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High blood pressure, aka hypertension, is known to increase the risk of cardiovascular disease. And the best way to prevent or rather manage (along with the prescribed meds) it, is exercise, particularly walking. A recent study found that walking can be beneficial in reducing the risk of heart attacks, heart failure, and stroke in people with high blood pressure. A new study found that you don’t necessarily need to walk 10,000 steps to reduce the risk of heart diseases, even fewer steps count. The findings of the study are published in the European Journal of Preventive Cardiology.

10,000 steps is not the gold standard of walking

Approximately 1.28 billion people worldwide are living with high blood pressure, which increases the risk of heart disease (49% increase), stroke (62% increase), and heart failure (77-89% increase). Until now, it was unclear how much physical activity is required to reduce the risk of major adverse cardiovascular events (MACE).The researchers analyzed over 36,000 people with high blood pressure and found that taking more steps, and walking faster, even though it’s below the recommended daily target of 10,000, can have a significant reduction in the risk of cardiovascular diseases.

The study found that every extra 1,000 steps after 2,300 steps was linked to a 17% reduction in the risk of developing a MACE. The benefits increased up to 10,000 steps. After 10,000, there was a significant reduction in the risk of stroke.“This study is one of the first to demonstrate a dose-response relationship between daily step count and major problems of the heart and blood vessels. In a nutshell, we found that, if you live with high blood pressure, the more you walk with greater intensity, the lower your risk for future serious cardiovascular events. These findings support the message that any amount of physical activity is beneficial, even below the widely recommended daily target of 10,000 steps,” Professor Emmanuel Stamatakis, Director of the Mackenzie Wearables Research Hub at the University of Sydney, Australia, who supervised the study, said, in a statement.

They found that there was a 17% reduction in overall risk for every extra 1,000 steps a day, and a 22% reduction in heart failure, 9% reduction in risk of heart attack, and a 24% reduction in risk of stroke. This means that every increase of 1,000 steps a day was associated with:

If a person walks for 30 minutes at a fast pace, the average (mean intensity) is 80 steps per minute. This was associated with a 30% reduced risk of MACE. There was no evidence of harm in people whose 30 minutes of fastest walking or running was over 130 steps a minute.

They found that every 1,000-step increase in daily step count led to an average lower risk of MACE, heart failure, myocardial infarctions, and stroke of 20.2%, 23.2%, 17.9%, and 24.6%, respectively.“Our findings offer patients accessible and measurable targets for heart health, even below 10,000 steps daily. Clinicians should promote physical activity as standard care, especially in patients with high blood pressure. Our results can inform new, tailored public health recommendations for these patients. Future recommendations on walking in people with high blood pressure could consider promoting higher stepping intensity,” Prof. Stamatakis added.

COVID-19 prevention methods such as masking and social distancing also suppressed the circulation of common respiratory diseases, leaving young children lacking immunity to pathogens they otherwise would have been exposed to, a new multi-center clinical research study reveals. The investigators say their findings help explain the large post-pandemic rebound in these diseases and enable more accurate predictions for the future.

The study, published Aug. 6 in The Lancet Infectious Diseases and funded by the National Institutes of Health, followed 174 children under the age of 10 from 2022-2023 across four academic medical centers across the country: Weill Cornell Medicine; University of Colorado Anschutz Medical Campus and Children’s Hospital Colorado; University of North Carolina; and the University of Alabama at Birmingham. Through repeat blood sampling and respiratory sampling during illness, the investigators gauged the children’s level of immunity to many common and emerging respiratory viruses, such as RSV, influenza and enterovirus D68 (EV-D68), which can cause the polio-like illness acute flaccid myelitis.

The findings, among the first from the National Institutes of Health’s PREMISE (Pandemic Response Repository through Microbial and Immune Surveillance and Epidemiology) Program, showed that most young children lacked immunity to many normal respiratory viruses during the pandemic, suggesting they had not been exposed, as they typically would have, due to prevention measures in place. Enrolled children received routine medical care while participating in the observational study. Following the lifting of pandemic measures, the level of immunity rose across all pathogens studied, reflective of the unprecedented widespread resurgence of these viruses in children post-pandemic.

