## 3 Results
### Effects of the Mediterranean Diet on the Intestinal Microbiome, Obesity, and Metabolic Syndrome
This can be ascribed to the ability of intestinal ALP to reduce inflammation by modifying gut microbiota synthesis and to dephosphorylate LPS, reducing intestinal permeability and increasing insulin sensitivity [28; 29]. Another transversal study investigated the relationship between the Mediterranean diet and gut microbiota in a group of 31 adults with non-declared pathology. Only those individuals who had not used antibiotics, glucocorticoids, immunosuppressive drugs, monoclonal antibodies, or other immunotherapies participated in this study. Dietary intake was evaluated using an annual semi-quantitative food frequency questionnaire (FFQ), with 160 items. Expert dieticians asked about cooking methods, the number and amounts of ingredients used in each recipe (e.g., type of oil or milk used), and other relevant information such as whether the participants at the fruit peels. During an interview, participants were asked, food by food, whether they normally consumed that food and how much they usually ate. For this purpose, three different serving sizes of each cooked food were presented in pictures to the participants so that they could choose from up to seven serving sizes. Food quantity was recorded in household units, by volume, or by measuring with a ruler. As for the alcoholic beverages, each participant was asked about the type and amount, for which household measures, such as a glass, a bottle, etc., were used. At the end of the study, there was an increase in the population of Bacteroidetes, Prevotella and a decrease in the population of Firmicutes and Lachnospiraceae. In addition, the Mediterranean diet increased faecal propionate and butyrate concentrations [30]. Table 1 summarizes the effects of the Mediterranean diet on the gut microbiome, in relation to the recent studies described previously. \begin{table}
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**Study Type** & **Study Sample/Duration** & **Participants** & **Protocol** & **Summary of Results** & **Study Reference** \\ \hline Clinical trial & 36 participants/3 months subjects, 18 normal-weight controls & 18 overweight/obese subjects, 18 normal-weight controls & Participants followed Mediterranean diet enriched with 40 g/day HQ-EVOO, 40 g/day HQ-EVOO, 40 g/day HQ-EVOO. & Mediterranean diet rich in HQ-EVO induced an increase in Lactobacillus strains in gut microbiota. & Mediterranean diet on the gut microbiome & Mediterranean diet & Mediterranean diet & Mediterranean diet & Mediterranean diet \\ \hline Randomized controlled trial & 82 Subjects/8 weeks & 82 overweight and obese subjects & 43 participants consumed a Mediterranean diet and 39 maintained their regular diets. & Reductions in carnitine and plasma cholesterol levels of _Facialibacterium_ & [24] \\ \hline \end{tabular}
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12-week single-arm pilot trial & 9 participants/12 weeks & Men and women 40-80 y, nonsmokers, with diagnosis of type 2 diabetes & Participants followed nutritional counseling sessions according to Mediterranean diet. & Increase in microbiota variety, wedella/Bacteroides ratio and reduction in HbA1c. & [27] \\ \hline Transversal study & 31 participants & 31 adults, 23 women, 8 men, 42 y with non-declared pathology & Following of Mediterranean diet. & Mediterranean diet increased the population of _Bacteroidetes_ & [30] \\ \hline \end{tabular}
\end{table} 
Table 1: Summary results of the effect of Mediterranean diet on human microbiome.