DEMGUTS Project: Unravelling the impact of Distinct Exercise Modalities on GUT microbiome and gut-derived metabolites in Sarcopenic older adults

Abstract

Sarcopenia is a progressive skeletal muscle disease with negative health outcomes. The most recent evidence reinforces the existence of a Muscle-Gut Axis, and therefore an association with human gut microbiota (GM) with the development of sarcopenia, due to the observed association between gut dysbiosis and frailty. Current guidelines highlight the role of physical exercise (PE), particularly strength/resistance training, in the treatment of sarcopenia. However, the effects of PE on GM in patients with sarcopenia are still scares and inconsistent. To date, no study has specifically addressed the optimal type of exercise in this high-risk group, considering the impact on GM composition and gut-derived metabolites. The DEMGUTS study aims to explore the impact of different exercise modes on GM composition and gut-derived metabolites in older adults with sarcopenia, through a pilot single center 3-parallel arm open-label randomized control trial. After confirmation of eligibility, participants will engage in a supervised exercise intervention (12 weeks, 3D/W, 60min/d). Eligible participants will be randomly allocated to one of three groups: i) moderate aerobic exercise (AER); ii) resistance exercise (RES); or iii) concurrent training (RES+AER). Participants will be assessed at i) baseline, ii) end of intervention (14 weeks) and iii) close-out (26 weeks). The primary outcome will be the change in the relative abundance of Faecalibacterium prausnitzii and other SCFAproducing bacteria after the intervention (14 weeks). Secondary outcomes include: 1) change in the relative abundance of Faecalibacterium prausnitzii at the close-out (26 weeks); 2) change in the relative abundance of Lactobacillus and Bifidobacterium after the intervention and at the close-out. Complementary outcomes will also be evaluated to characterize the impact of each exercise intervention on body composition, skeletal muscle function, functional performance, and overall GM composition. Other important confounding outcomes such as daily physical activity, nutritional pattern and supplements intake will be analysed. At the long term, this study will contribute to a better clinical guidance and exercise prescription in older adults with sarcopenia using an evidence-based approach, exploring the optimal exercise mode to promote favourable benefits for gut and skeletal muscle health