title: Long-term effects of an exercise and Mediterranean diet intervention in the vascular function of an older, healthy population.
abstract: BACKGROUND
  Preserving endothelial function and microvascular integrity is suggested to reduce cardiovascular disease risk. It was recently shown that the age-dependent decline in endothelial and microvascular integrity may be reversed when combining exercise with Mediterranean diet (MD) in an 8-week intervention. The present study investigates whether the risk-reduction improvement in microcirculatory and cardiorespiratory functions are sustained in this age-group after a 1-year follow-up.
  
  
  METHODS
  Twenty sedentary healthy participants (age, 55±4years) from the original study underwent cardiopulmonary exercise tolerance test and were assessed for their upper- and lower-limb vascular endothelial cutaneous vascular conductance (CVC) using laser Doppler fluximetry (LDF) with endothelium-dependent [ACh (acetylcholine chloride)] and endothelium-independent [SNP (sodium nitroprusside)] vasodilation, 1year after completing the intervention.
  
  
  RESULTS
  Both MD and exercise groups appeared to have an improved microvascular responses, in comparison to baseline as far as ACh is concerned. Exploring the interactions between the time point and the original group, however, revealed a stronger improvement in the MD group in comparison to the exercise group, for ACh (p=0.04, d=0.41). In the upper body, the time point and group interaction for ACh, indicated a better improvement for MD, without however statistical significance (p=0.07, d=0.24). Additionally, cardiorespiratory improvement in ventilatory threshold was maintained, 1year after (12.2±3.0 vs. 13.2±3.2ml∙kg(-1)∙min(-1), p<0.05).
  
  
  CONCLUSIONS
  The original improvements from an 8-week exercise and MD intervention were still evident, particularly in the microcirculatory and cardiorespiratory assessments, 1year after the initial study. This suggests that a brief intervention combining MD with exercise in this high-risk group promises long-term health benefits.
authors.affiliation: Centre for Sports and Exercise Science, Sheffield Hallam University, UK. Electronic address: m.klonizakis@shu.ac.uk.
authors.forename: Markos
authors.initials: M
authors.lastname: Klonizakis
authors.affiliation: Academy of Sport and Physical Activity, Sheffield Hallam University, UK. Electronic address: a.alkhatib@shu.ac.uk.
authors.forename: Ahmad
authors.initials: A
authors.lastname: Alkhatib
authors.affiliation: School of Sport and Exercise Science, University of Lincoln, UK. Electronic address: gmiddleton@lincoln.ac.uk.
authors.forename: Geoff
authors.initials: G
authors.lastname: Middleton
mesh_terms: D000367:Age Factors; D000375:Aging; D001783:Blood Flow Velocity; D038441:Diet, Mediterranean; D015444:Exercise; D005080:Exercise Test; D017079:Exercise Tolerance; D005260:Female; D006304:Health Status; D006801:Humans; D017078:Laser-Doppler Flowmetry; D035002:Lower Extremity; D008297:Male; D008833:Microcirculation; D008875:Middle Aged; D012123:Pulmonary Ventilation; D012039:Regional Blood Flow; D057185:Sedentary Behavior; D012867:Skin / Q000098:blood supply*; D013997:Time Factors; D016896:Treatment Outcome; D034941:Upper Extremity; D014664:Vasodilation; D014665:Vasodilator Agents
chemical_list: D014665:Vasodilator Agents
keywords: Ageing; Endothelium; Fitness assessment; Mediterranean diet; Microcirculation; Nutrition