Six-Week Exercise Training With Dietary Restriction Improves Central Hemodynamics Associated With Altered Gut Microbiota in Adolescents With Obesity

Junhao Huang, Jingwen Liao, Yang Fang, Hailin Deng, Honggang Yin, Bing Shen, Min Hu, Junhao Huang, Jingwen Liao, Yang Fang, Hailin Deng, Honggang Yin, Bing Shen, Min Hu

Abstract

Purpose: Obesity in children and in adolescents can lead to adult cardiovascular diseases, and the gut microbiota plays a crucial role in obesity pathophysiology. Exercise and diet interventions are typical approaches to improve physical condition and to alter the gut microbiota in individuals with obesity. However, whether central hemodynamic parameters including subendocardial viability ratio, the augmentation index standardized to a heart rate of 75/min (AIx75), resting heart rate, and blood pressure, correlate with gut microbiota changes associated with exercise and diet is unclear.

Methods: Adolescents (n = 24, 12.88 ± 0.41 years) with obesity completed our 6-week program of endurance and strength exercises along with dietary restriction. Blood and fecal samples were collected, and physical parameters were measured before and 24 h after the last session of the intervention program. Pulse wave analysis using applanation tonometry provided the subendocardial viability ratio, a surrogate measure of microvascular myocardial perfusion, and AIx75, a measure of arterial stiffness and peripheral arteriolar resistance. Correlation analysis detected any associations of anthropometric or central hemodynamic parameters with gut microbiome composition.

Results: Exercise and diet interventions significantly reduced body weight, body mass index, body fat, and waist-to-hip ratio, and lowered levels of fasting blood glucose, serum triglycerides, and high-density lipoprotein cholesterol. AIx75 and resting heart rate were also significantly reduced after the intervention without changes to systolic or diastolic blood pressure. The ratio of intestinal microbiota Firmicutes to Bacteroidetes displayed a marked increase after intervention. Interventional changes in gut microbiota members were significantly associated with anthropometric and metabolic parameters. Microbial changes were also significantly correlated with central hemodynamic parameters, including subendocardial viability ratio, AIx75, and resting heart rate.

Conclusion: Exercise and diet interventions significantly improved measures of central hemodynamics, including subendocardial viability ratio, AIx75, and resting heart rate, which were correlated with altered gut microbiota in adolescents with obesity. Our findings shed light on the effects and mechanisms underlying exercise and diet interventions on obesity and suggest this approach for treating patients with both cardiovascular disease and obesity.

Trial registration: ClinicalTrials.gov NCT03762629.

Keywords: dietary restriction; exercise; gut microflora; obese adolescents; subendocardial viability ratio.

Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Copyright © 2020 Huang, Liao, Fang, Deng, Yin, Shen and Hu.

Figures

Figure 1
Figure 1
Characteristics of two microbiota. (A) Venn diagram. The Venn diagram shows the unique operational taxonomic units (OTUs) pre-intervention (Before; brown) and post-intervention (After; light-red), and the number of shared OTUs (dark-red) pre- and post-intervention. (B) OTU rank abundance curves. The legend indicates the Sample Number. Before presents pre-intervention. After presents post-intervention. (C) Species accumulation boxplot of the 48 samples.
Figure 2
Figure 2
The taxonomic composition distribution in samples at the phylum level. The abscissa represents the Sample Number. Before presents pre-intervention, After presents post-intervention. The 48 samples are divided into two parts. The blue part is from After1 to After24, and the red part is from Before1 to Before24. The legend in the upper right corner represents the name of the species at the phylum level. The content of the bacteria is displayed in the histogram in the corresponding proportion and color.
Figure 3
Figure 3
Linear discriminant analysis effect size before and after diet and exercise intervention. (A) Cladogram of the gastric microbial taxa associated with individuals before and after diet and exercise intervention. Taxa higher in relative abundance before the intervention are in green, and those higher after the intervention are in red. (B) Histogram of the linear discriminant analysis (LDA) scores for differentially abundant taxonomic features before and after the intervention. Significance obtained by LDA effect size at P < 0.05, (Kruskal–Wallis test) and LDA score >2.
Figure 4
Figure 4
Correlation network between changes in gut microbiota members and clinical parameters after a 6-week combined exercise and diet intervention. (A) Correlations between changes in gut microbiota members and metabolic parameters. (B) Correlations between changes in gut microbiota members and central hemodynamics. The blue square represents clinical parameters, the red circle represents gut microbiota; the red line represents the positive correlation coefficient, and the green line represents the negative correlation coefficient.

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