Effects of Exercise and Diet on Vascular Function in Pre-Frail Individuals

Preventive or therapeutic interventions may be provided to pre-frail patients. Therefore, we investigated whether dietary and exercise interventions were effective in improving physical fitness levels and vascular functions in pre-frail older women. We conducted an 8-week parallel-group randomized controlled trial in community-dwelling pre-frail older women. Frailty was categorized using the Fried criteria. Forty-eight participants aged = 65 years (mean age, 81.5 ± 4.3 years) enrolled and divided equally into a control group (CG), a diet group (DG), and aerobic exercise and diet group (ADG), and an aerobic exercise with electromyostimulation (EMS) and diet group (AEDG). For 8 weeks, the participants received a set of protein-added customized meals twice daily during weekdays. The aerobic exercise groups performed stepping exercises at 50 %-70 % of the maximal heart rate for 3 days/week, and the AEDG had additional EMS applied on each limb at an exercise intensity 5-6, according to the revised rating of perceived exertion (RPE) (range 0-10. Body composition, blood pressure (BP), physical fitness, cardiovascular biomarkers, arterial stiffness measured by pulse wave velocity (PWV), and endothelial dysfunction measured by flow-mediated dilation (FMD) were measured at baseline and were followed up during the 8-week intervention period. There were no group differences in age, height, weight, BMI, free fat mass, and %body fat. Total caloric intake levels increased to approximately 1,500 kcal/day in all intervention groups after 8 weeks (p < 0.05). There were no significant differences in body weight and BMI between or within the interventions. For physical fitness variables, the right grip strength significantly increased in the DG, ADG, and AEDG (p < 0.05). Short physical performance battery, 6-min walking distance and FMD significantly increased in the ADG and AEDG (p < 0.05). BP and PWV did not differ between interventions (p < 0.05). There were no significant group ? time differences in glucose, HbA1c, total cholesterol, low-density lipoprotein-cholesterol, triglyceride, insulin, HOMA-IR, nitric oxide, and C-reactive protein levels, but the high-density lipoprotein-cholesterol level significantly increased after 8 weeks in all intervention groups (p < 0.05). These results indicate that consuming protein-added to healthy lunch-box and performing aerobic exercises for 8 weeks can improve physical fitness and vascular functions in pre-frail older women, thereby preventing early frailty.