Cardiac Effects of Combined Versus Individual Interventions of Mediterranean Diet and Exercise in Adults with the Hypertriglyceridemic Waist Phenotype: A Randomized Trial.
Paquin A, Prémont C, et al. • Metabolic syndrome and related disorders • 2026
No interaction between the MedDiet and exercise interventions on LV structure and function was observed among adults with the hypertriglyceridemic waist phenotype.
Key Findings
Results
Combining a Mediterranean Diet and exercise did not improve left ventricular structure or function more than the sum of each individual intervention.
A 2 × 2 factorial randomized trial compared MedDiet alone, exercise alone, MedDiet + exercise, and control for 16 weeks.
An interaction ratio between MedDiet and exercise was calculated in mixed-effects models adjusted for age, sex, and baseline values.
"No significant interactions between interventions were identified with respect to LV measurements."
Results
Posterior wall thickness was higher after the intervention in the MedDiet groups than in the non-MedDiet groups.
The difference was 0.04 cm (95% CI: 0.01-0.07).
Posterior wall thickness is a measure of LV structure.
Post-intervention echocardiographic values were compared adjusting for age, sex, and baseline values.
Results
Septal mitral annular tissue Doppler e' velocity, a marker of diastolic function, was higher in the exercise groups than in the non-exercise groups.
The difference was 0.4 cm/s (95% CI: 0.0-0.8).
The lower bound of the confidence interval is at 0.0, so the effect is borderline.
Results
Most participants had LV measurements within the normal range at baseline, and the study sample was predominantly women.
200 adults with the hypertriglyceridemic waist phenotype were recruited; 185 (76% women) had available echocardiographic data.
Inclusion criteria: triglycerides ≥1.50 mmol/L and waist circumference ≥80 cm in women or ≥94 cm in men.
Methods
The interventions were structured as 16-week programs with defined diet and exercise components.
MedDiet groups received education, counseling, and key MedDiet food items.
Exercise groups followed a structured program aiming for 150 min per week of moderate-intensity aerobic exercise.
Data were collected at screening, baseline, and post-intervention visits.
Conclusions
The authors conclude that longer follow-up or populations with more advanced cardiac alterations are needed to determine whether the combined interventions can prevent adverse LV remodeling.
Participants largely had normal LV measurements, which may limit the room for improvement.
The intervention lasted only 16 weeks.
What This Means
This study tested whether combining a Mediterranean diet with a structured exercise program would benefit heart structure and function more than either approach alone. It enrolled 200 adults with the hypertriglyceridemic waist phenotype (a large waist plus high blood triglycerides), a pattern linked to heart disease risk. Participants were randomly assigned for 16 weeks to diet, exercise, both, or a control group, and heart ultrasound data were available for 185 of them.
The combination did not show an added benefit beyond the individual interventions. Small differences did appear: the heart's posterior wall was slightly thicker in the diet groups, and a measure of how well the heart relaxes (e' velocity) was slightly higher in the exercise groups, although the latter was borderline. Most participants had normal heart measurements at the start, so there may have been little room for improvement.
This research suggests that, over 16 weeks in people with mostly healthy heart measurements, combining diet and exercise does not change heart structure and function more than expected from each alone. Longer studies, or studies in people with more advanced heart changes, are needed to find out whether the combination could help prevent harmful heart remodeling over time.
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Paquin A, Prémont C, Mathieu M, Lê-Brassard M, Gigleux I, Neyron A, et al.. (2026). Cardiac Effects of Combined Versus Individual Interventions of Mediterranean Diet and Exercise in Adults with the Hypertriglyceridemic Waist Phenotype: A Randomized Trial.. Metabolic syndrome and related disorders. https://doi.org/10.1177/15578518261500227