High intake of vegetables is linked to lower white blood cell profile and the effect is mediated by the gut microbiome

BMC Med. 2021 Feb 11;19(1):37. doi: 10.1186/s12916-021-01913-w.


Background: Chronic inflammation, which can be modulated by diet, is linked to high white blood cell counts and correlates with higher cardiometabolic risk and risk of more severe infections, as in the case of COVID-19.

Methods: Here, we assessed the association between white blood cell profile (lymphocytes, basophils, eosinophils, neutrophils, monocytes and total white blood cells) as markers of chronic inflammation, habitual diet and gut microbiome composition (determined by sequencing of the 16S RNA) in 986 healthy individuals from the PREDICT-1 nutritional intervention study. We then investigated whether the gut microbiome mediates part of the benefits of vegetable intake on lymphocyte counts.

Results: Higher levels of white blood cells, lymphocytes and basophils were all significantly correlated with lower habitual intake of vegetables, with vegetable intake explaining between 3.59 and 6.58% of variation in white blood cells after adjusting for covariates and multiple testing using false discovery rate (q < 0.1). No such association was seen with fruit intake. A mediation analysis found that 20.00% of the effect of vegetable intake on lymphocyte counts was mediated by one bacterial genus, Collinsella, known to increase with the intake of processed foods and previously associated with fatty liver disease. We further correlated white blood cells to other inflammatory markers including IL6 and GlycA, fasting and post-prandial glucose levels and found a significant relationship between inflammation and diet.

Conclusion: A habitual diet high in vegetables, but not fruits, is linked to a lower inflammatory profile for white blood cells, and a fifth of the effect is mediated by the genus Collinsella.

Trial registration: The ClinicalTrials.gov registration identifier is NCT03479866 .

Keywords: Chronic inflammation; Diet; Gut microbiome; Vegetable intake; White blood cell.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Actinobacteria
  • Adult
  • Biomarkers / blood
  • COVID-19
  • Clostridiales
  • Clostridium
  • Diet*
  • Fasting
  • Female
  • Fruit*
  • Gastrointestinal Microbiome / genetics*
  • Humans
  • Interleukin-6 / blood
  • Leukocyte Count
  • Leukocytes*
  • Lymphocyte Count
  • Male
  • Mediation Analysis
  • Middle Aged
  • RNA, Ribosomal, 16S / genetics
  • Ruminococcus
  • SARS-CoV-2
  • Vegetables*


  • Biomarkers
  • Interleukin-6
  • RNA, Ribosomal, 16S

Associated data

  • ClinicalTrials.gov/NCT03479866