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. 2021 Sep 29;13(10):3459.
doi: 10.3390/nu13103459.

A Six-Day, Lifestyle-Based Immersion Program Mitigates Cardiovascular Risk Factors and Induces Shifts in Gut Microbiota, Specifically Lachnospiraceae, Ruminococcaceae, Faecalibacterium prausnitzii: A Pilot Study

Angelica P Ahrens  1 , Tyler Culpepper  2 , Brittany Saldivar  2 , Stephen Anton  3 , Scott Stoll  4 , Eileen M Handberg  5 , Ke Xu  6 , Carl Pepine  5 , Eric W Triplett  1 , Monica Aggarwal  5
Affiliations

A Six-Day, Lifestyle-Based Immersion Program Mitigates Cardiovascular Risk Factors and Induces Shifts in Gut Microbiota, Specifically Lachnospiraceae, Ruminococcaceae, Faecalibacterium prausnitzii: A Pilot Study

Angelica P Ahrens et al. Nutrients. .

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.

Keywords: TMAO; cardiovascular disease; cholesterol; hsCRP; hypertension; inflammation; lifestyle; microbiome; plant based diet; whole food.

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Conflict of interest statement

Aggarwal has 5% of her time protected through a Gatorade funded education grant. She receives royalties from general-interest books on health and sometimes receives lecture honoraria. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript, or in the decision to publish the results.

Figures

Figure 1
Figure 1
Schedule of the six-day intervention.
Figure 2
Figure 2
Microbial shifts across the intervention among the most abundant taxa. (a) Bacterial taxa significantly increased in subjects at T1 (red) versus T2 (green) as identified by Linear discriminant analysis Effect Size (LEfSe) analysis; (b) bacterial clades of the respective bacteria.
Figure 3
Figure 3
Change in relative abundances correlated with change in anthropometric measures. Spearman correlation of change in relative abundance and change in anthropometric measures across the intervention. Significant correlations are marked with an asterisk, with color and size of the circle indicative of the strength of correlation at right. (a) Family and genus level correlations; (b) species and ASV level correlations. ASV sequence IDs indicated by X. BMI, body mass index; HDL, high-density lipoprotein; TMAO, trimethylamine N-oxide.
Figure 3
Figure 3
Change in relative abundances correlated with change in anthropometric measures. Spearman correlation of change in relative abundance and change in anthropometric measures across the intervention. Significant correlations are marked with an asterisk, with color and size of the circle indicative of the strength of correlation at right. (a) Family and genus level correlations; (b) species and ASV level correlations. ASV sequence IDs indicated by X. BMI, body mass index; HDL, high-density lipoprotein; TMAO, trimethylamine N-oxide.
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