1. Effect of aerobic exercise and low carbohydrate diet on pre-diabetic non-alcoholic fatty liver disease in postmenopausal women and middle aged men - the role of gut microbiota composition
- Author
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Wu Yi Liu, Chang Xu, Petri Wiklund, Ren Wei Wang, Ronald Borra, Xin Fei Wen, Shu Mei Cheng, Xue Bo Chen, Xia Ming Du, Zheng Chang Xia, Da Jiang Lu, Jun Zou, Yi Min Zhang, Rui Li, Yan Qiu Chen, Satu Pekkala, Pei Jie Chen, Jun Jun Liu, Jia Xin Yao, Jian Qin Sun, Ru Wang, Jun Ge, Eveliina Munukka, Sulin Cheng, Qing Gu, Wen Bin Liu, Jie Ren, Xiao Tan, and Yang Liu
- Subjects
Male ,Health Behavior ,PATHOGENESIS ,Physiology ,Gut flora ,law.invention ,Impaired glucose tolerance ,Diet, Carbohydrate-Restricted ,Study Protocol ,Randomized controlled trial ,Non-alcoholic Fatty Liver Disease ,law ,Surveys and Questionnaires ,EPIDEMIOLOGY ,Glucose metabolism ,biology ,Microbiota ,Fatty liver ,Middle Aged ,Postmenopause ,Liver ,Research Design ,Metabonomics ,OBESITY ,Body Composition ,Female ,LIFE-STYLE ,Liver fat content ,Human ,medicine.medical_specialty ,Gut microbiota ,Carbohydrate metabolism ,CHINA ,Prediabetic State ,IMPAIRED GLUCOSE-TOLERANCE ,Diabetes mellitus ,Internal medicine ,Dietary Carbohydrates ,medicine ,Humans ,Aerobic exercise ,Exercise ,Life Style ,Aged ,business.industry ,Public Health, Environmental and Occupational Health ,DIABETES-MELLITUS ,Feeding Behavior ,ADULTS ,medicine.disease ,biology.organism_classification ,Obesity ,Gastrointestinal Tract ,Clinical setting ,MICE ,Endocrinology ,Lipid metabolism ,Dietary Supplements ,business - Abstract
Background Pre-diabetes and non-alcoholic fatty liver disease (NAFLD) are associated with an unhealthy lifestyle and pose extremely high costs to the healthcare system. In this study, we aim to explore whether individualized aerobic exercise (AEx) and low carbohydrate diet (LCh) intervention affect hepatic fat content (HFC) in pre-diabetes via modification of gut microbiota composition and other post-interventional effects. Methods/design A 6-month randomized intervention with 6-month follow-up is conducted from January 2013 to December 2015. The target sample size for intervention is 200 postmenopausal women and middle-aged men aged 50–65 year-old with pre-diabetes and NAFLD. The qualified subjects are randomized into 4 groups with 50 subjects in each group: 1 = AEx, 2 = LCh, 3 = AEx + LCh, and 4 = control. In addition, two age-matched reference groups (5 = pre-diabetes without NAFLD (n = 50) and 6 = Healthy without pre-diabetes or NAFLD (n = 50)) are included. The exercise program consists of progressive and variable aerobic exercise (intensity of 60 to 75% of initial fitness level, 3–5 times/week and 30–60 min/time). The diet program includes dietary consultation plus supplementation with a special lunch meal (40% of total energy intake/day) which aims to reduce the amount of carbohydrate consumption (30%). The control and reference groups are advised to maintain their habitual habits during the intervention. The primary outcome measures are HFC, serum metabolomics and gut microbiota composition. The secondary outcome measures include body composition and cytokines. In addition, socio-psychological aspects, social support, physical activity and diet will be performed by means of questionnaire and interview. Discussion Specific individualized exercise and diet intervention in this study offers a more efficient approach for liver fat reduction and diabetes prevention via modification of gut microbiota composition. Besides, the study explores the importance of incorporating fitness assessment and exercise in the management of patients with pre-diabetes and fatty liver disorders. If our program is shown to be effective, it will open new strategies to combat these chronic diseases. Trial registration Current Controlled Trials: ISRCTN42622771.
- Published
- 2014