title: Moderate-to-high-intensity training and a hypocaloric Mediterranean diet enhance endothelial progenitor cells and fitness in subjects with the metabolic syndrome.
abstract: A reduction in EPC (endothelial progenitor cell) number could explain the development and progression of atherosclerosis in the MetS (metabolic syndrome). Although much research in recent years has focused on the Mediterranean dietary pattern and the MetS, the effect of this diet with/without moderate-to-high-intensity endurance training on EPCs levels and CrF (cardiorespiratory fitness) remains unclear. In the present study, the objective was to assess the effect of a Mediterranean diet hypocaloric model with and without moderate-to-high-intensity endurance training on EPC number and CrF of MetS patients. Thus 45 MetS patients (50-66 years) were randomized to a 12-week intervention with the hypocaloric MeD (Mediterranean diet) or the MeDE (MeD plus moderate-to-high-intensity endurance training). Training included two weekly supervised sessions [80% MaxHR (maximum heart rate); leg and arm pedalling] and one at-home session (65-75% MaxHR; walking controlled by heart rate monitors). Changes in: (i) EPC number [CD34(+)KDR(+) (kinase insert domain-containing receptor)], (ii) CrF variables and (iii) MetS components and IRH (ischaemic reactive hyperaemia) were determined at the end of the study. A total of 40 subjects completed all 12 weeks of the study, with 20 in each group. The MeDE led to a greater increase in EPC numbers and CrF than did the MeD intervention (P ≤ 0.001). In addition, a positive correlation was observed between the increase in EPCs and fitness in the MeDE group (r=0.72; r(2)=0.52; P ≤ 0.001). Body weight loss, insulin sensitivity, TAGs (triacylglycerols) and blood pressure showed a greater decrease in the MeDE than MeD groups. Furthermore, IRH was only improved after the MeDE intervention. In conclusion, compliance with moderate-to-high-intensity endurance training enhances the positive effects of a model of MeD on the regenerative capacity of endothelium and on the fitness of MetS patients.
authors.affiliation: Lipids and Atherosclerosis Unit, Department of Medicine, IMIBIC/Hospital Universitario Reina Sofía/Universidad de Cordoba, Cordoba, Spain.
authors.forename: Juan Marcelo
authors.initials: JM
authors.lastname: Fernández
authors.forename: Daniel
authors.initials: D
authors.lastname: Rosado-Álvarez
authors.forename: Marzo Edir
authors.initials: ME
authors.lastname: Da Silva Grigoletto
authors.forename: Oriol Alberto
authors.initials: OA
authors.lastname: Rangel-Zúñiga
authors.forename: Leslie Lorena
authors.initials: LL
authors.lastname: Landaeta-Díaz
authors.forename: Javier
authors.initials: J
authors.lastname: Caballero-Villarraso
authors.forename: José
authors.initials: J
authors.lastname: López-Miranda
authors.forename: Francisco
authors.initials: F
authors.lastname: Pérez-Jiménez
authors.forename: Francisco
authors.initials: F
authors.lastname: Fuentes-Jiménez
mesh_terms: D000368:Aged; D002318:Cardiovascular Diseases / Q000150:complications / Q000453:epidemiology / Q000473:pathology; D038441:Diet, Mediterranean; D042783:Endothelial Cells / Q000502:physiology; D005081:Exercise Therapy; D005260:Female; D006801:Humans; D008297:Male; D024821:Metabolic Syndrome / Q000150:complications / Q000473:pathology / Q000628:therapy*; D008875:Middle Aged; D010807:Physical Endurance; D010809:Physical Fitness; D012038:Regeneration; D012307:Risk Factors; D013234:Stem Cells / Q000502:physiology