Journal Article

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

Kleinewietfeld, Markus, Cramer, Holger, Avery, Ellen G., Mähler, Anja, Hohmann, Christoph, Dechend, Ralf, Löber, Ulrike, Forslund, Sofia K., Steckhan, Nico, Maifeld, András, Bzdok, Danilo, Michalsen, Andreas, Bartolomaeus, Hendrik, Markó, Lajos, Dobos, Gustav, Müller, Dominik N., Lesker, Till Robin, Strowig, Till, Hamad, Ibrahim, Šušnjar, Urša, Wilck, Nicola, Chen, Chia-Yu

2021

Overview

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. Nutritional modification including fasting has been shown to reduce cardiometabolic risk linked to western diet. Here the authors show implementation of fasting resulted in alterations to the intestinal microbiota, and circulating immune cells, improving blood pressure and body weight in patients with metabolic syndrome.

• Publisher: Nature Publishing Group UK,Nature Publishing Group,Nature Portfolio
• Subject: 13/31 / 45/23 / 692/53/2423 / 692/699/317 / 692/699/75 / 692/699/75/2099 / 692/699/75/243 / Acid production / Aged / Akkermansia - physiology / Antihypertensives / Blood circulation / Blood pressure / Blood Pressure - physiology / Body Mass Index / Body weight / Body Weight - physiology / CD4 antigen / CD8 antigen / Correlation analysis / Desulfovibrionaceae - physiology / Diet / Digestive system / Effector cells / Fasting / Fasting - physiology / Fatty acids / Feces - microbiology / Female / Gastrointestinal Microbiome - physiology / Gastrointestinal tract / Gut microbiota / Health risks / Helper cells / Humanities and Social Sciences / Humans / Hypertension / Hypertension - complications / Hypertension - microbiology / Hypertension - physiopathology / Immune system / Immunoregulation / Intestinal microflora / Intestine / Learning algorithms / Lymphocytes / Lymphocytes T / Machine learning / Male / Metabolic disorders / Metabolic syndrome / Metabolic Syndrome - complications / Metabolic Syndrome - microbiology / Metabolic Syndrome - physiopathology / Microbiomes / Microbiota / Middle Aged / Monocytes / Mucosa / multidisciplinary / Non-pharmacological intervention / Patients / Ruminococcus - physiology / Science / Science (multidisciplinary) / T-Lymphocyte Subsets - immunology / T-Lymphocyte Subsets - physiology