest that more frequent consumption of foods potentially containing LM is associated with some indicators of lower chronic disease risk. Further research is needed to explore estimated live dietary microbe intake and health outcomes.