Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Article
  • Published:

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

Subjects

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.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on SpringerLink
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

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.

Similar content being viewed by others

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).

References

  1. Koenen, K. C. et al. Post-traumatic stress disorder in the world mental health surveys. Psychol. Med. 47, 2260–2274 (2017).

    Article  PubMed  PubMed Central  Google Scholar 

  2. Hoppen, T. H. & Morina, N. The prevalence of PTSD and major depression in the global population of adult war survivors: a meta-analytically informed estimate in absolute numbers. Eur. J. Psychotraumatol. 10, 1578637 (2019).

    Article  PubMed  PubMed Central  Google Scholar 

  3. Brackbill, R. M. et al. Asthma and post-traumatic stress symptoms 5 to 6 years following exposure to the World Trade Center terrorist attack. JAMA 302, 502–516 (2009).

    Article  PubMed  Google Scholar 

  4. Remch, M., Laskaris, Z., Flory, J., Mora-McLaughlin, C. & Morabia, A. Post-traumatic stress disorder and cardiovascular diseases: a cohort study of men and women involved in cleaning the debris of the World Trade Center complex. Circ. Cardiovasc. Qual. Outcomes 11, e004572 (2018).

    Article  PubMed  PubMed Central  Google Scholar 

  5. Dedert, E. A., Calhoun, P. S., Watkins, L. L., Sherwood, A. & Beckham, J. C. Post-traumatic stress disorder, cardiovascular, and metabolic disease: a review of the evidence. Ann. Behav. Med. 39, 61–78 (2010).

    Article  PubMed  Google Scholar 

  6. Michopoulos, V., Powers, A., Gillespie, C. F., Ressler, K. J. & Jovanovic, T. Inflammation in fear- and anxiety-based disorders: PTSD, GAD, and beyond. Neuropsychopharmacology 42, 254–270 (2017).

    Article  PubMed  Google Scholar 

  7. Morasco, B. J. et al. The relationship between PTSD and chronic pain: mediating role of coping strategies and depression. Pain 154, 609–616 (2013).

    Article  PubMed  PubMed Central  Google Scholar 

  8. Masodkar, K., Johnson, J. & Peterson, M. J. A review of post-traumatic stress disorder and obesity: exploring the link. Prim. Care Companion CNS Disord. https://doi.org/10.4088/PCC.15r01848 (2016).

  9. Scherrer, J. F. et al. Association between clinically meaningful post-traumatic stress disorder improvement and risk of type 2 diabetes. JAMA Psychiatry 76, 1159–1166 (2019).

    Article  PubMed  PubMed Central  Google Scholar 

  10. Gradus, J. L. et al. Post-traumatic stress disorder and gastrointestinal disorders in the Danish population. Epidemiology 28, 354–360 (2017).

    Article  PubMed  PubMed Central  Google Scholar 

  11. Roberts, A. L. et al. Association of post-traumatic stress disorder with accelerated cognitive decline in middle-aged women. JAMA Netw. Open 5, e2217698 (2022).

    Article  PubMed  PubMed Central  Google Scholar 

  12. Li, Y., Hao, Y., Fan, F. & Zhang, B. The role of microbiome in insomnia, circadian disturbance and depression. Front. Psychiatry 9, 669 (2018).

    Article  PubMed  PubMed Central  Google Scholar 

  13. Skonieczna-Zydecka, K., Marlicz, W., Misera, A., Koulaouzidis, A. & Loniewski, I. Microbiome—the missing link in the gut-brain axis: focus on its role in gastrointestinal and mental health. J. Clin. Med. https://doi.org/10.3390/jcm7120521 (2018).

  14. Sharon, G., Sampson, T. R., Geschwind, D. H. & Mazmanian, S. K. The central nervous system and the gut microbiome. Cell 167, 915–932 (2016).

    Article  PubMed  PubMed Central  Google Scholar 

  15. Collins, S. M. & Bercik, P. The relationship between intestinal microbiota and the central nervous system in normal gastrointestinal function and disease. Gastroenterology 136, 2003–2014 (2009).

    Article  PubMed  Google Scholar 

  16. De Vadder, F. et al. Gut microbiota regulates maturation of the adult enteric nervous system via enteric serotonin networks. Proc. Natl Acad. Sci. USA 115, 6458–6463 (2018).

    Article  PubMed  PubMed Central  Google Scholar 

  17. Morais, L. H., Schreiber, H. L. T. & Mazmanian, S. K. The gut microbiota–brain axis in behaviour and brain disorders. Nat. Rev. Microbiol. https://doi.org/10.1038/s41579-020-00460-0 (2020).