PREMISE is a one-of-a-kind study as we followed very young children, with their parents’ consent, over a year for longitudinal sample collection, affording us the unique opportunity to assess immunity due to primary infection, re-exposure and even vaccination, during a time when mask requirements and other non-pharmaceutical interventions were lifted.”

Dr. Perdita Permaul, co-first author, section chief of pediatric allergy and immunology, associate professor of clinical pediatrics and trial principal investigator at Weill Cornell Medicine

The data allowed experts to recreate past circulation patterns and model predictions for future outbreaks with greater accuracy and precision. They showed that PREMISE data from 2022-23 could be used to accurately predict the subsequent wave of disease of the emerging pathogen EV-D68 that occurred in 2024.

“Findings from our study successfully demonstrate the utility of longitudinal immunologic surveillance in children, particularly young, immunologically naïve unexposed children, to help model the behavior of endemic viruses,” said Dr. Permaul, who is also an Englander Clinical Scholar at Weill Cornell Medicine and a pediatric allergist and immunologist at NewYork-Presbyterian Komansky Children’s Hospital of Children’s Hospital of New York.

Investigators have so far evaluated nearly 1,000 children through PREMISE, based at NIH’s Vaccine Research Center, providing a treasure-trove of sampling and data that can be used to learn which parts of viruses the human immune system attacks to develop immunity. This information may enable teams to better design new antibody treatments and effective vaccines to mimic this response.

“This approach allows for the rapid development of vaccine and monoclonal antibody therapeutics for pathogens of interest in children,” Dr. Permaul said. “Future analysis of blood samples collected from almost 1,000 children enrolled in PREMISE includes pathogen-specific T and B cell responses. Longitudinal immune surveillance in young children is an important tool for informing public health planning, assessing the effectiveness of pharmacologic and non-pharmacological interventions, developing ‘on the shelf’ therapeutics and mitigating overall disease burden.”

This study is fully funded by a subcontract with Frederick National Laboratory for Cancer Research (FNLCR), currently operated by Leidos Biomedical Research, Inc. through Agreement 21X192QT1. FNLCR funding was provided by the NIH Vaccine Research Center. The total project funding is $7.98 million over five years.  No financing for this project is supplied by nongovernmental sources.

Can what you eat during pregnancy really change your gut bacteria? New research reveals how the Mediterranean diet boosts beneficial microbes for expectant mothers, while stress-busting mindfulness may not be enough.

Study: Effects of Mediterranean diet or Mindfulness Based-Stress Reduction during Pregnancy on Maternal Gut and Vaginal Microbiota. A sub-analysis of the IMPACT BCN trial. Image Credit: leonori / Shutterstock

In a recent study published in The American Journal of Clinical Nutrition, researchers conducted a clinical sub-analysis to investigate the impacts of maternal diet and stress levels on the maternal microbiome. The study leveraged data from the IMPACT BCN randomized trial and found that a Mediterranean diet intervention significantly altered the composition of the maternal gut microbiota, promoting an increase in beneficial, short-chain fatty acid-producing bacteria.

A mindfulness-based stress reduction program had more modest effects on the maternal gut microbiome, with some increases in health-associated bacteria, but did not significantly alter overall microbiome structure (p=0.094). These findings highlight the maternal gut as a potential therapeutic target for improving both maternal health and potentially influencing long-term child welfare. It is important to note that microbiome outcomes were measured as exploratory endpoints, and further research is needed to determine how these changes may influence clinical outcomes for mothers and infants.

Background

Pregnancy represents a period of substantial and profound physiological change, extending beyond just the mother and her developing fetus to also include their resident microbial symbionts. Notably, research has found that maternal gut and vaginal microbiomes are the primary sources for seeding the infant’s microbiota, a process critical for the latter’s development of a healthy immune system and metabolism in later life.

Parallel studies have established a link between the independent influences of diet and stress on non-pregnant adult microbiome composition and function. Unfortunately, there remains a scarcity of evidence from randomized trials on whether structured lifestyle interventions, such as diet and stress level interventions, especially during pregnancy, can purposefully and beneficially alter these crucial microbial ecosystems.

