The study, the largest of its kind in Poland, is being led by the Pomeranian Medical University in Szczecin, in collaboration with the University of Physical Education in Kraków, the Jagiellonian University, and the Academy of Physical Education in Katowice.

Researchers are focusing on men diagnosed with metabolic syndrome and obesity, analyzing a wide range of health indicators including body composition, blood biochemistry, hormone levels, the intestinal microbiome, and DNA methylation—a marker of biological age.

According to Dr. Agnieszka Suder from the University of Physical Education in Kraków, metabolic syndrome is a condition that is not a disease entity in itself but is characterized by a series of disturbing symptoms: abdominal obesity, increased pressure, lipid disorders, insulin resistance.

“The key is the visceral fat tissue, which is not only an energy storage, but also has hormonal activity,” she said. “Fat cells, adipocytes, produce proteins (adipocins) that affect the whole body: they disturb the regulation of appetite, glucose levels, they are conducive to chronic inflammation. At the same time, people with a metabolic syndrome have lower level of beneficial anti-inflammatory proteins, e.g. adiponectine.”

The study will include 100 men with a BMI over 30 and waist circumference exceeding 94 cm. Participants are randomly assigned to one of four groups: diet-only, exercise-only, a combination of both, or a control group. The 12-week intervention will be repeated in rounds to minimize seasonal effects.

Diet, training and metabolic health

Participants follow a specially designed anti-inflammatory diet and an original training regimen. Earlier work by Karol Makiel and Agnieszka Suder demonstrated that combining aerobic and strength training was most effective in improving health among metabolic syndrome patients.

“Their diet, on the other hand, is anti-inflammatory, developed based on the latest scientific reports,” said Makiel. “Its foundation is polyunsaturated omega-3 fatty acids, which have a strong anti-inflammatory effect and support regenerative processes. Their supply should reach up to 25 g per day, which is much more than in a typical diet, and their proportion to other fats has been carefully balanced to maximally reduce lipotoxicity, i.e. the harmful effects of some fats on the body's cells.”

Saturated fats, omega-6 fatty acids, and trans fats are minimized. Instead, participants consume fatty sea fish, linseed oil, and walnuts. The diet also includes low glycaemic index foods rich in fiber, such as legumes, whole grains, vegetables, and berries. Ingredients like curcumin, shown to impact biological ageing, are also included.

“Preliminary results after twelve weeks of the first round of the study are very promising: in one of the participants, glucose levels dropped from 11.7 to 4.18 mmol/l, and cholesterol from 5.9 to 2.9 mmol/l. Several men lost 5–15 kg during that time, the record holder over 20.5 kg. The waist circumferences have decreased, the well-being and quality of sleep improved,” Makiel said.

“These are really spectacular results, obtained without medications, only by changing the lifestyle,” he added.

Diet, training and the rate of ageing

A unique aspect of the study is its use of epigenetic clocks to measure biological age based on DNA methylation. Project leader Dr. Ewelina Pośpiech, a professor at the Pomeranian Medical University and expert in epigenetics, explained: “Methylation is a mechanism that regulates gene activity, not by changing the DNA sequence, but via DNA chemical modifications, which are observed in response to environmental and lifestyle factors, such as diet, physical activity, stress and pollution.

“Epigenetic clocks, based on the analysis of the characteristic DNA methylation patterns in specific places of the genome, will allow scientists to determine whether the changes made by participants affect the ageing rate of their body.”

She added: “We live longer, but the quality of life of the elderly is often bad. People have many diseases, feel bad, their capability is limited. There are data that indicate that if each of us rejuvenated biologically by seven years, the frequency of chronic diseases would drop by about 50 percent. So half of us would stop getting sick. In times of so rapidly ageing societies, it is crucial—not only for the health of the individual, but also for healthcare systems and the economy.”

Researchers will assess biological age before, midway, and after the intervention.

Diet, training and the intestinal microbiome

The final component of the study focuses on the intestinal microbiome.

According to Dr. Tomasz Kościółek, bioinformatics expert at Onebiome Sp. z o.o., gut bacteria respond dynamically to diet and lifestyle and are critical for regulating metabolism, immune function, and overall health.

“By sequencing the DNA of these microorganisms, we can assess their composition, and predict their activity with the help of bioinformatic algorithms,” Kościółek said. “That is why at the beginning and end of the study we collect stool samples from the participants, and then we subject them to metagenomic analysis. Thanks to this, we see if they changed under the influence of diet and training.”

“By sequencing the DNA of these microorganisms, we can assess their composition, and predict their activity with the help of bioinformatic algorithms,” Kościółek said. “That is why at the beginning and end of the study we collect stool samples from the participants, and then we subject them to metagenomic analysis. Thanks to this, we see if they changed under the influence of diet and training.”

He added, “There is more and more evidence that the characteristics of the microbiome effectively indicate which interventions or types of supplementation are effective in specific patients. I would like the intestinal microbiome analysis to become as routine as blood counts.”

Volunteers invited to the study

The project will run through 2026, with new participant groups starting in September 2025 and January 2026. Researchers are actively seeking volunteers and encourage interested individuals to apply by emailing karol.makiel@awf.krakow.pl.

“We want to help people at risk to avoid medicines and surgery,” said Makiel. “Our previous experience shows that such an intervention can really change a person's life. We provide interdisciplinary care to participants, motivate, create support groups. Recurrence of obesity in people from the previous study was much rarer than in patients without the support of specialists.”

The study is funded by the Polish National Science Centre under project number 2024/53/B/NZ7/02257.

Katarzyna Czechowicz (PAP)

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