    Article  PubMed  Google Scholar 

  18. Collins, S. M., Surette, M. & Bercik, P. The interplay between the intestinal microbiota and the brain. Nat. Rev. Microbiol. 10, 735–742 (2012).

    Article  PubMed  Google Scholar 

  19. Nikolova, V. L. et al. Perturbations in gut microbiota composition in psychiatric disorders: a review and meta-analysis. JAMA Psychiatry 78, 1343–1354 (2021).

    Article  PubMed  Google Scholar 

  20. Cowan, C. S. M. et al. Gutsy moves: the amygdala as a critical node in microbiota to brain signaling. Bioessays https://doi.org/10.1002/bies.201700172 (2018).

  21. Mahan, A. L. & Ressler, K. J. Fear conditioning, synaptic plasticity and the amygdala: implications for post-traumatic stress disorder. Trends Neurosci. 35, 24–35 (2012).

    Article  PubMed  Google Scholar 

  22. Jovanovic, T. & Ressler, K. J. How the neurocircuitry and genetics of fear inhibition may inform our understanding of PTSD. Am. J. Psychiatry 167, 648–662 (2010).

    Article  PubMed  PubMed Central  Google Scholar 

  23. Tawakol, A. et al. Relation between resting amygdalar activity and cardiovascular events: a longitudinal and cohort study. Lancet 389, 834–845 (2017).

    Article  PubMed  PubMed Central  Google Scholar 

  24. Osborne, M. T. et al. Amygdalar activity predicts future incident diabetes independently of adiposity. Psychoneuroendocrinology 100, 32–40 (2019).

    Article  PubMed  Google Scholar 

  25. Kim, Y. et al. Post-traumatic stress disorder and changes in diet quality over 20 years among US women. Psychol. Med. 51, 310–319 (2021).

    Article  PubMed  Google Scholar 

  26. van den Berk-Clark, C. et al. Association between post-traumatic stress disorder and lack of exercise, poor diet, obesity, and co-occuring smoking: a systematic review and meta-analysis. Health Psychol. 37, 407–416 (2018).

    Article  PubMed  PubMed Central  Google Scholar 

  27. Hirth, J. M., Rahman, M. & Berenson, A. B. The association of post-traumatic stress disorder with fast food and soda consumption and unhealthy weight loss behaviors among young women. J. Womens Health 20, 1141–1149 (2011).

    Article  Google Scholar 

  28. Vilija, M. & Romualdas, M. Unhealthy food in relation to post-traumatic stress symptoms among adolescents. Appetite 74, 86–91 (2014).

    Article  PubMed  Google Scholar 

  29. Makki, K., Deehan, E. C., Walter, J. & Backhed, F. The impact of dietary fiber on gut microbiota in host health and disease. Cell Host Microbe 23, 705–715 (2018).

    Article  PubMed  Google Scholar 

  30. Berg, G. et al. Microbiome definition re-visited: old concepts and new challenges. Microbiome 8, 103 (2020).

    Article  PubMed  PubMed Central  Google Scholar 

  31. Guinane, C. M. & Cotter, P. D. Role of the gut microbiota in health and chronic gastrointestinal disease: understanding a hidden metabolic organ. Ther. Adv. Gastroenterol. 6, 295–308 (2013).

    Article  Google Scholar 

  32. Hemmings, S. M. J. et al. Themicrobiome in post-traumatic stress disorder and trauma-exposed controls: an exploratory study. Psychosom. Med. 79, 936–946 (2017).

    Article  PubMed  PubMed Central  Google Scholar 

  33. Bajaj, J. S. et al. Post-traumatic stress disorder is associated with altered gut microbiota that modulates cognitive performance in veterans with cirrhosis. Am. J. Physiol. Gastrointest. Liver Physiol. 317, G661–G669 (2019).

    Article  PubMed  PubMed Central  Google Scholar 

  34. Malan-Muller, S. et al. Exploring the relationship between the gut microbiome and mental health outcomes in a post-traumatic stress disorder cohort relative to trauma-exposed controls. Eur. Neuropsychopharmacol. 56, 24–38 (2022).

    Article  PubMed  Google Scholar 

  35. Levert-Levitt, E. et al. Oral microbiota signatures in post-traumatic stress disorder (PTSD) veterans. Mol. Psychiatry https://doi.org/10.1038/s41380-022-01704-6 (2022).

