1.
Association between physical activity and changes in intestinal microbiota composition: A systematic review.
Aya, V, Flórez, A, Perez, L, Ramírez, JD
PloS one. 2021;16(2):e0247039
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The human gut flora or microbiota is made up of many different microorganisms, including bacteria, fungi, and viruses. Researchers still find it difficult to clearly define what constitutes a healthy gut flora. This is made more challenging by the fact that the array of microorganisms in the gut are influenced by multiple internal and external factors. Such as diet, sleep, circadian rhythm, age, and physical activity, and they also change with disease. This review sought to gather the current evidence on how physical activity (external factor) impacts the microbial make-up of the gut in healthy humans and the conferred metabolic benefits on the human host. The review included 17 studies with the findings from athletes and exercise intervention programs. Whereby some research demonstrates a consistent beneficial relationship between a favourable microbiota composition and exercise, the authors felt unable to draw a firm conclusion due to the complexity of the microbial system and other influencing factors. The authors called for further, larger scaled studies, that should distinguish between different types of exercise (i.e. endurance and high-intensity training) and age groups, as well as incorporating more information on the subject's diet and lifestyle factors. Of clinical relevance could be the potential of physical activity as a modulator gut microbiome composition.
Abstract
INTRODUCTION The intestinal microbiota comprises bacteria, fungi, archaea, protists, helminths and viruses that symbiotically inhabit the digestive system. To date, research has provided limited data on the possible association between an active lifestyle and a healthy composition of human microbiota. This review was aimed to summarize the results of human studies comparing the microbiome of healthy individuals with different physical activity amounts. METHODS We searched Medline/Ovid, NIH/PubMed, and Academic Search Complete between August-October 2020. Inclusion criteria comprised: (a) cross-sectional studies focused on comparing gut microbiome among subjects with different physical activity levels; (b) studies describing human gut microbiome responses to any type of exercise stimulus; (c) studies containing healthy adult women and men. We excluded studies containing diet modifications, probiotic or prebiotic consumption, as well as studies focused on diabetes, hypertension, cancer, hormonal dysfunction. Methodological quality and risk of bias for each study were assessed using the Risk Of Bias In Non-randomized Studies-of Interventions tool. The results from cross-sectional and longitudinal studies are shown independently. RESULTS A total of 17 articles were eligible for inclusion: ten cross-sectional and seven longitudinal studies. Main outcomes vary significantly according to physical activity amounts in longitudinal studies. We identified discrete changes in diversity indexes and relative abundance of certain bacteria in active people. CONCLUSION As literature in this field is rapidly growing, it is important that studies incorporate diverse methods to evaluate other aspects related to active lifestyles such as sleep and dietary patterns. Exploration of other groups such as viruses, archaea and parasites may lead to a better understanding of gut microbiota adaptation to physical activity and sports and its potentially beneficial effects on host metabolism and endurance.
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Links between metabolic syndrome and the microbiome.
Gildner, TE
Evolution, medicine, and public health. 2020;2020(1):45-46
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Metabolic syndrome (MetS) is a cluster of co-occurring pathological conditions, characterised by insulin resistance, abdominal obesity, hypertension and dyslipidaemia One possible factor contributing to MetS risk is change in microbiome composition. Diets high in processed foods appear to alter microbiome composition in ways that promote higher fat mass and insulin resistance. Additionally, a sedentary lifestyle decreases microbiome diversity, elevating inflammation and metabolic disease risk. Research on how the microbiome responds to modest, attainable changes in diet and physical activity will help identify which dietary adjustments and exercise types have the greatest potential to protect patients from MetS.
Abstract
Metabolic syndrome (MetS) is a cluster of harmful conditions which occur together, such as insulin resistance, abdominal obesity, and hypertension. The global prevalence of MetS is growing rapidly, with some estimates suggesting over one billion people worldwide experience increased morality and disease rates linked with this syndrome. One possible factor contributing to MetS risk is changes in microbiome composition. Approximately 100 trillion bacteria and other microbes reside in the human intestinal tract, collectively termed the gut microbiome. Humans and microbes share a long evolutionary history, with many of these microbes influencing human health outcomes. However, environmental conditions have changed dramatically with human technological innovations; many of these changes (e.g., diets high in processed foods and sedentary lifestyles) appear to impact human-microbe relationships. In general, recent changes in diet and activity patterns have been linked to decreased microbiome diversity, elevating inflammation and metabolic disease risk and likely promoting the development of MetS. Targeting patient diet or exercise patterns may therefore help doctors better treat patients suffering from MetS. Still, additional work is needed to determine how the microbiome responds to changes in patient activity and diet patterns across culturally and biologically diverse human populations.
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Association of the Functional Medicine Model of Care With Patient-Reported Health-Related Quality-of-Life Outcomes.
