Combined moderate and high intensity exercise with dietary restriction improves cardiac autonomic function associated with a reduction in central and systemic arterial stiffness in obese adults: a clinical trial

Min Hu; Shen Wang; Dan Wang; Qinhao Lai; Xiaoying Chen; Shiwei Duan; Mengke Zhao; Junhao Huang

doi:10.7717/peerj.3900

Combined moderate and high intensity exercise with dietary restriction improves cardiac autonomic function associated with a reduction in central and systemic arterial stiffness in obese adults: a clinical trial

PeerJ. 2017 Oct 5:5:e3900. doi: 10.7717/peerj.3900. eCollection 2017.

Authors

Min Hu^{1

2}, Shen Wang^{1

2

3}, Dan Wang^{1

2}, Qinhao Lai^{1

2}, Xiaoying Chen⁴, Shiwei Duan⁴, Mengke Zhao^{1

2}, Junhao Huang^{1

2}

Affiliations

¹ Guangdong Provincial Key Laboratory of Sports and Health Promotion, Scientific Research Center, Guangzhou Sport University, Guangzhou, China.
² Department of Sports and Health, Guangzhou Sport University, Guangzhou, China.
³ School of Kinesiology, Shanghai University of Sport, Shanghai, China.
⁴ Medical Genetics Center, School of Medicine, Ningbo University, Ningbo, China.

Abstract

Objective: The present study aimed to assess the effects of exercise with dietary restriction on cardiac autonomic activity, arterial stiffness, and cardiovascular biomarkers in obese individuals.

Methods: Seventeen obese adults completed an 8-week exercise and dietary program. Anthropometry, body composition, and multiple biochemical markers were measured. We used carotid-femoral pulse wave velocity (cfPWV), brachial-ankle pulse wave velocity (baPWV), central blood pressure, and augmentation index (AIx) to assess arterial stiffness. To determine cardiac autonomic activity, heart rate variability (HRV) was analyzed by standard deviation of normal-to-normal intervals (SDNN), square root of the mean squared differences of successive normal-to-normal intervals (RMSSD), total power (TF), low-frequency power in normalized units (LFnu), high-frequency power in normalized units (HFnu), and low-frequency power/high-frequency power (LF/HF).

Results: Following the exercise and diet intervention, obese subjects had significant reductions in body weight, body mass index, body fat percentage, brachial systolic blood pressure, and resting heart rate, and they had shown improvements in blood chemistry markers such as lipid profiles, insulin, and high-sensitivity C-reactive protein. There was a significant reduction in both cfPWV and baPWV following the intervention when compared to baseline levels. Moreover, the AIx and aortic systolic blood pressure were significantly reduced after the intervention. The diet and exercise intervention significantly increased cardiac autonomic modulation (determined by improved SDNN, RMSSD, TP LF, HF, and LF/HF), which was partly due to changes in heart rate, insulin resistance, and the inflammatory pattern. Furthermore, we observed a correlation between enhanced cardiac autonomic modulation (LF/HF) and decreased arterial stiffness, as measured by central cfPWV and systemic baPWV.

Discussion: An 8-week combined intervention of diet and exercise is effective in improving cardiac autonomic function in obese adults, with an associated decrease in central and systemic arterial stiffness.

Keywords: Arterial stiffness; Autonomic function; Diet; Exercise; Obesity.

Grants and funding

This work was supported by grants from Pearl River Scholar Program in Guangdong Province of China, National Natural Science Foundation of China (No. 31600969, 31771315), Natural Science Foundation of Guangdong Province (No. 2016A030313625) and the Foundation of Youth Talents in Higher Education of Guangdong Province of China (No. 2015KQNCX083). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.