    Article  PubMed  Google Scholar 

  36. Bao, Y. et al. Origin, methods, and evolution of the three Nurses’ Health Studies. Am. J. Public Health 106, 1573–1581 (2016).

    Article  PubMed  PubMed Central  Google Scholar 

  37. Koenen, K. C. et al. Protocol for investigating genetic determinants of post-traumatic stress disorder in women from the Nurses’ Health Study II. BMC Psychiatry 9, 29 (2009).

    Article  PubMed  PubMed Central  Google Scholar 

  38. Huang, T. et al. The mind–body study: study design and reproducibility and interrelationships of psychosocial factors in the Nurses’ Health Study II. Cancer Causes Control 30, 779–790 (2019).

    Article  PubMed  PubMed Central  Google Scholar 

  39. Truong, D. T. et al. MetaPhlAn2 for enhanced metagenomic taxonomic profiling. Nat. Methods 12, 902–903 (2015).

    Article  PubMed  Google Scholar 

  40. Franzosa, E. A. et al. Species-level functional profiling of metagenomes and metatranscriptomes. Nat. Methods 15, 962–968 (2018).

    Article  PubMed  PubMed Central  Google Scholar 

  41. Mehta, R. S. et al. Stability of the human faecal microbiome in a cohort of adult men. Nat Microbiol. 3, 347–355 (2018).

    Article  PubMed  PubMed Central  Google Scholar 

  42. Stewart, C. J. et al. Temporal development of the gut microbiome in early childhood from the TEDDY study. Nature 562, 583–588 (2018).

    Article  PubMed  PubMed Central  Google Scholar 

  43. Wang, D. D. et al. The gut microbiome modulates the protective association between a Mediterranean diet and cardiometabolic disease risk. Nat. Med. 27, 333–343 (2021).

    Article  PubMed  PubMed Central  Google Scholar 

  44. Arvidsson, L. et al. Bidirectional associations between psychosocial well-being and adherence to healthy dietary guidelines in European children: prospective findings from the IDEFICS study. BMC Public Health 17, 926 (2017).

    Article  PubMed  PubMed Central  Google Scholar 

  45. Mandal, S. et al. Analysis of composition of microbiomes: a novel method for studying microbial composition. Microb. Ecol. Health Dis. 26, 27663 (2015).

    PubMed  Google Scholar 

  46. Ke, S. et al. A computational method to dissect colonization resistance of the gut microbiota against pathogens. Cell Rep. Methods https://doi.org/10.1016/j.crmeth.2023.100576 (2023).

  47. Pascual Cuadrado, D. et al. Long-term molecular differences between resilient and susceptible mice after a single traumatic exposure. Br. J. Pharmacol. 179, 4161–4180 (2022).

    Article  PubMed  Google Scholar 

  48. Leonardi, R. & Jackowski, S. Biosynthesis of pantothenic acid and coenzyme A. EcoSal Plus https://doi.org/10.1128/ecosalplus.3.6.3.4 (2007).

  49. Leeming, E. R., Johnson, A. J., Spector, T. D. & Le Roy, C. I. Effect of diet on the gut microbiota: rethinking intervention duration. Nutrients https://doi.org/10.3390/nu11122862 (2019).

  50. Asnicar, F. et al. Microbiome connections with host metabolism and habitual diet from 1,098 deeply phenotyped individuals. Nat. Med. 27, 321–332 (2021).

    Article  PubMed  PubMed Central  Google Scholar 

  51. Chen, L. et al. Influence of the microbiome, diet and genetics on inter-individual variation in the human plasma metabolome. Nat. Med. 28, 2333–2343 (2022).

    Article  PubMed  PubMed Central  Google Scholar 

  52. Lynch, S. V. & Pedersen, O. The human intestinal microbiome in health and disease. N. Engl. J. Med. 375, 2369–2379 (2016).

    Article  PubMed  Google Scholar 

  53. Sze, M. A. & Schloss, P. D. Looking for a signal in the noise: revisiting obesity and the microbiome. mBio https://doi.org/10.1128/mBio.01018-16 (2016).

  54. Surana, N. K. & Kasper, D. L. Deciphering the tete-a-tete between the microbiota and the immune system. J. Clin. Invest. 124, 4197–4203 (2014).

    PubMed  PubMed Central  Google Scholar 

  55. Surana, N. K. & Kasper, D. L. Moving beyond microbiome-wide associations to causal microbe identification. Nature 552, 244–247 (2017).

