Evolutionary Mismatch and Lifestyle-Related Diseases: A Study of a 6-Month Intensive Lifestyle Intervention

Scand J Med Sci Sports. 2024 Dec;34(12):e14770. doi: 10.1111/sms.14770.

Abstract

Chronic medical conditions caused by the inadequate adaptation of the body to modern lifestyles, such as physical inactivity and unhealthy diets, are on the rise. This study assessed whether a comprehensive lifestyle intervention, including high volumes of supervised exercise, could improve health outcomes. Eight volunteers with lifestyle-related diseases received a 6-month lifestyle intervention consisting of 8000-10 000 steps/day, 6 moderate-intensity endurance and 3 resistance training sessions per week, a 5-week long hike, and dietary advice. This was followed by 7 months of limited remote supervision, ending 13 months from baseline. The participants (3 females, 5 males; mean age 42.9 years) had conditions including type 2 diabetes (T2D), depression/stress, and metabolic syndrome (MS). After 6 months, body weight decreased significantly by 23 kg (95% CI; -33.7 to -12.2), with a minor non-significant decrease in lean body mass of 1.96 kg (95% CI; -4.34 to 0.27). Maximal oxygen consumption (VO2max) increased by 18.5 mL/O2/kg/min. (95% CI; 13.8-23.1) and systolic and diastolic blood pressures decreased by 33 (95% CI; -39 to -26) and 18 mmHg (95% CI; -23 to -14), respectively. Three of the 4 participants with T2D had normalized glycated hemoglobin (HbA1c) levels, and all showed improved 2-h oral glucose tolerance (OGTT) without pharmacological treatment. Participants with T2D continued to lower HbA1c during the 7-month follow-up period. This 6-month lifestyle intervention restored metabolic health and improved cardiovascular health in 8 participants with lifestyle-related diseases while reducing the need for pharmacological treatments. These findings suggest that comprehensive lifestyle changes can reverse several medical conditions caused by evolutionary mismatch.

Keywords: diabetes; evolutionary mismatch; exercise; lifestyle; metabolic syndrome; nutrition; physical activity.

MeSH terms

  • Adult
  • Blood Pressure
  • Depression / therapy
  • Diabetes Mellitus, Type 2* / prevention & control
  • Diabetes Mellitus, Type 2* / therapy
  • Exercise / physiology
  • Female
  • Glycated Hemoglobin / analysis
  • Humans
  • Life Style*
  • Male
  • Metabolic Syndrome* / therapy
  • Middle Aged
  • Oxygen Consumption
  • Resistance Training
  • Stress, Psychological / therapy
  • Weight Loss

Substances

  • Glycated Hemoglobin