title: Mediterranean diet, moderate-to-high intensity training, and health-related quality of life in adults with metabolic syndrome.
abstract: BACKGROUND
  Much recent research has focused on the benefits of the Mediterranean diet on risk factors of metabolic syndrome (MetS). In addition numerous investigations have also demonstrated that moderate and high-intensity endurance training may induce greater beneficial adaptations in body composition and cardiometabolic risk than low-intensity endurance training. How a model of Mediterranean diet with and without moderate-to-high intensity training influences health-related quality of life (HRQoL) and physical fitness in MetS patients is unknown.
  
  
  METHODS
  A total of 45 sedentary MetS males and females (50⊟66 years) were randomly divided into two groups: (a) hypocaloric, normoproteic Mediterranean diet (MeD); and (b) the same diet plus periodized moderate-to-high intensity training (MeDE) for 12 weeks. HRQoL (EuroQol and SF-36 questionnaires), fitness, response to submaximal exercise, and risk factors of MetS were determined before and after treatment.
  
  
  RESULTS
  MeD improved some physical and mental domains of HRQoL (physical function, vitality, general physical health, emotional role, and self-perception of health) and resulted in weight loss and improvement of MetS risk factors (intra-group p < 0.05). Moreover, the MeDE intervention resulted in greater improvement in these domains and the improvement of other HRQoL components (physical role, bodily pain, social function, and health profile). MeDE increased physical fitness, resulted in a better physiological response to submaximal effort and caused a greater weight loss (intra-group and inter-group, p < 0.05).
  
  
  CONCLUSIONS
  A model of hypocaloric Mediterranean diet combined with periodized moderate-to-high intensity training may lead to greater improvement in HRQoL through a greater effect on physical and functional fitness, bodyweight, and risk factors than diet alone.
authors.affiliation: IMIBIC/Hospital Universitario Reina Sofía/Universidad de Cordoba, Cordoba, Spain; and Instituto de Salud Carlos III, Madrid, Spain.
authors.forename: L
authors.initials: L
authors.lastname: Landaeta-Díaz
authors.forename: J M
authors.initials: JM
authors.lastname: Fernández
authors.forename: M
authors.initials: M
authors.lastname: Da Silva-Grigoletto
authors.forename: D
authors.initials: D
authors.lastname: Rosado-Alvarez
authors.forename: A
authors.initials: A
authors.lastname: Gómez-Garduño
authors.forename: F
authors.initials: F
authors.lastname: Gómez-Delgado
authors.forename: J
authors.initials: J
authors.lastname: López-Miranda
authors.forename: F
authors.initials: F
authors.lastname: Pérez-Jiménez
authors.forename: F
authors.initials: F
authors.lastname: Fuentes-Jiménez
mesh_terms: D000368:Aged; D000704:Analysis of Variance; D031204:Caloric Restriction; D003131:Combined Modality Therapy; D038441:Diet, Mediterranean; D005080:Exercise Test; D005081:Exercise Therapy; D005260:Female; D006801:Humans; D008297:Male; D008603:Mental Health; D024821:Metabolic Syndrome / Q000175:diagnosis / Q000503:physiopathology / Q000523:psychology / Q000628:therapy*; D008875:Middle Aged; D010807:Physical Endurance; D010809:Physical Fitness; D011788:Quality of Life; D013030:Spain; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome; D015431:Weight Loss