    Article  PubMed  PubMed Central  Google Scholar 

  56. Cheung, S. G. et al. Systematic review of gut microbiota and major depression. Front Psychiatry 10, 34 (2019).

    Article  PubMed  PubMed Central  Google Scholar 

  57. Haran, J. P. et al. Alzheimer’s disease microbiome is associated with dysregulation of the anti-inflammatory P-glycoprotein pathway. mBio https://doi.org/10.1128/mBio.00632-19 (2019).

  58. De Angelis, M. et al. Fecal microbiota and metabolome of children with autism and pervasive developmental disorder not otherwise specified. PLoS ONE 8, e76993 (2013).

    Article  PubMed  PubMed Central  Google Scholar 

  59. Kimono, D. et al. Host Akkermansia muciniphila abundance correlates with Gulf War illness symptom persistence via NLRP3-mediated neuroinflammation and decreased brain-derived neurotrophic factor. Neurosci. Insights 15, 2633105520942480 (2020).

    Article  PubMed  PubMed Central  Google Scholar 

  60. Tyeryar, K. R., Vongtau, H. O. & Undieh, A. S. Diverse antidepressants increase CDP-diacylglycerol production and phosphatidylinositide resynthesis in depression-relevant regions of the rat brain. BMC Neurosci. 9, 12 (2008).

    Article  PubMed  PubMed Central  Google Scholar 

  61. Patassini, S. et al. Cerebral vitamin B5 (D-pantothenic acid) deficiency as a potential cause of metabolic perturbation and neurodegeneration in Huntington’s disease. Metabolites https://doi.org/10.3390/metabo9060113 (2019).

  62. Davison, K. M. & Kaplan, B. J. Nutrient intakes are correlated with overall psychiatric functioning in adults with mood disorders. Can. J. Psychiatry 57, 85–92 (2012).

    Article  PubMed  Google Scholar 

  63. Hayflick, S. J. Defective pantothenate metabolism and neurodegeneration. Biochem. Soc. Trans. 42, 1063–1068 (2014).

    Article  PubMed  PubMed Central  Google Scholar 

  64. Skarupski, K. A., Tangney, C. C., Li, H., Evans, D. A. & Morris, M. C. Mediterranean diet and depressive symptoms among older adults over time. J. Nutr. Health Aging 17, 441–445 (2013).

    Article  PubMed  PubMed Central  Google Scholar 

  65. Molendijk, M., Molero, P., Ortuno Sanchez-Pedreno, F., Van der Does, W. & Angel Martinez-Gonzalez, M. Diet quality and depression risk: a systematic review and dose–response meta-analysis of prospective studies. J. Affect. Disord. 226, 346–354 (2018).

    Article  PubMed  Google Scholar 

  66. Reyes-Rodriguez, M. L. et al. Post-traumatic stress disorder in anorexia nervosa. Psychosom. Med. 73, 491–497 (2011).

    Article  PubMed  PubMed Central  Google Scholar 

  67. Grilo, C. M., White, M. A., Barnes, R. D. & Masheb, R. M. Post-traumatic stress disorder in women with binge eating disorder in primary care. J. Psychiatr. Pract. 18, 408–412 (2012).

    Article  PubMed  PubMed Central  Google Scholar 

  68. Ghosh, T. S. et al. Mediterranean diet intervention alters the gut microbiome in older people reducing frailty and improving health status: the NU-AGE 1-year dietary intervention across five European countries. Gut 69, 1218–1228 (2020).

    Article  PubMed  Google Scholar 

  69. Flint, H. J., Scott, K. P., Duncan, S. H., Louis, P. & Forano, E. Microbial degradation of complex carbohydrates in the gut. Gut Microbes 3, 289–306 (2012).

    Article  PubMed  PubMed Central  Google Scholar 

  70. Chung, W. S. et al. Modulation of the human gut microbiota by dietary fibres occurs at the species level. BMC Biol. 14, 3 (2016).

    Article  PubMed  PubMed Central  Google Scholar 

  71. Dalile, B., Van Oudenhove, L., Vervliet, B. & Verbeke, K. The role of short-chain fatty acids in microbiota–gut–brain communication. Nat. Rev. Gastroenterol. Hepatol. 16, 461–478 (2019).

    Article  PubMed  Google Scholar 

  72. Procházková, N. et al. Advancing human gut microbiota research by considering gut transit time. Gut 72, 180–191 (2023).

    Article  PubMed  Google Scholar 

  73. Ohira, H., Tsutsui, W. & Fujioka, Y. Are short chain fatty acids in gut microbiota defensive players for inflammation and atherosclerosis? J. Atheroscler. Thromb. 24, 660–672 (2017).

