Intensive practical lifestyle intervention improves endothelial function in metabolic syndrome independent of weight loss: a randomized controlled trial

• Published in: Metabolism, clinical and experimental clinical and experimental, 2011-12, Vol.60 (12), p.1736-1740
• Main Authors: Seligman, Beatriz G.S, Polanczyk, Carisi A, Santos, Angela S.B, Foppa, Murilo, Junges, Mauricio, Bonzanini, Laisa, Nicolaidis, Gabriela, Camey, Suzi, Lopes, André L, Sehl, Paulo, Duncan, Bruce B, Clausell, Nadine
• Format: Article
• Language: English
• Subjects: Adult; Albuminuria - urine; Biological and medical sciences; Biomarkers - blood; Blood Flow Velocity; Blood Glucose - metabolism; Blood Pressure; Body Mass Index; Diet (effects); Diet, Fat-Restricted; Endocrinology & Metabolism; Endothelium, Vascular - physiopathology; Exercise; Exercise (programs); Feeding. Feeding behavior; Female; Fundamental and applied biological sciences. Psychology; Health; Hormones; Humans; Insulin - blood; Insulin Resistance; Insulin-Like Growth Factor I - metabolism; Lifestyle; Lipids - blood; Male; Medical sciences; Metabolic diseases; Metabolic Syndrome - blood; Metabolic Syndrome - diet therapy; Metabolic Syndrome - physiopathology; Metabolic Syndrome - rehabilitation; Middle Aged; Miscellaneous; Other metabolic disorders; Physical fitness (programs); Risk Factors; Risk Reduction Behavior; Stress; Vasodilation; Vertebrates: anatomy and physiology, studies on body, several organs or systems; Waist Circumference; Walking; Weight Loss
• ISSN: 0026-0495; 1532-8600
• DOI: 10.1016/j.metabol.2011.05.006

Abstract 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 VO2 ) 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.