Abstract
Cardiovascular disease (CVD) prevalence remains elevated globally. We have previously shown that a one-week lifestyle “immersion program” leads to clinical improvements and sustained improvements in quality of life in moderate to high atherosclerotic CVD (ASCVD) risk individuals. In a subsequent year of this similarly modeled immersion program, we again collected markers of cardiovascular health and, additionally, evaluated intestinal microbiome composition. ASCVD risk volunteers (n = 73) completed the one-week “immersion program” involving nutrition (100% plant-based foods), stress management education, and exercise. Anthropometric measurements and CVD risk factors were compared at baseline and post intervention. A subgroup (n = 22) provided stool, which we analyzed with 16S rRNA sequencing. We assessed abundance changes within-person, correlated the abundance shifts with clinical changes, and inferred functional pathways using PICRUSt. Reductions in blood pressure, total cholesterol, and triglycerides, were observed without reduction in weight. Significant increases in butyrate producers were detected, including Lachnospiraceae and Oscillospirales. Within-person, significant shifts in relative abundance (RA) occurred, e.g., increased Lachnospiraceae (+58.8% RA, p = 0.0002), Ruminococcaceae (+82.1%, p = 0.0003), Faecalibacterium prausnitzii (+54.5%, p = 0.002), and diversification and richness. Microbiota changes significantly correlated with body mass index (BMI), blood pressure (BP), cholesterol, high-sensitivity C-reactive protein (hsCRP), glucose, and trimethylamine N-oxide (TMAO) changes. Pairwise decreases were inferred in microbial genes corresponding to cancer, metabolic disease, and amino acid metabolism. This brief lifestyle-based intervention improved lipids and BP and enhanced known butyrate producers, without significant weight loss. These results demonstrate a promising non-pharmacological preventative strategy for improving cardiovascular health.
Highlights
The prevalence of cardiovascular disease (CVD) remains elevated globally in part due to an increase in cardiovascular risk factors, such as diabetes, hypertension, and hypercholesterolemia [1]
A highly controlled, inpatient lifestyle intervention led to a reduction in body weight, blood pressure, glucose, and an increase in high-density lipoprotein (HDL), and these effects were sustained for 12 months post-intervention [12]
We previously demonstrated in a pilot study that a short, one week lifestyle intervention involving changes in both diet and physical activity significantly lowered blood pressure, total cholesterol, triglycerides and low-density lipoproteins (LDL)
Summary
The prevalence of cardiovascular disease (CVD) remains elevated globally in part due to an increase in cardiovascular risk factors, such as diabetes, hypertension, and hypercholesterolemia [1]. 50% of adult Americans are considered hypertensive, [2,3], approximately 12% have elevated cholesterol [4], and almost 11% of patients have diabetes This increase in cardiovascular risk factors is due, in part, to poor diet, smoking, and sedentary lifestyle [5,6]. Interventions that result in weight loss are associated with significant reductions in known cardiovascular risk factors including BP, low-density lipoproteins (LDL), triglycerides (TG), fasting glucose, and hemoglobin A1c (HbA1c) [9,10,11]. Such lifestyle interventions, whether low or high intensity, have been shown to have lasting effects. A highly controlled, inpatient lifestyle intervention led to a reduction in body weight, blood pressure, glucose, and an increase in HDL, and these effects were sustained for 12 months post-intervention [12]
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