    Article  PubMed  PubMed Central  Google Scholar 

  74. Koh, A., De Vadder, F., Kovatcheva-Datchary, P. & Backhed, F. From dietary fiber to host physiology: short-chain fatty acids as key bacterial metabolites. Cell 165, 1332–1345 (2016).

    Article  PubMed  Google Scholar 

  75. Pluznick, J. L. Microbial short-chain fatty acids and blood pressure regulation. Curr. Hypertens. Rep. 19, 25 (2017).

    Article  PubMed  PubMed Central  Google Scholar 

  76. Morgan, C. A. III. et al. Symptoms of dissociation in humans experiencing acute, uncontrollable stress: a prospective investigation. Am. J. Psychiatry 158, 1239–1247 (2001).

    Article  PubMed  Google Scholar 

  77. Schnurr PP, Vieilhauer MJ, Weathers F, Findler M. The Brief Trauma Questionnaire. (National Center for PTSD, 1999).

  78. Schnurr, P. P., Spiro, A., Vielhauer, M. J., Findler, M. N. & Hamblen, J. L. Trauma in the lives of older men: findings from the normative aging study. J. Clin. Geropsychol. 8, 175–187 (2002).

    Article  Google Scholar 

  79. Breslau, N., Peterson, E. L., Kessler, R. C. & Schultz, L. R. Short screening scale for DSM-IV post-traumatic stress disorder. Am. J. Psychiatry 156, 908–911 (1999).

    Article  PubMed  Google Scholar 

  80. Kubzansky, L. D. et al. The weight of traumatic stress: a prospective study of posttraumatic stress disorder symptoms and weight status in women. JAMA Psychiatry 71, 44–51 (2014).

    Article  PubMed  PubMed Central  Google Scholar 

  81. Roberts, A. L. et al. Post-traumatic stress disorder is associated with increased risk of ovarian cancer: a prospective and retrospective longitudinal cohort study. Cancer Res. 79, 5113–5120 (2019).

    Article  PubMed  PubMed Central  Google Scholar 

  82. Sumner, J. A. et al. Trauma exposure and post-traumatic stress disorder symptoms predict onset of cardiovascular events in women. Circulation 132, 251–259 (2015).

    Article  PubMed  PubMed Central  Google Scholar 

  83. Andresen, E. M., Malmgren, J. A., Carter, W. B. & Patrick, D. L. Screening for depression in well older adults: evaluation of a short form of the CES-D (Center for Epidemiologic Studies Depression Scale). Am. J. Prev. Med. 10, 77–84 (1994).

    Article  PubMed  Google Scholar 

  84. Lee, Y. C. et al. Post-traumatic stress disorder and risk for incident rheumatoid arthritis. Arthritis Care Res. 68, 292–298 (2016).

    Article  Google Scholar 

  85. Spitzer, R. L., Kroenke, K., Williams, J. B. & Lowe, B. A brief measure for assessing generalized anxiety disorder: the GAD-7. Arch. Intern. Med. 166, 1092–1097 (2006).

    Article  PubMed  Google Scholar 

  86. Bernstein, D. P. et al. Initial reliability and validity of a new retrospective measure of child abuse and neglect. Am. J. Psychiatry 151, 1132–1136 (1994).

    Article  PubMed  Google Scholar 

  87. Straus, M. A., Hamby, S. L., Finkelhor, D., Moore, D. W. & Runyan, D. Identification of child maltreatment with the parent–child conflict tactics scales: development and psychometric data for a national sample of American parents. Child Abuse Negl. 22, 249–270 (1998).

    Article  PubMed  Google Scholar 

  88. Sternthal, M. J., Slopen, N. & Williams, D. R. Racial disparities in health: how much does stress really matter? Du Bois Rev. 8, 95–113 (2011).

    Article  PubMed  PubMed Central  Google Scholar 

  89. Flint, A. J. et al. Food-addiction scale measurement in 2 cohorts of middle-aged and older women. Am. J. Clin. Nutr. 99, 578–586 (2014).

    Article  PubMed  PubMed Central  Google Scholar 

  90. Chiuve, S. E. et al. Alternative dietary indices both strongly predict risk of chronic disease. J. Nutr. 142, 1009–1018 (2012).

    Article  PubMed  PubMed Central  Google Scholar 

  91. Fung, T. T. et al. Diet-quality scores and plasma concentrations of markers of inflammation and endothelial dysfunction. Am. J. Clin. Nutr. 82, 163–173 (2005).

