January 2024

According to Bergens et al, studies that have examined the effects of healthy diets characterized by a
high intake of fruit and vegetables on inflammatory and metabolic markers produce inconclusive
results.2 Furthermore, few researchers have explored whether a combination of diet and exercise
elicits greater benefits compared to solely changing one’s diet. As such, Bergens et al utilized the
ORUDIET study protocol to determine the impact of a balanced diet alone or in combination with
exercise. The researchers conducted a 3-arm randomized controlled trial on a sample of 300 healthy
adults aged 55-70 years old. There were three groups of participants, healthy diet (HD), healthy diet
with physical activity (HD-PA), and control. Participants in the HD and HD-PA groups were instructed
to increase fruit and vegetable intake to 5 servings per day during the 16-week trial. Those
participants were also required to attend two dietary counseling sessions to identify potential barriers
in implementing a new dietary habit to support adherence to the experiment. In addition to receiving
the same dietary intervention, participants in the HD-PA group were instructed to engage in at least
150 minutes of moderate-vigorous exercise per week. Similarly, to the HD group, participants in the
HD-PA group were required to attend two counseling sessions to identify barriers for being physically
active. The participants in the control group were asked to maintain their current dietary and exercise
habits. Bergens et al measured primary outcomes such as metabolic and inflammatory biomarkers. As
well, measured secondary outcomes of body composition parameters via anthropometrical
assessments. The researchers used an FFQ to assess dietary patterns, an Actigraph GT3x activity
monitor to assess physical activity, a sphygmomanometer to measure blood pressure, and a squat jump
test to assess physical function.2 Data regarding the changes in body composition is demonstrated in
the results conducted by Hernandez-Reyes et al to evaluate the impact different PA levels have on
body fat mass and body fat in overweight and obese women.4 The participants followed the same
dietary pattern of a moderate fat restricted Mediterranean diet while distributed into three separate
PA groups, moderate, intense, and control. At the three-month mark, body weight significantly
declined from 82.56 ± 14.46 kg to 76.91 ± 12.94 kg. Body weight, BMI, and body fat percentage
continued to decrease at the six-month mark. The only significant difference in PA in the three month
and six-month marks, was seen in the intense PA group showing a correlation between high intensity
exercise and a reduction in body weight after six months of the hypocaloric diet, rich in vegetables and
low in red meat replaced with poultry and fish. Thus, a correlation is shown between a diet of lean
meat, and some form of moderate/intense PA compared to a sedentary lifestyle that has the effect of
altering body composition.4 Although the 3-arm randomized controlled trial conducted by Bergens et
al is a study protocol that only provides the framework for a future study, it establishes guidelines to
examine how healthy diets and physical activity can combat metabolic deteriorations in older adults
using epigenetic aging techniques.2,3
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