Supplementing exercise: translational considerations for nutraceutical and lifestyle interventions

Abstract

Ageing is the primary risk factor for cardiovascular diseases (CVD). With the unprecedented increase in the ageing population, the need for effective interventions and an understanding of their mechanism(s) of action is of utmost biomedical importance. Exercise elicits beneficial effects on cardiovascular health in older adults and is an important lifestyle intervention for the primary prevention of CVD. Preclinical studies suggest that the polyphenol resveratrol, a caloric restriction mimetic, potentiates the beneficial effects of exercise and may be a novel intervention for CVD prevention. Recently, Gliemann et al. (2013) conducted a translational investigation to assess the efficacy of concomitant resveratrol and exercise training for improving multiple markers of cardiovascular health including exercise capacity, functional performance and vascular function in older adults, as well as the mechanisms involved therein. Gliemann et al. (2013) randomized older (60- to 72-year-old) sedentary men into two groups matched for aerobic capacity and clinical characteristics. Both groups underwent 8 weeks of exercise training with either placebo or resveratrol supplementation (250 mg trans-resveratrol per day). Resveratrol supplementation with exercise did not provide synergistic benefits on the outcomes assessed compared with exercise alone and blunted exercise-induced improvements in some outcomes. Specifically, while percentage body fat decreased and functional performance increased in both groups, the resveratrol group failed to achieve significant reductions in mean arterial pressure and exhibited a significantly smaller increase in maximal oxygen uptake. Subjects randomized to the resveratrol and exercise group also exhibited increased muscle expression of the procoagulant and vasoconstrictor protein, thromboxane. In contrast to the authors’ hypothesis, skeletal muscle expression of the central metabolic regulator sirtuin-1 (SIRT1) did not change across the intervention period in either group. The findings by Gliemann et al. (2013) suggest that in contrast to select evidence from preclinical studies, concomitant resveratrol supplementation and exercise training do not have synergistic effects to improve markers of cardiovascular health in humans. This contradiction highlights two important issues, i.e. the importance of effective clinical translation of preclinical findings to humans and the importance of hormesis in the maintenance of human health.