Effective Intervention Strategies Combining Mediterranean Diet and Exercise for Reducing Obesity, Metabolic and Cardiovascular Risks in High-Risk Populations: Mini Review

Abstract

The global rise in obesity and cardiovascular disease is not showing any sign of slowing
down, and effective health interventions may provide an important part of the solution. Whilst
comprehensive evidence about the health benefits of the Mediterranean Diet (MD) continues
to emerge for obesity, diabetes and cardiovascular disease, the combined MD benefits with
physical activity and exercise benefits remain under-investigated. Recent evidence suggests a
cardio metabolic risk improvement through combining aerobic exercise with MD, though the
problems related to dropout, remain critical. Many interventions conducted in populations at
high Cardiovascular disease (CVD) risk such as older patients, postmenopausal women, obese
patients and those with metabolic syndrome have shown promising effects when combining
exercise training strategies with MD, particularly in improving vascular endothelial function,
markers of inflammation, glucose control and cardiorespiratory capacity. However, it is still
unknown whether the specific benefits are attributable to exercise alone or to MD alone. Various physical activity and exercise training protocols including moderate aerobic, high-intensity
interval training and strength training have shown effectiveness in reversing the cardiovascular risk in a variety of high-risk populations. Nonetheless, combining the exercise-dependent
health effects with MD requires further investigation, particularly in considering the independent or joint changes in the CVD risk-biomarkers associated with either exercise training, MD
compliance, or joint effectiveness on endothelial vascular function disease pro-inflammatory
and anti-inflammatory biomarkers, and the identification of the most appropriate exercise training protocols in terms of mode, duration and intensity in high-risk populations