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Mediterranean Diet and Weight Loss: Targeting the Bile Acid/Gut Microbiome Axis to Reduce Colorectal Cancer

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Editor's note
Bile acid metabolism emerges as a mechanistic bridge between Mediterranean-style eating and colorectal cancer risk reduction—a pathway largely absent from obesity and prevention literature until now. This completed RCT in African Americans fills a critical evidence gap by testing whether diet composition alone, or diet plus weight loss, drives protective metabolite shifts; preliminary data suggest it may outperform calorie restriction in isolation. Gastroenterologists and preventive oncologists should monitor this for actionable guidance on personalized CRC prevention beyond generic weight loss counseling.

Source: ctgov · University of Illinois at Chicago · COMPLETED · 2026-05-27

URL: https://clinicaltrials.gov/study/NCT04753359

AI rationale (4/5, tier: emerging): RCT testing diet-microbiome-metabolite axis (bile acids, anti-cancer metabolites) in human cohort; directly targets keystone mechanisms but excludes mechanistic depth on specific taxa.

A Mediterranean Diet (MedDiet), a largely plant-based dietary pattern, is relevant to CRC prevention and microbial production of anti-cancer metabolites in observational studies. A MedDiet can shift BA metabolism as shown in primates and when combined with calorie restriction, shows superior adherence and weight control in humans, given its palatability. To date, no studies have tested in an RCT the effects of a MedDiet alone (MedA), WL through lifestyle intervention (WL-A) or a calorie-restricted MedDiet for WL (WL-Med) on the BA-gut microbiome axis and its relevance to CRC prevention among AAs. A multidisciplinary team combining expertise in psychology, nutrition, microbiology, molecular cell biology, computational biology, medicine and biostatistics, proposes to conduct a four-arm RCT in which 232 obese AAs, 45-75 years old complete one of the following 6-month interventions: Med-A, weight stable; WL-A, calorie restriction with no diet pattern change; WLMed; or Control. The investig

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Published 2026-05-28 · Last kit-update 2026-05-28