Understanding these associations would provide prospective mothers and their caregivers with the information to optimize maternal and fetal physiological outcomes.

About the study

The present study aims to address this knowledge gap by conducting a sub-analysis of the Improving Mothers for a better PrenAtal Care Trial BarCeloNa (IMPACT BCN) cohort, a randomized controlled trial (parallel design) carried out at the Hospital Clínic and Hospital Sant Joan de Déu (BCNatal) in Barcelona, Spain. IMPACT BCN aimed to elucidate whether lifestyle interventions could reduce the incidence of small-for-gestational-age (SGA) newborns.

The current study focused on the maternal microbiome as a key exploratory outcome and used a subsample of 351 pregnant individuals from the main trial who were at high risk of having an SGA baby. Identified participants were randomly assigned to one of three experimental subgroups: 1. The Med Diet group – These individuals received counselling to adopt a Mediterranean dietary pattern, supplemented with extra-virgin olive oil and walnuts. 2. The Stress Reduction (SR) group – These individuals were enrolled in an 8-week mindfulness-based stress reduction program (Kabat-Zinn adapted for pregnancy), and 3. Usual/routine Care group: These individuals were subjected to standard prenatal care protocols without additional intervention.

Study data collection comprised the extraction of maternal fecal and vaginal samples (following intervention termination – 34-36 weeks’ gestation). Crucially, a subset of 85 participants was used to obtain baseline readings (before intervention initiation). Microbiome structure was evaluated using high-resolution 16S rRNA gene sequencing for community characterization and functional evaluation.

Study findings

Study findings revealed that modifiable behaviors, particularly diet, are strongly linked to microbiome health in pregnant women. Specifically, the Med Diet intervention was closely associated with the overall alteration of the gut microbiota structure (p = 0.002), leading to a significant enrichment in bacteria from the Firmicutes phylum. Adherence to the Med Diet was observed to promote the growth of bacteria (e.g., Ruminococcaceae and Lachnospiraceae) known to produce beneficial short-chain fatty acids (SCFAs).

Simultaneously, Med Diet adherence reduced microbiome concentrations of potentially harmful bacteria, most notably the genus Campylobacter (p < 0.001). While the strength of outcomes was more limited, the mindfulness-based stress reduction intervention was associated with enrichment of specific health-associated bacteria, such as Ruminococcaceae_UCG-010 and Turicibacter, but did not significantly affect the overall gut microbiota composition (p=0.094 for overall structure).

Microbial diversity was observed to decrease as pregnancy progressed, with this reduction being more pronounced among participants in the intervention groups.

Additionally, independent of intervention group assignment, higher adherence to the Mediterranean diet pattern correlated with greater microbial diversity and beneficial microbial shifts.

It should be noted that the study exclusively analyzed the maternal microbiome; the offspring’s microbiome was not assessed.

Neither intervention had a significant effect on the composition or diversity of the vaginal microbiota, which remained stable (dominated by the Lactobacillus genus), as is typical during a healthy pregnancy.

Conclusions

The present study provides the first evidence highlighting the role of structured interventions (targeting modifiable behaviours) in influencing the maternal gut microbiome during pregnancy. It demonstrates that a Mediterranean diet can foster a gut environment rich in beneficial, anti-inflammatory SCFA-producing bacteria, providing a plausible mechanism through which this diet may improve pregnancy outcomes. However, clinical outcomes related to these microbiome changes were not directly assessed in this sub-analysis and should be investigated in future research. While the stress reduction program’s effect was more subtle, study findings still suggest a link between psychological well-being and gut microbial health.

Together, these outcomes position the maternal gut microbiome as a potentially important therapeutic target. By optimizing a mother’s diet and promoting stress management, it may be possible to cultivate a healthier microbial environment that benefits both mother and child. Future research exploring the long-term impacts of these microbial shifts on neonatal and child health may allow for the development of personalized maternal behavioral interventions designed to optimize both her and her offspring’s safety and holistic health.