Fasting alters the gut microbiome reducing blood pressure and body weight in metabolic syndrome patients

Abstract

Periods of fasting and refeeding may reduce cardiometabolic risk elevated by Western diet. Here we show in the substudy of NCT02099968, investigating the clinical parameters, the immunome and gut microbiome exploratory endpoints, that in hypertensive metabolic syndrome patients, a 5-day fast followed by a modified Dietary Approach to Stop Hypertension diet reduces systolic blood pressure, need for antihypertensive medications, body-mass index at three months post intervention compared to a modified Dietary Approach to Stop Hypertension diet alone. Fasting alters the gut microbiome, impacting bacterial taxa and gene modules associated with short-chain fatty acid production. Cross-system analyses reveal a positive correlation of circulating mucosa-associated invariant T cells, non-classical monocytes and CD4+ effector T cells with systolic blood pressure. Furthermore, regulatory T cells positively correlate with body-mass index and weight. Machine learning analysis of baseline immunome or microbiome data predicts sustained systolic blood pressure response within the fasting group, identifying CD8+ effector T cells, Th17 cells and regulatory T cells or Desulfovibrionaceae, Hydrogenoanaerobacterium, Akkermansia, and Ruminococcaceae as important contributors to the model. Here we report that the high-resolution multi-omics data highlight fasting as a promising non-pharmacological intervention for the treatment of high blood pressure in metabolic syndrome patients.

Role of the gut microbiome in chronic diseases: a narrative review

“…This suggests that the gut microbiota are potentially intertwined functionally to control blood pressure, and their dysfunctions could be associated with hypertension. A recent study found that a Mediterranean diet which typically encompasses a high fiber diet followed by fasting was shown to reduce systolic blood pressure, need for antihypertensive medications, body-mass index at three months post intervention compared to following a Mediterranean diet alone [ 89 ]. These data highlight fasting followed by a shift to a health-promoting diet as a promising non-pharmacological intervention for patients with hypertension and other cardiometabolic diseases.…”

Batch effects removal for microbiome data via conditional quantile regression (ConQuR)

“…Also, it is differentially abundant between control and coronary artery disease (CAD) patients 29 , where the strong link between hypertension and CAD has been shown 30, 31 . Hydrogenoanaerobacterium is a crucial contributor to modeling the change of blood pressure in studying the effect of fasting on high blood pressure in metabolic syndrome patients 32 . Supported by the biological findings, we confirm that ConQuR helps to peel off the confounding batch effects, maintain the true signals and lead to meaningful discoveries.…”

“…Hydrogenoanaerobacterium is a crucial contributor to modeling the change of blood pressure in studying the effect of fasting on high blood pressure in metabolic syndrome patients 32 .…”

The Effects of Green Tea on Diabetes and Gut Microbiome in db/db Mice: Studies with Tea Extracts vs. Tea Powder

“…These results point to the importance of both food consumption and gut microbiota in affecting metabolic parameters. Food intake and gut microbiota interact with each other; it has been reported that fasting, caloric restriction, and hyperphagia can alter the gut microbiome [ 42 , 43 , 44 ], whereas the microbiome can affect the vagus nerve and brain regions, which play key roles in regulating feeding behaviors [ 45 ]. Thus, in addition to the palatability of the diet, the differential effect of the green tea-supplemented diets on food intake may partially result from changes in the gut microbiota, especially in the later part of the experiment.…”