Effects of combined exercise training with or without nutritional counseling on cardiovascular risk factors in older adults with hypertension: a pragmatic randomized trial
4 affiliations
- 1Postgraduate Program in Cardiology, School of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS 90035-903 Brazil
- 2Sports and Exercise Training Study Group, Clinical Research Center, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS 90035-903 Brazil
- 3Postgraduate Program in Human Movement Sciences, School of Physical Education, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS 90690-200 Brazil
- 4Present Address: Postgraduate Program in Cardiology, School of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS 90035-903 Brazil
Abstract
High blood pressure and elevated glycemia increase cardiovascular risk in older adults. Physical activity and diet are cornerstone non-pharmacological strategies to manage these risk factors. However, interventions in community settings focusing on the combination of exercise and nutrition are scarce. This pragmatic randomized controlled trial compared combined exercise training with versus without nutritional counseling on fasting blood glucose (primary outcome), blood pressure, body composition, and cardiorespiratory fitness in older adults with hypertension. Thirty-two participants (50–80 years) were randomly assigned to exercise training alone (EX; n = 16), comprising walking/jogging and calisthenics (60 min per session, twice weekly), or exercise training plus nutritional counseling based on the Brazilian Dietary Guidelines (EX + N; n = 16; six biweekly group sessions emphasizing food quality and reduction of ultra-processed foods without energy restriction). The 12-week combined training was conducted in outdoor athletics track. Data were analyzed using generalized estimating equations with intention-to-treat principle. Between-group differences used Bonferroni correction, effect sizes used Hedges’ g, and significance was α < 0.05. Twenty-nine participants completed the intervention. Fasting blood glucose was lower in EX + N than EX (-10 mg/dL; P = 0.004; g = 1.07). Systolic blood pressure decreased within EX + N (−10 mmHg; P = 0.034; g = 0.89) but not within EX, with no between-group difference (P = 0.220; g = 0.43). No between-group differences for diastolic blood pressure, body composition, or cardiorespiratory fitness. Nutritional counseling added to a community-based exercise program reduced fasting blood glucose compared with exercise alone, supporting the addition of nutritional counseling to exercise as a pragmatic strategy.
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BibTeX
@article{schneider2026effects,
title = {{Effects of combined exercise training with or without nutritional counseling on cardiovascular risk factors in older adults with hypertension: a pragmatic randomized trial}},
author = {Vinícius Mallmann Schneider and Laura de Lima Silva and Gabriel Carvalho and Gabriel Lemes and Dalva Muniz Pereira and Rodrigo Ferrari},
journal = {Journal of Human Hypertension},
year = {2026},
month = sep,
doi = {10.1038/s41371-026-01217-7},
url = {https://doi.org/10.1038/s41371-026-01217-7},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Effects of combined exercise training with or without nutritional counseling on cardiovascular risk factors in older adults with hypertension: a pragmatic randomized trial
AU - Vinícius Mallmann Schneider
AU - Laura de Lima Silva
AU - Gabriel Carvalho
AU - Gabriel Lemes
AU - Dalva Muniz Pereira
AU - Rodrigo Ferrari
PY - 2026
DA - 2026/09/03
JO - Journal of Human Hypertension
DO - 10.1038/s41371-026-01217-7
UR - https://doi.org/10.1038/s41371-026-01217-7
AB - High blood pressure and elevated glycemia increase cardiovascular risk in older adults. Physical activity and diet are cornerstone non-pharmacological strategies to manage these risk factors. However, interventions in community settings focusing on the combination of exercise and nutrition are scarce. This pragmatic randomized controlled trial compared combined exercise training with versus without nutritional counseling on fasting blood glucose (primary outcome), blood pressure, body composition, and cardiorespiratory fitness in older adults with hypertension. Thirty-two participants (50–80 years) were randomly assigned to exercise training alone (EX; n = 16), comprising walking/jogging and calisthenics (60 min per session, twice weekly), or exercise training plus nutritional counseling based on the Brazilian Dietary Guidelines (EX + N; n = 16; six biweekly group sessions emphasizing food quality and reduction of ultra-processed foods without energy restriction). The 12-week combined training was conducted in outdoor athletics track. Data were analyzed using generalized estimating equations with intention-to-treat principle. Between-group differences used Bonferroni correction, effect sizes used Hedges’ g, and significance was α < 0.05. Twenty-nine participants completed the intervention. Fasting blood glucose was lower in EX + N than EX (-10 mg/dL; P = 0.004; g = 1.07). Systolic blood pressure decreased within EX + N (−10 mmHg; P = 0.034; g = 0.89) but not within EX, with no between-group difference (P = 0.220; g = 0.43). No between-group differences for diastolic blood pressure, body composition, or cardiorespiratory fitness. Nutritional counseling added to a community-based exercise program reduced fasting blood glucose compared with exercise alone, supporting the addition of nutritional counseling to exercise as a pragmatic strategy.
SN - 0950-9240
SN - 1476-5527
ER -