Long-Term Effects in the EXERDIET-HTA Study: Supervised Exercise Training vs. Physical Activity Advice

ABSTRACT

Purpose: To determine whether improvements in cardiorespiratory fitness (CRF), blood pressure (BP) and body composition previously seen after a 16-week exercise intervention (POST) with hypocaloric diet are maintained following six months (6M) of unsupervised exercise time. Methods: Overweight/obese, physically inactive participants with primary hypertension (HTN) (n = 190) were randomly assigned into an attention control group (physical activity recommendations) or one of three supervised exercise groups. After POST, all participants received diet and physical activity advice for the following 6M but no supervision. All anthropometric and physiological measurements were taken pre and post the 16-week supervised intervention period, as well as after 6M of no supervision. Results: After 6M: 1) body mass (BM) (Δ = 2.5%) and waist circumference (Δ = 1.8%) were higher (P < .005) than POST, but lower (P < .005) than pre-intervention (BM, Δ = −5.1%; waist circumference, Δ = −4.7%), with high-volume and high-intensity interval training group revealing a higher BM reduction (Δ = −6.4 kg) compared to control group (Δ = −3.5 kg); 2) BP variables were higher (P < .001) compared to POST with no change from pre-intervention; and 3) CRF was higher compared to pre-intervention (Δ = 17.1%, P < .001) but lower than POST (Δ = −5.7%, P < .001). Conclusions: When an overweight/obese population with HTN attains significant improvements in cardiometabolic health POST intervention with diet restriction, there is a significant reduction following 6M when exercise and diet supervision is removed, and only recommendations were applied. These results suggest the need for a regular, systematic and supervised diet and exercise programs to avoid subsequent declines in cardiometabolic health.

KEYWORDS:

• Obesity
• blood pressure
• cardiorespiratory fitness
• body composition

Acknowledgments

Our special thanks to Javier Pérez-Asenjo, the cardiologist who has promoted and taken part in this project with medical assessment. Also, thanks to the Department of Physical Education and Sport and Faculty of Physical Education and Sport-Physical Activity and Sport Sciences Section (University of the Basque Country, UPV/EHU) for believing in our project and providing the material and facilities to start with. Also, thanks to Exercycle S.L. (BH Fitness Company) for the machines donated to conduct the exercise intervention. Last but not least to all undergraduate students who collaborated in this project (2011-2017 academic years).

Additional information

Funding

This work was supported by the University of the Basque Country (EHU14/08, PPGA18/15) and the Government of the Basque Country supported PC, AMAB, and IGA with predoctoral grants. www.clinicaltrials.gov, number NCT02283047.