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Association of probable post-traumatic stress disorder with dietary pattern and gut microbiome in a cohort of women

Nature Mental Health volume 1, pages 900–913 (2023)Cite this article

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Abstract

Post-traumatic stress disorder (PTSD) is a psychiatric condition that may occur in people who have experienced or witnessed traumatic events. The microbiota–gut–brain axis has been suggested to play an important role in mental health. Here we analysed information on trauma exposure and PTSD symptoms with gut microbiome data and dietary information of 191 individuals enrolled in a substudy of an ongoing longitudinal cohort of women. We demonstrated that higher PTSD symptom levels were associated with less adherence to the Mediterranean diet pattern, and this association was also linked to specific PTSD putative protective species such as Eubacterium eligens. Moreover, the microbial pathways involved in the biosynthesis of pantothenate and coenzyme A were identified as PTSD putative protective, and these pathways were mainly contributed by PTSD putative protective species such as Akkermansia muciniphila. These findings have the potential to inform dietary- or microbiome-based interventions for PTSD prevention or amelioration.

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Fig. 1: Conceptual framework of the study.
Fig. 2: The stability of gut microbiome over time in a cohort of adult women.
Fig. 3: Host factors associated with the gut microbiome.
Fig. 4: Associations between the diversity of the gut microbiome and PTSD status.
Fig. 5: Correlation among PTSD score, host factors and microbiome diversity.

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Data availability

The data that support the findings of our study can be accessed through Brigham and Women’s Hospital and Harvard T.H. Chan School of Public Health. Data are available (https://sites.google.com/channing.harvard.edu/cohortdocs/) with the permission of Brigham and Women’s Hospital and Harvard T.H. Chan School of Public Health.

Code availability

The codes for statistical analyses and visualization are available in the GitHub repository (https://github.com/ShanlinKe/PTSD).

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Acknowledgements

Y.-Y.L. is supported by grants R01AI141529, R01HD093761, RF1AG067744, UH3OD023268, U19AI095219 and U01HL089856 from the National Institutes of Health, USA, as well as a pilot grant from the Biology of Trauma Initiative of Broad Institute, USA. K.C.K., A.R., L.D.K. and A.L.R. are supported by R01MH101269 from the National Institutes of Health, USA. Y.-Y.L. and K.C.K. are supported by the Harvard T.H. Chan School of Public Health Dean’s Fund for Scientific Advancement Incubation Award, and the Office of the Assistant Secretary of Defense for Health Affairs, through the Traumatic Brain Injury and Psychological Health Research Program (Focused Program Award) under award no. (W81XWH-22-S-TBIPH2), endorsed by the Department of Defense, USA. S.K. is supported by the Women’s Health Interdisciplinary Stress Program of Research (WHISPR) Pilot Grant from the Connors Center at Brigham and Women’s Hospital. Research reported in this publication was also supported by the NHSII cohort infrastructure grant U01 CA176726 from National Institutes of Health, USA.

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Authors and Affiliations

  1. Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA

    Shanlin Ke, Xu-Wen Wang, Tianyi Huang & Yang-Yu Liu

  2. Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA

    Andrew Ratanatharathorn

  3. Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA

    Tianyi Huang

  4. Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA

    Andrea L. Roberts

  5. Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, IL, USA

    Francine Grodstein

  6. Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA

    Laura D. Kubzansky

  7. Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA

    Karestan C. Koenen

  8. Center for Artificial Intelligence and Modeling, The Carl R. Woese Institute for Genomic Biology, University of Illinois at Urbana–Champaign, Champaign, IL, USA

    Yang-Yu Liu

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  8. Karestan C. Koenen
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  9. Yang-Yu Liu
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Contributions

Y.-Y.L. and K.C.K. conceived, designed and obtained funding for the project. S.K. performed all the data analysis. X.-W.W. contributed to the code of diet and nutrition data analysis. A.R., A.L.R. and T.H. contributed to the analysis of PTSD symptoms and phenotypic data. K.C.K., L.D.K., and Y.-Y.L. contributed to the result interpretation. S.K. and Y.-Y.L. wrote the manuscript. X.-W.W., A.R., T.H., A.L.R., F.G., L.D.K. and K.C.K. revised the manuscript. All authors approved the manuscript.

Corresponding authors

Correspondence to Karestan C. Koenen or Yang-Yu Liu.

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Nature Mental Health thanks Sahar El Aidy and the other, anonymous reviewers for their contribution to the peer review of this work.

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Supplementary information

Supplementary Information

Supplementary Figs. 1–11, discussion and Tables 1–7.

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Source data

Source Data Fig. 2

Statistical source data: microbial diversity. Source Data Fig. 3 Statistical source data: EnvFit test. Source Data Fig. 4 Statistical source data: microbial diversity. Source Data Fig. 5 Statistical source data: correlation matrix. Source Data Extended Data Fig./Table 1 Statistical source data: number pf species/pathways. Source Data Extended Data Fig./Table 2 Statistical source data: microbiome at phyla level. Source Data Extended Data Fig./Table 3 Statistical source data: abundance of PTSD-related species. Source Data Extended Data Fig./Table 4 Statistical source data: abundance of PTSD-related pathways. Source Data Extended Data Fig./Table 5 Statistical source data: sample size. Source Data Extended Data Fig./Table 6 Statistical source data: associations between foods and species. Source Data Extended Data Fig./Table 7 Statistical source data: associations between nutrients and species. Source Data Extended Data Fig./Table 8 Statistical source data: E. ligens and PTSD over time. Source Data Extended Data Fig./Table 9 Statistical source data: contributional diversity of pantothenate and CoA biosynthesis-related pathways. Source Data Extended Data Fig./Table 10 Statistical source data: pantothenate and CoA biosynthesis and PTSD over time. Source Data Extended Data Fig./Table 11 Statistical source data: mediation analysis.

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Ke, S., Wang, XW., Ratanatharathorn, A. et al. Association of probable post-traumatic stress disorder with dietary pattern and gut microbiome in a cohort of women. Nat. Mental Health 1, 900–913 (2023). https://doi.org/10.1038/s44220-023-00145-6

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