Intensive Lifestyle Intervention Can Benefit Health While Changing Our Microbiota

Trillions of microbiota live in our gut. Some of these microbiota perform activities such as the extraction of calories from food and the management of nutrients. While the microbiota are common to all people, each individual has a unique set of the microbiota. And some of the microbiota have a positive impact on our health, while some do not. And one study has concluded that intensive lifestyle intervention plus an energy-restricted Mediterranean diet can improve heath while causing a change in certain microbiota.

The study consisted of two groups: an intensive lifestyle intervention group (IG) and a control group (CG). Both groups followed a Mediterranean diet. The IG participants followed an energy-restricted Mediterranean diet and the participants were advised to engage in physical activity. The CG participants followed a non energy-restricted Mediterranean diet with no advice on physical activity.

The study consisted of men and women from the age of 55 to 75. Participants did not have a “documented history of cardiovascular disease at baseline.” The participants' BMI ranged from 27 to 40. Each participant also had at least three of the components of metabolic syndrome as defined by the American Heart Association and the National Heart, Lung, and Blood Institute.

There were 400 participants in the study. The participants were randomized to one of the two groups, each group consisting of 200 subjects. The CG participants received information on the Mediterranean diet, along with one individual and one group session every six months, to keep the participants on track. The information was delivered by trained dietitians and nurses.

The IC participants received more individualized attention, including motivational interviewing delivered by trained dietitians. The IC group also participated in group sessions. And for one year, the IC participants received a monthly follow-up phone call. The IC group members were also given specific weight loss goals.

At the end of the one-year study, the researchers concluded that for the IC participants, there was a  decrease in “BMI, fasting glucose, glycated hemoglobin, and triglycerides and an increase in HDL cholesterol” compared to the CG participants. There was also a decrease in microbiota, including "Butyricicoccus, Haemophilus, Ruminiclostridium 5, and Eubacterium hallii in the IG compared with the CG."

So, there seems to be a relationship between an intensive lifestyle intervention, plus a Mediterranean diet, and gut microbiota.  Of course, more research is needed to determine what the relationship is, but the combination of intensive lifestyle intervention plus a healthy diet, once more, appears to be a key tool for improving health.

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Waist Circumference and Waist-To-Height Ratio for Determining Diabetes Risk

BMI is probably the most commonly used obesity related measurement. However, BMI is not necessarily the best measurement for abdominal obesity. And BMI is not the best predictor of cardiometabolic risks, such as diabetes. Anthropomorphic measurements involving waist are better indicators of these risks in many cases. These measurements include waist circumference (WC), waist-to hip ratio (WHR), and waist-to-height ratio (WHtR).

Two reasons why BMI is the measurement used most often for obesity are its ease of calculation (Weight in Kilograms/(Height in Meters^{2 )} and the U.S. government's recommendation that the measurement be used by physicians. The "government guidelines urge physicians to screen all adult patients for obesity, and offer health and lifestyle counseling for those with a high body mass index (BMI)."

However, a recent study shows that WC and WHtR are better measurements for predicting diabetes risk than BMI. The study was done in China, and consisted of 4052 adult  participants, who were at least 40 years of age. Sixty-seven percent of the participants were women.

The researchers used face-to-face interviews or physical examinations to obtain the data. The researchers found that the risk of diabetes increased with the age of the participants and when related family members had had diabetes. Also, the risk of diabetes was less in those participants with a college degree or more. The researchers also found that WC and WHtR were more closely related to diabetes, and, therefore, better predictors of the disease.

It should be noted that investigators in one study did find that WHtR was a more useful measurement in Asians than in non-Asians. Still, the investigators indicated that their study results supported "the use of WHtR in identifying adults at increased cardiometabolic risk."

Physicians and other healthcare providers might want to consider using WC and WHtR, as well as BMI, as part of patient assessment tools. Including WC and WHtR in their set of patient assessment tools could give providers more insight into unhealthy cardiometabolic conditions like diabetes.  Using these measurements could help providers deliver better care to the patient.

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