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gut microbiome diet

Modulatory effects of exercise interventions on the gut microbiota in older adults: a systematic review and meta-analysis

30 May 2026

Liu J, Bao Z, Zhang W, Zhou Y, Sun J.

Summary

What the study found

This systematic review and meta-analysis indicates that exercise interventions significantly improve gut microbiome diversity in older adults. By engaging in regular physical activity, seniors can increase the abundance of beneficial bacteria and reduce levels of potentially harmful microbes, helping to combat age-related gut degradation.

Key findings

  • Exercise significantly increased alpha-diversity, specifically improving the Shannon and Chao1 indices which represent a more robust and resilient gut ecosystem.
  • The most pronounced benefits were observed with moderate-intensity exercise, which outperformed low-intensity routines in modulating microbial health.
  • Specific beneficial genera like Akkermansia increased significantly, while levels of the potentially pro-inflammatory genus Escherichia decreased.
  • A dose-response relationship was identified, suggesting that the optimal "sweet spot" for gut health occurs at approximately 700–900 METs/week.
  • Improvements were particularly notable in males and individuals with a higher body mass index (BMI).

Practical takeaways

For those focused on longevity, aim for a consistent routine of moderate-intensity activity, such as brisk walking or swimming, for approximately 150 to 200 minutes per week. This level of activity helps cultivate a "younger" microbiome by boosting protective species like Akkermansia that support metabolic health.

Limitations

The findings are limited by the relatively small number of available trials and the short duration of many included studies. Furthermore, the high degree of variation in exercise protocols makes it difficult to pinpoint the single most effective type of workout for gut health.

Abstract

<h4>Background</h4>Structural alterations in the gut microbiota (GM) are closely linked to aging and age-related diseases. Although exercise may improve health in older adults by modulating gut microecology, its specific effects on GM lack systematic evaluation.<h4>Objective</h4>To systematically assess the effects of exercise interventions on GM diversity and characteristic microbial genera in older adults.<h4>Methods</h4>PubMed, Embase, the Cochrane Library, and Web of Science were searched from inception to December 2025 and updated in February 2026. Eligible studies included trials evaluating the effects of exercise interventions on gut microbiota in older adults. Risk of bias and evidence certainty were assessed using the Cochrane Risk of Bias 2.0 tool and the GRADE framework, respectively. Random-effects models were used to calculate Hedges' g. Subgroup analyses, meta-regression, and restricted cubic spline dose-response analyses were performed.<h4>Results</h4>Sixteen studies were included. Exercise significantly increased α-diversity, reflected by improvements in the Shannon index (g = 0.22, 95% CI: 0.06-0.38, P = 0.007) and Chao1 index (g = 0.22, 95% CI: 0.08-0.35, P = 0.002). The Observed index showed marginal significance (P = 0.052), whereas the Simpson index was unchanged. Moderate-intensity exercise demonstrated a stronger effect (g = 0.38, 95% CI: 0.18-0.58), with greater benefits in males and individuals with higher BMI. Meta-regression suggested a negative age-effect trend (β = -0.0238, P = 0.079). A significant inverted U-shaped dose-response relationship was observed for the Shannon index (non-linear P = 0.0226), with optimal effects at 700-900 METs/week. No significant changes were found in the two dominant phyla or Bifidobacterium; however, Akkermansia increased (g = 0.60, 95% CI: 0.29-0.92, P < 0.001) and Escherichia decreased (g = -0.64, 95% CI: -1.20 to -0.08, P = 0.026).<h4>Conclusion</h4>Exercise enhances α-diversity and modulates specific genera while maintaining core GM stability in older adults, with dose-dependent effects requiring confirmation in longitudinal studies.
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