Key result
High-intensity exercise plus a low-sugar diet improves FMD by ~1.6% in metabolic syndrome.
Why the study?
The metabolic and vascular effects of lifestyle interventions with different exercise intensities and diets in nondiabetic subjects with metabolic syndrome were not fully evaluated.
RCT (n=75)
randomized
Mean Difference: 1.56 (95% CI 0.1–3.02)
p-value: p=.036
High-intensity exercise with no-sugar diet may best improve endothelial function in metabolic syndrome; extends lifestyle data independent of weight loss.
The objective was to evaluate the metabolic and vascular effects of lifestyle interventions involving a healthy diet and either a moderate- or a high-intensity exercise regimen in nondiabetic subjects with metabolic syndrome. The effects of these interventions on flow-mediated vasodilation (FMD) and risk profiles were compared with a standard low-fat diet and engaging in daily walking (standard of care). Seventy-five healthy adults with metabolic syndrome (30-55 years old) were randomized to a 10,000-steps-a-day exercise program, a 3-times-a-week fitness (>75% peak VO(2)) program, or a 1-hour-walking-a-day program for 12 weeks. The first 2 interventions were combined with an accessible healthy, no-sugar diet; and the third was combined with a tailored low-fat diet. The outcomes, including FMD and risk factors, were examined at 12 weeks and at 1-year reassessment. Significant increase in FMD (mean difference = 1.51%, 95% confidence interval = 1.05%-3.017%, P = .0007) and decrease in arterial pressure (mean difference = 19.3 ± 2.3/-12.6 ± 1.8 mm Hg, P = .0001) were observed in all groups. However, the FMD changed most favorably in the high-intensity, low-sugar group (mean difference = 1.56%, 95% confidence interval = 0.1%-3.02%, P = .036). Significant improvements in body mass index, waist, insulin-like growth factor-1, homeostasis model assessment of insulin resistance, insulin, glucose, urinary albumin excretion, and lipid profiles occurred in all groups. Metabolic syndrome was resolved in 64%. One year later, weight loss (-9.1 ± 2.3 kg, P = .0001) and arterial pressure decrease (-18.5 ± 2.3/-12.3 ± 2.1 mm Hg, P = .0001) were maintained. Practical, health-centered diet combined with high-intensity exercise is associated with enhanced vascular protection. These data suggest that more intense exercise combined with a low-sugar diet modulates endothelium-dependent vasodilation.
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Seligman et al. (2011) conducted an RCT in metabolic syndrome (n=75). Moderate- or high-intensity exercise combined with a healthy, no-sugar diet vs. 1-hour-walking-a-day program combined with a tailored low-fat diet was evaluated on flow-mediated vasodilation (FMD) (MD 1.56%, 95% CI 0.1-3.02, p=.036). High-intensity exercise combined with a low-sugar diet improved flow-mediated vasodilation most favorably (mean difference 1.56%; 95% CI 0.1-3.02; P=.036) in adults with metabolic syndrome.
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