Exercise neutralizes dyslipidaemia risk by modulating gut health

New research suggests that engaging in moderate-to-vigorous physical activity (MVPA) can counteract the harmful association between sedentary behaviour and dyslipidaemia by promoting a healthier, more diverse community of gut bacteria.

In a cohort of Chinese adults, prolonged sedentary hours were associated with a 63-percent increased risk of dyslipidaemia (tertile 3 vs 1: adjusted hazard ratio [HR], 1.63, 95 percent confidence interval [CI], 1.19–2.22), whereas total physical activity was associated with a risk reduction (tertile 3 vs 1: HR, 0.88, 95 percent CI, 0.66–1.19). [J Am Heart Assoc 2025;doi:10.1161/JAHA.125.043797]

Joint association analysis showed that MVPA mitigated the adverse effect of sedentary hours on dyslipidaemia risk. Relative to participants with long sedentary hours and low MVPA levels, the risk was reduced among those with shorter sedentary time and higher MVPA levels (HR, 0.70, 95 percent CI, 0.50–0.98) and those with longer sedentary time and higher MVPA levels (HR, 0.83 (95 percent CI, 0.60–1.16).

When 1‐year gut microbial changes associated with MVPA were assessed using faecal samples from a subset of 754 participants, the microbial α‐diversity was found to have declined from baseline for participants with low MVPA (p=0.024). On the other hand, the β‐diversity shifted from baseline for participants across all MVPA groups (p≤0.005 for all). According to the investigators, these shifts potentially contributed to dyslipidaemia prevention.

Further analysis identified seven and 13 microbial genera to be associated with MVPA and sedentary time, respectively. Among these genera, Eggerthella and Desulfovibrio correlated positively with MVPA levels but inversely with sedentary time. Desulfovibrio also showed an inverse association with dyslipidaemia (odds ratio, 0.78, 95 percent CI, 0.606–0.997).

“Mechanistically, physical activity may positively influence gut microbiota by shortening colonic food transit time, potentially reducing the risk of metabolic disorders,” the investigators said. [Sci China Life Sci 2024;67:892-899]

Physical activity has been reported to indirectly modulates gut microbiota through immune system interactions, such as enhancing mucosal immunoglobulin A levels, promoting immune cell circulation, and suppressing inflammatory mediators in gut lymphocytes. [Nutrients 2024;16:2657]

Furthermore, physical activity helps in the oxidative absorption of fructose, which gut microbiota metabolize into short‐chain fatty acids that help regulate blood cholesterol by inhibiting liver lipid synthase activity. [Nutrients 2024;16:2657; Front Physiol 2013;4:332; Annu Rev Nutr 2022;42:45-66]

Future studies should address whether a combined approach of targeted modulation of gut microbiota plus MVPA could synergistically prevent dyslipidaemia in sedentary populations, the investigators said.

For the study, the investigators used data from 1,188 Chinese adults who participated in the Anhui Liver Diseases Study. Of these, 396 (median age 55 years, 56.5 percent female), 397 (median age 54 years, 65 percent female), 395 (median age 55 years, 70.1 percent female) were in the MVPA tertiles 1 (median, 43 METs-h/week), 2 (median, 104 METs-h/week), and 3 (median, 221 METs-h/week), respectively. Physical activity was assessed via four quarterly 3‐day diaries (2 weekdays and 1 weekend day) during the year.

Over a median follow‐up of 4 years, a total of 306 incident cases of dyslipidaemia were documented.