Internal Medicine Department, Graduate Program in Cardiovascular Sciences, Federal University of Rio Grande do Sul, Divisions of Internal Medicine and Cardiology, Hospital de Clínicas de Porto Alegre, Porto Alegre 90035903, Brazil.
Metabolism. 2011 Dec;60(12):1736-40. doi: 10.1016/j.metabol.2011.05.006. Epub 2011 Jun 22.
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.
目的是评估涉及健康饮食和中等强度或高强度运动方案的生活方式干预对非糖尿病代谢综合征患者的代谢和血管影响。将这些干预措施对血流介导的血管扩张（FMD）和风险特征的影响与标准低脂饮食和日常散步（标准护理）进行比较。75 名年龄在 30-55 岁之间的健康代谢综合征成年人被随机分配到每天 10000 步的运动计划、每周 3 次的健身（>75%峰值 VO₂）计划或每天 1 小时步行的计划中，持续 12 周。前 2 个干预措施与可获得的健康无糖饮食相结合；第三个干预措施与量身定制的低脂饮食相结合。在 12 周和 1 年重新评估时检查包括 FMD 和危险因素在内的结果。所有组均观察到 FMD（平均差异=1.51%，95%置信区间=1.05%-3.017%，P=0.0007）和动脉压（平均差异=19.3±2.3/-12.6±1.8mmHg，P=0.0001）的显著增加。然而，高强度低糖组的 FMD 变化最有利（平均差异=1.56%，95%置信区间=0.1%-3.02%，P=0.036）。所有组的体重指数、腰围、胰岛素样生长因子-1、稳态模型评估的胰岛素抵抗、胰岛素、血糖、尿白蛋白排泄和血脂谱均显著改善。64%的代谢综合征得到解决。一年后，体重减轻（-9.1±2.3kg，P=0.0001）和动脉压下降（-18.5±2.3/-12.3±2.1mmHg，P=0.0001）得以维持。以健康为中心的实用饮食与高强度运动相结合与增强的血管保护相关。这些数据表明，更剧烈的运动结合低糖饮食可调节内皮依赖性血管舒张。
