A new study shows that participants who have successfully lost weight have positive changes at the molecular level after a one-year intensive diet, exercise, and stress management program to reduce cardiovascular risk, researchers report. The study was published in "Circulation: Cardiovascular Genetics" on February 22, 2014.
“The really new and important change in this research is that through a year of lifestyle changes, you not only get some physical changes – such as weight loss and blood pressure drop – but you can also get some molecular changes, those Changes in molecular levels are associated with improved vascular health," lead author Darrell Ellsworth (Windber Institute) told heartwire.
However, just as people who are unable to maintain diet and exercise will rebound in weight, these changes in molecular levels are also short-lived, emphasizing the importance of making lifelong healthy choices. “The study further emphasizes that lifestyle change is beneficial and needs to be sustained,†says Darrell Ellsworth.
In-depth exploration of molecular level changes
Although we believe that lifestyle changes reduce cardiovascular disease (CVD) by affecting endothelial function and progression of atherosclerosis, little is known about molecular level effects. “Many researchers have explored short-term changes in gene expression during diet or exercise, but no one has really explored the reversal of heart disease during lifestyle change programs,†says Ellsworth.
Those who participated in the project were people with heart disease or high risk of heart disease. They actively reduced weight loss, exercise and stress reduction programs to reduce cardiovascular risk and tried to reduce the number of medications and avoid invasive treatments such as stents and angioplasty. Surgery or coronary artery bypass surgery.
“We can see that if they stick to the project, their weight will be reduced, blood pressure and blood lipid levels will drop, and they will feel better. We are interested in what has changed at the molecular level.â€
The investigators analyzed the effects of CVD risk reduction programs on gene expression in peripheral blood samples (baseline, 12 hours, and 1 year). A total of 63 participants and 63 controls matched for age, gender, and CVD status were included in the study.
At the start of the study, participants had CAD or had two or more CAD risk factors (hypertension, high cholesterol, diabetes, obesity, or a family history of heart disease). The control group received standard medical care from a primary care physician. The average age of the patients was 60.3 years (range 44.5-78.4).
The content of the lifestyle change project includes:
• Very low fat vegetarian (fat provides <10% calories)
• 180 minutes / week of moderate aerobic training
• 1 hour of blood pressure management per day
• Weekly group support meeting
For participants in lifestyle change programs, the prevalence of hypertension fell from 41% to 17% at the end of the year, the prevalence of obesity fell from 60% to 37%, and the prevalence of dyslipidemia was 54. % dropped to 37%. These participants experienced a dramatic 60% reduction in fat absorption and a 38% improvement in physical fitness. This response improved 5% for BMI, 7% for triglycerides, and 7% for blood pressure.
Beneficial effects on the vascular system
The researchers took blood samples from the participants and controls and isolated the RNA, then used the Gene Chip (Affymetrix) human genome array to analyze which genes were turned on or off. They analyzed about 22,000 genes.
“After a year of lifestyle change, we saw 143 genes change in expression,†Ellsworth said. “There are many of these genes involved in the immune response. Most genes (99%) are downregulated, these are vascular inflammation. a reduced number of indicators"
Conversely, at the end of the year, changes in cardiovascular risk markers or gene expression in the control group were small.
From 12 weeks to 52 weeks, the number of genes that have changed significantly has increased more than five-fold, suggesting that molecular changes in patients with long-term healthy lifestyles may be greater than those who participate in short-term activities.
At baseline, patients took 79 different CVD drugs, which may affect the outcome. However, regardless of whether the participants received new drug treatment during the study, the change in gene expression was similar, and this potential interference was ruled out.
By changing lifestyles, successful and sustained regulation of gene expression has beneficial effects on the vascular system, unlike traditional risk factors. "Ellsworth and colleagues concluded that the possible mechanism is that healthy lifestyles restore the balance of white blood cell gene expression by down-regulating important genes involved in the pathogenesis of lactoferrin and other atherosclerosis."
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