A healthy diet is associated with greater physical fitness in middle-aged adults, according to research published today in the European Journal of Preventive Cardiology , a journal of the European Society of Cardiology (ESC).
Association of healthy dietary patterns and cardiorespiratory fitness in the community Summary Goals To evaluate associations of dietary indices and quantitative measures of cardiorespiratory fitness (CRF) in a large community-based sample that leverages metabolomic profiling to interrogate shared biology. Methods and results Participants in the Framingham Heart Study (FHS) underwent maximal effort cardiopulmonary exercise testing for CRF quantification (via VO2max) and completed semiquantitative food frequency questionnaires. Diet quality was assessed using the Alternative Healthy Eating Index (AHEI) and the Mediterranean Style Diet Score (MDS), and fasting blood concentrations of 201 metabolites were quantified. In 2380 FHS participants (54 ± 9 years, 54% female, body mass index 28 ± 5 kg/m2), 1 SD higher AHEI and SMD were associated with 5.2% (1.2 ml/kg/min, 95% CI 4.3–6.0%, P < 0.0001) and 4.5% (1.0 ml/kg/min, 95% CI 3.6–5.3%, P < 0.0001), 0001) VO2 peak higher in linear models adjusted for age, sex, total daily energy intake, cardiovascular risk factors, and physical activity. In participants with metabolite profiling (N = 1154), 24 metabolites were concordantly associated with both dietary indices and VO2max in multivariable-adjusted linear models (FDR < 5%). Metabolites that were associated with lower CRF and poorer dietary quality included C6 and C7 carnitines, C16:0 ceramide, and dimethylguanidino valeric acid, and metabolites that were positively associated with higher CRF and favorable dietary quality included plasmalogen phosphatidylcholine C38:7 and C38:7 and phosphatidylethanolamine C40:7 plasmalogens. Conclusion Higher quality diet is associated with higher cardiorespiratory fitness (CRF) cross-sectionally in a sample of community-dwelling middle-aged people, and metabolites highlight potential shared favorable effects on cardiometabolic health. |
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"This study provides some of the strongest and most rigorous data yet to support the connection that a better diet can lead to better fitness ," said study author Dr. Michael Mi of Beth Israel Medical Center. Deaconess, Boston, USA “The fitness improvement we saw in participants with better diets was similar to the effect of taking 4,000 more steps each day.”
Cardiorespiratory fitness reflects the body’s ability to provide and use oxygen for exercise, and integrates the health of multiple organ systems, such as the heart, lungs, blood vessels, and muscles. It is one of the most powerful predictors of longevity and health. While exercise increases cardiorespiratory fitness, it is also the case that among people who do the same amount of exercise, there are differences in physical fitness, suggesting that additional factors contribute. A nutritious diet is associated with numerous health benefits, but it has not been clear whether it is also related to fitness.
This study examined whether a healthy diet is associated with physical fitness in community-dwelling adults. The study included 2,380 people in the Framingham Heart Study . The average age was 54 years and 54% were women. Participants underwent a maximal effort cardiopulmonary exercise test on a cycle ergometer to measure VO2 peak. This is the gold standard assessment of fitness and indicates the amount of oxygen used during the highest intensity exercise possible.
Participants also completed the semiquantitative Harvard Food Frequency Questionnaire to assess their intake of 126 dietary items over the past year, ranging from never or less than once a month to six or more servings per day. The information was used to score diet quality using the Alternative Healthy Eating Index (AHEI; 0 to 110) and the Mediterranean Style Diet Score (MDS; 0 to 25), which are associated with heart health. Higher scores indicated a better quality diet that emphasized vegetables, fruits, whole grains, nuts, legumes, fish and healthy fats and limited red meat and alcohol.
The researchers evaluated the association between diet quality and fitness after controlling for other factors that could influence the relationship, such as age, sex, total daily energy intake, body mass index, smoking, cholesterol levels, blood pressure, diabetes and the level of usual physical activity. . The average AHEI and MDS were 66.7 and 12.4, respectively. Compared to the mean score, a 13-point increase in the AHEI and a 4.7-point increase in the MDS was associated with a 5.2% and 4.5% higher VO2peak, respectively.
Dr Mi said: “In middle-aged adults, healthy dietary patterns were strongly and favorably associated with physical fitness, even after accounting for usual activity levels. The relationship was similar in women and men, and more pronounced in those under 54 years of age compared to older adults.”
To uncover the potential mechanism linking diet and fitness, the researchers conducted further analysis. They examined the relationship between diet quality, fitness, and metabolites , which are substances produced during digestion and released into the blood during exercise. A total of 201 metabolites (e.g., amino acids) were measured in blood samples collected from a subset of 1,154 study participants. Some 24 metabolites were associated with poor diet and fitness, or favorable diet and fitness, after adjusting for the same factors considered in the previous analyses. Dr Mi said: "Our metabolite data suggests that healthy eating is associated with better metabolic health, which could be a possible way to lead to better fitness and exercise capacity."
Regarding limitations, he noted: “This was an observational study and we cannot conclude that eating well causes better physical condition, nor exclude the possibility of an inverse relationship, that is, that fit people choose to eat healthily.” .
Dr. Mi concluded: “There are already many compelling health reasons to consume a high-quality diet, and we provide yet another with its association with exercise. “A Mediterranean-style diet with fresh, whole foods and minimal processed foods, red meat, and alcohol is a great place to start.”
