Intensive Cardiovascular Risk Reduction Can Positively Alter Gene Expression

The mechanism that underlies the beneficial effects of a healthy diet and regular moderate exercise has been partially attributed to improvements in endothelial function and vascular biology. A recent study in Circulation: Cardiovascular Genetics provided the link between healthy lifestyle interventions and changes in gene expression at the molecular level, proving that diet and exercise changes can provide not only clinical benefits but sustained modulation of gene expression. 

Sixty-three patients and 63 controls with known coronary artery disease (CAD) or at high risk for CAD were matched for age, sex, and cardiovascular diseases status and randomized to a year-long intensive lifestyle modification program. The program consisted of 4 components: (1) very low-fat vegetarian diet (<10% of calories from fat); (2) 180 minutes per week of moderate aerobic exercise; (3) 1 hour of stress management each day; and (4) weekly group support sessions. The result was a 61% decrease in dietary fat and a 34% increase in physical fitness. Data were collected at baseline, 12 weeks, and at 1 year, and peripheral blood levels of molecular mediators were measured.

In addition to promoting weight loss and reducing the burden of hypertension and dyslipidemia, this rigorous risk reduction program resulted in differential expression of 26 genes at 12 weeks and 143 genes after 1 year. The expression of many proinflammatory genes associated with neutrophil activation was reduced in the intervention group as were pathways relevant to vascular function, carbohydrate metabolism, steroid hormones, and pathogenesis of atherosclerosis.

Based on the results of this study, providers can now begin to inform their patients about the long-term molecular benefits of a healthy diet, regular exercise, and stress reduction, which likely explain the clinical advantages of these lifestyle changes. Stress reduction, which is often under-emphasized during clinic visits, was an important part of the lifestyle interventions.

References:

Ellsworth DL, Croft DT, Weyandt J, et al. Intensive cardiovascular risk reduction induces sustainable changes in expression of genes and pathways important to vascular function. Circ Cardiovasc Genet. Published online March 3, 2014. (Full text PDF)