Beidelschies, M, Alejandro-Rodriguez, M, Ji, X, Lapin, B, Hanaway, P, Rothberg, MB
JAMA network open. 2019;2(10):e1914017
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The functional medicine model of care provides an operating system that works to reverse illness, promote health, and optimize function by addressing underlying causes, symptoms, and functional imbalances in interconnected biological networks. The aim of this study was to investigate the association between the functional medicine model of care and health-related quality of life (HRQoL) by comparing functional medicine with care received in a family medicine setting. The study is a single-centre retrospective cohort study which recruited 7252 new patients. The study evaluated the association of HRQoL in patients receiving functional medicine care vs patients receiving primary care. Results indicate that clients seen at the Centre for Functional Medicine were more likely to experience a clinically meaningful change in their (patient-reported outcome measurement information system and global physical health) scores at 6 months, which was less likely to decrease over time. Authors conclude that the functional medicine model of care may have beneficial and sustainable associations with improved HRQoL in patients as measured by patient-reported outcome measurement information system, global physical health and global mental health scores.
Abstract
Importance: The incidence of chronic disease is increasing along with health care-related costs. The functional medicine model of care provides a unique operating system to reverse illness, promote health, and optimize function. The association between this model of care and patient's health-related quality of life (HRQoL) is unknown. Objective: To assess the association between functional medicine and patient-reported HRQoL using Patient-Reported Outcome Measurement Information System (PROMIS) global health measures. Design, Setting, and Participants: A retrospective cohort study was performed to compare 7252 patients aged 18 years or older treated in a functional medicine setting with propensity score (PS)-matched patients in a primary care setting. Sensitivity analyses assessed improvement limited to patients seen at both 6 and 12 months. The study included patients who visited the Cleveland Clinic Center for Functional Medicine or a Cleveland Clinic family health center between April 1, 2015, and March 1, 2017. Main Outcomes and Measures: The primary outcome was change in PROMIS Global Physical Health (GPH) at 6 months. Secondary outcomes included PROMIS Global Mental Health (GMH) at 6 months and PROMIS GPH and GMH at 12 months. The PROMIS GPH and GMH scores were transformed to a T-score from 0 to 100 with a mean of 50. Higher scores indicate a better health-related quality of life. Results: Of the 7252 patients (functional medicine center: 1595; family health center: 5657), 4780 (65.9%) were women; mean (SD) age was 54.1 (16.0) years. At 6 months, functional medicine patients exhibited significantly larger improvements in PROMIS GPH T-score points than were seen in patients treated at a family health center (mean [SD] change, functional medicine center: 1.59 [6.29] vs family health center: 0.33 [6.09], P = .004 in 398 PS-matched pairs). At 12 months, functional medicine patients showed improvement similar to that observed at 6 months; however, comparisons with patients seen at the family health center were not significant. Patients in the functional medicine center with data at both 6 and 12 months demonstrated improvements in PROMIS GPH (mean [SD], 2.61 [6.53]) that were significantly larger compared with patients seen at a family health center (mean [SD], 0.25 [6.54]) (P = .02 in 91 PS-matched pairs). Conclusions and Relevance: In this study, the functional medicine model of care demonstrated beneficial and sustainable associations with patient-reported HRQoL. Prospective studies are warranted to confirm these findings.
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Physical exercise, gut, gut microbiota, and atherosclerotic cardiovascular diseases.
Chen, J, Guo, Y, Gui, Y, Xu, D
Lipids in health and disease. 2018;17(1):17
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Cardiovascular diseases (CVD), such as heart attacks and strokes, are the leading cause for mortality worldwide. Many studies have shown beneficial effects of physical exercise on cardiovascular risk factors, such as high cholesterol, high blood pressure, abdominal obesity and diabetes. However, some of the mechanisms, by which these beneficial effects occur, are not well understood. It is believed that gut microbiota, affected by physical exercise, altering the intestinal environment, plays a role. This review paper summarised the current understanding on the effects of physical exercise on CVD, through its effects on the gut microbiota and intestinal function. The authors reviewed animal and human studies looking at how various types of exercise, such as high-intensity interval training (mice), running (rats and mice) and rugby (humans), affect diversity and distribution of microbes, metabolites produced by microbiota, intestinal wall integrity and systemic inflammation. Based on the reviewed papers, the authors concluded that, although further research is warranted, many studies confirm the premise that physical exercise can prevent CVD through modifying gut microbiota and alleviating systemic inflammation.
Abstract
Arteriosclerotic cardiovascular diseases (ASCVDs) are the leading cause of morbidity and mortality worldwide and its risk can be independently decreased by regular physical activity. Recently, ASCVD and its risk factors were found to be impacted by the gut microbiota through its diversity, distribution and metabolites. Meanwhile, several experiments demonstrated the relationship between physical exercise and diversity, distribution, metabolite of the gut microbiota as well as its functions on the lipid metabolism and chronic systematic inflammation. In this review, we summarize the current knowledge on the effects of physical exercise on ASCVD through modulation of the gut microbiota and intestinal function.