Modulation of the intestinal microbiota with lifestyle: results of an intensive 14-day program

Abstract

This case report describes the changes in the gut microbiota of a 61-year-old patient with class III obesity and hypertension after a 14-day inpatient program at a specialized Lifestyle Medicine clinic (Rituaali). The patient underwent an intensive program that included a plant-based diet, daily physical activity, psychological counseling sessions, group discussions on purpose, spirituality, and social connections. Gut microbiota analysis was performed before and after the inpatient stay using high-performance sequencing of the V3/V4 region of the 16S rRNA gene. Comparing the microbiota tests from 08/26/2024 and 09/20/2024, there was a significant increase in Faecalibacterium prausnitzii (13.6% to 22.4%), Eubacterium rectale (1.2% to 3.0%), and Roseburia (1.0% to 1.6%), bacteria known for their anti-inflammatory properties and short-chain fatty acid (SCFA) production, which promote intestinal barrier integrity. Furthermore, there was a significant reduction in pro-inflammatory bacteria such as Escherichia coli (3.2% to 2.1%) and the disappearance of pathobionts such as Klebsiella pneumoniae and Sutterella wadsworthensis. The proportion of Proteobacteria, a phylum associated with chronic inflammation, decreased from 8.0% to 2.1%, while the Firmicutes/Bacteroidetes ratio adjusted from 4.2 to 3.8, creating a more balanced microbial environment. These findings suggest that lifestyle interventions, particularly a plant-based diet combined with physical activity and psychological support, have a beneficial impact on gut microbiota modulation, reducing the presence of pro-inflammatory bacteria and promoting the growth of beneficial species associated with gut health. This case highlights the potential of Lifestyle Medicine to improve metabolic and inflammatory parameters through microbiome modulation.