Effects of a Short-Term Nutritional Intervention on Vascular Changes in Individuals with Obesity and Low or Moderate Cardiovascular Health.

Abstract

Introduction: Most cardiovascular events can be prevented by controlling health conditions and behaviors that reflect cardiovascular health (CVH) classification as high, moderate, and low.

Aim: To evaluate the effect of weight loss through an 8-week hypocaloric diet on vascular function and sympathetic tone in individuals with obesity and moderate or poor CVH.

Methods: Individuals aged 40-70 years and body mass index  ≥ 30 kg/m² followed a low-calorie diet (800 kcal/day reduction) for 8 weeks. Central hemodynamics (Mobil-O-Graph®), heart rate variability (Polar® RS800), and microvascular reactivity (Laser Speckle Contrast Imaging) were assessed at baseline and post-intervention.

Results: Seventy-one patients were divided into moderate CVH (n = 44) and low CVH (n = 27) groups. After the intervention, both groups presented similar weight loss (3.4 vs 3.1%). Only the low CVH group showed a significant reduction in central systolic blood pressure (cSBP, 113 ± 12 to 109 ± 9 mmHg; p = 0.049) and an increase in cutaneous vascular conductance in post-occlusive reactive hyperemia (CVC-PORH, 0.99 ± 0.28 to 1.08 ± 0.28 APU/mmHg; p = 0.039). Conversely, only the moderate CVH group exhibited an increase in RR interval (933 ± 130 to 994 ± 131 ms; p = 0.006) and a decrease in sympathetic nervous system index (iSNS). Significant inverse correlations were observed in the low CVH group between the variations in CVC-PORH with pulse wave velocity (r = - 0.40, p = 0.044) and with iSNS (r = - 0.52, p = 0.021).

Conclusion: Even modest weight loss led to early improvements in vascular function and blood pressure in individuals with low CVH, while autonomic benefits were more evident in those with moderate CVH.