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A low-calorie diet with or without exercise reduces postprandial aortic waveform in females with obesity
Heiston EM, Gilbertson NM, Eichner NZM, Malin SK
Medicine and Science in Sports and Exercise 2021 Apr;53(4):796-803
clinical trial
5/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: No; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: Yes; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

PURPOSE: Arterial stiffness is considered a predictor of cardiovascular disease. Females have higher values of arterial stiffness than males, suggesting a greater risk of heart-related complications. Although a low-calorie diet (LCD) reduces fasting arterial stiffness, in part through weight loss, it is unknown if interval exercise (INT) adds to the benefit of LCD on fasting and postprandial arterial stiffness in females with obesity. METHODS: Twenty-five females (47 +/- 2.6 yr, 37.6 +/- 1.3 kg/m2) were randomized to 13 d of LCD (n = 12; mixed meals of approximately 1,200 kcal/d) or LCD+INT (n = 13; 60 min/d of supervised 3-min intervals at 90% HRpeak and 50% HRpeak). Arterial stiffness (augmentation index (AIx) and carotid-femoral pulse wave velocity (cfPWV)) and blood biochemistries were measured during a 75-g oral glucose tolerance test before and after the intervention to determine fasting and postprandial arterial stiffness as well as insulin sensitivity (simple index of insulin sensitivity (SIIS)) and inflammation (C-reactive protein, interleukin 8, and tumor necrosis factor alpha). RESULTS: Although LCD+INT increased VO2peak and HDL compared with LCD (p = 0.04 and p < 0.01, respectively), both interventions decreased body fat, LDL, total cholesterol, and triglycerides (all p < 0.01) and increased SIIS (p = 0.03). Despite no effect on fasting AIx (p = 0.27), LCD and LCD+INT decreased AIx60min (-7.4% +/- 4.3% versus -7.0% +/- 5.0%, p = 0.04) and tAUC120min (-663 +/- 263 versus -457 +/- 406, p = 0.03). There were no changes in fasting cfPWV (p = 0.91) or cfPWV120min (p = 0.62). Increased SIIS and decreased interleukin 8 were associated with reduced fasting AIx (r = -0.44, p = 0.03, and r = 0.40, p = 0.055), whereas decreased C-reactive protein correlated with reduced postprandial AIx60min (r = 0.43, p = 0.04). CONCLUSION: Independent of exercise, 13 d of LCD reduces postprandial AIx in females with obesity. Insulin sensitivity and inflammation correlated with improved arterial stiffness, suggesting unique mechanisms regulate fasted versus postprandial arterial stiffness.

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