Effects Of Time Restricted Fasting And Exercise On Arterial Stiffness In Sedentary Middle-aged And Elderly Adults:a Randomized Controlled Trial

Objective: This study adopts a randomized controlled experimental design to explore whether diet and exercise interventions are beneficial to the risk of arterial stiffness and other secondary outcomes in sedentary middle-aged and elderly people through 8-week time restricted fasting,exercise and combination of the two interventions.In order to provide a scientific and effective experimental basis for reducing cardiovascular risk.Methods: In this experiment,56 sedentary middle-aged and elderly subjects recruited were randomly divided into control group(CON group),exercise group(EX group),time restricted fasting group(TRF group)and exercise combined with time restricted fasting group(EX+TRF group).After 8 weeks of intervention,compared the arterial stiffness function indicators and blood indicators,body composition,glucose and lipid metabolism,blood factor inflammation indicators and dietary intake among the four groups of subjects before and after the intervention.CON group(n=11),EX group(n=11),TRF group(n=11)and EX+TRF group(n=14)were finally included in the analysis.SPSS 25.0 was used to analyze the paired samples T test within the group and two-way analysis of variance between the groups.Results:(1)Main results: After 8 weeks of intervention,the change value of arterial stiffness function index flow-mediated transition(FMD)was significant difference in EX group and EX+TRF group(P<0.05);the change value of anklebrachial index left(ABIL),in the comparison between the TRF group and the CON group;period of ejection(ED)was significant difference(P<0.05)in the EX+TRF group and the CON group;pulse wave velocity(PWV)and ankle-brachial index right(ABIR)were in the EX group,and cervical-femoral pulse wave velocity(Cfpwv),ABIL and ABIR were in the CON group,there were significant differences(P<0.05);in the EX group and EX+TRF group,matrix metalloproteinases-2(MMP-2)was significantly down-regulated(P<0.05),arterial stiffness index(AI)was significantly up-regulated(P<0.05),and matrix metalloproteinases-9(MMP-9)had no significant effect.(2)Secondary results: body weight and skeletal muscle decreased,and the EX+TRF group was the most significant(P<0.05);body mass index(BMI)decreased most significantly in the TRF group,increased in the CON group,and increased body fat percentage in the intervention group.Among them,EX+TRF group was the most significant(P<0.05).Glucose and lipid metabolism and dietary intake changed significantly in the EX+TRF group,among which triglycerides,high-density lipoprotein and low-density lipoprotein were significantly different(P<0.05),dietary intake showed a downward trend,and had Significant difference(P<0.05),blood factors interleukin-6(IL-6),tumor necrosis factor-α(TNF-α)and C-reactive protein(CRP)in the group analysis of EX+TRF group,there were significant differences(P<0.05).Conclusion:(1)8-week TRF and EX intervention can significantly reduce the risk of AS in sedentary middle-aged and elderly people: single EX intervention and combined with TRF have significant effects on functional indicators FMD and ED,while TRF alone has a regulating effect on ABI significantly.(2)After single TRF intervention and combined EX intervention,the effects of reducing dietary intake and improving body composition are significant;while EX alone has a significant effect on regulating the level of inflammatory factors,and TRF alone has a significant effect on the level of lipid metabolism.(3)8 weeks of TRF,EX and EX+TRF have lower adverse reactions and high compliance in the sedentary middle-aged and elderly people,showing that TRF,EX and EX+TRF have better effects application value.