    Article  PubMed  Google Scholar 

  92. Fung, T. T. et al. Adherence to a DASH-style diet and risk of coronary heart disease and stroke in women. Arch. Intern. Med. 168, 713–720 (2008).

    Article  PubMed  Google Scholar 

  93. Varraso, R. et al. Alternate healthy eating index 2010 and risk of chronic obstructive pulmonary disease among US women and men: prospective study. BMJ 350, h286 (2015).

    Article  PubMed  PubMed Central  Google Scholar 

  94. Human Microbiome Project, C. A framework for human microbiome research. Nature 486, 215–221 (2012).

    Article  Google Scholar 

  95. Integrative HMP (iHMP) Research Network Consortium. The Integrative Human Microbiome Project. Nature 569, 641–648, (2019).

  96. Kneaddata. The Huttenhower Lab http://huttenhower.sph.harvard.edu/kneaddata (2017).

  97. Martino, C. et al. A novel sparse compositional technique reveals microbial perturbations. mSystems https://doi.org/10.1128/mSystems.00016-19 (2019).

  98. Tingley, D., Yamamoto, T., Hirose, K., Keele, L. & Imai, K. mediation: R package for causal mediation analysis. J. Stat. Softw. https://doi.org/10.18637/jss.v059.i05 (2014).

  99. Olson, C. A. et al. The gut microbiota mediates the anti-seizure effects of the ketogenic diet. Cell 173, 1728–1741e1713 (2018).

    Article  PubMed  PubMed Central  Google Scholar 

  100. McGaughey, K. D. et al. Relative abundance of Akkermansia spp. and other bacterial phylotypes correlates with anxiety- and depressive-like behavior following social defeat in mice. Sci. Rep. 9, 3281 (2019).

    Article  PubMed  PubMed Central  Google Scholar 

  101. Petrov, V. A. et al. Analysis of gut microbiota in patients with Parkinson’s disease. Bull. Exp. Biol. Med. 162, 734–737 (2017).

    Article  PubMed  Google Scholar 

  102. Barandouzi, Z. A., Starkweather, A. R., Henderson, W. A., Gyamfi, A. & Cong, X. S. Altered composition of gut microbiota in depression: a systematic review. Front. Psychiatry 11, 541 (2020).

    Article  PubMed  PubMed Central  Google Scholar 

  103. Allen, A. P. et al. Bifidobacterium longum 1714 as a translational psychobiotic: modulation of stress, electrophysiology and neurocognition in healthy volunteers. Transl. Psychiatry 6, e939 (2016).

    Article  PubMed  PubMed Central  Google Scholar 

  104. Savignac, H. M., Kiely, B., Dinan, T. G. & Cryan, J. F. Bifidobacteria exert strain-specific effects on stress-related behavior and physiology in BALB/c mice. Neurogastroenterol. Motil. 26, 1615–1627 (2014).

    Article  PubMed  Google Scholar 

  105. Liu, F. et al. Altered composition and function of intestinal microbiota in autism spectrum disorders: a systematic review. Transl. Psychiatry 9, 43 (2019).

    Article  PubMed  PubMed Central  Google Scholar 

  106. Flannery, J. E. et al. Gut feelings begin in childhood: the gut metagenome correlates with early environment, caregiving, and behavior. mBio https://doi.org/10.1128/mBio.02780-19 (2020).

  107. Borgo, F. et al. Microbiota in anorexia nervosa: the triangle between bacterial species, metabolites and psychological tests. PLoS ONE 12, e0179739 (2017).

    Article  PubMed  PubMed Central  Google Scholar 

Download references

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.

Author information

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

Authors
  1. Shanlin Ke
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Xu-Wen Wang
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Andrew Ratanatharathorn
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Tianyi Huang
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Andrea L. Roberts
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Francine Grodstein
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Laura D. Kubzansky
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Karestan C. Koenen
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Yang-Yu Liu
    View author publications

    You can also search for this author in PubMed Google Scholar

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.

Ethics declarations

Competing interests

The authors declare no competing interests.

Peer review

Peer review information

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

Additional information

Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Supplementary information

Supplementary Information

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

Reporting Summary

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.

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

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

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/s44220-023-00145-6

Search

Advanced search

Quick links

Nature Briefing

Sign up for the Nature Briefing newsletter — what matters in science, free to your inbox daily.

Get the most important science stories of the day, free in your inbox. Sign up for Nature Briefing