Sustainable Exercise and Nutrition Programs for Managing Metabolic Disorders in Older Women

Condition(s) studied

Investigational drug(s) / intervention(s)

Sustainable Diet Program: Intervention based on the Mediterranean sustainable diet. It emphasizes the consumption of fish, fruits, and vegetables, while reducing the intake of meat and meat-derived products. The diet is tailored to the participants' health status, activity level, and nutritional requirements, following the recommendations of the Spanish Society of Cardiology and Endocrinology. Macronutrient and micronutrient goals follow national guidelines and are tracked using specialized dietary software.

Supervised Physical Exercise Program: A 12-week supervised physical exercise program led by certified professionals in Sport Sciences. Exercise prescriptions are tailored individually based on baseline assessments and international guidelines from fields such as cardiology and metabolism. The sessions may include strength, endurance, or combined training. In the supervised period, the instructor guides the sessions, while during the unsupervised period, exercises are followed via an online platform that provides detailed explanations and graphics.

Combined Sustainable Diet and Exercise Program: This experimental arm combines the dietary intervention based on the sustainable Mediterranean diet with the structured physical exercise program. Both components are personalized and adhere to national and international health and nutrition recommendations. The program includes a 12-week supervised phase and an unsupervised online phase, aiming to maximize improvements in metabolic, physical, and psychosocial health in older women with metabolic alterations.

Study summary

This study aims to evaluate the impact of sustainable diet and exercise programs on metabolic health and quality of life in older women. Participants will be assigned to different intervention groups including supervised physical training, personalized dietary guidance based on the Mediterranean dietary pattern, or a combination of both. The programs will be implemented over several weeks, with continuous monitoring of variables such as body composition, functional capacity, strength, fatigue perception, sleep quality, and emotional well-being. The project also includes the development of a digital platform to support remote engagement and long-term health behavior change.

Eligibility

Primary outcome measure(s)

• Weight — Baseline (Week 0) and Week 12
  Measured in kilograms using a calibrated digital scale.
• Heigth — Baseline (Week 0) and Week 12
  Measured in centimeters using a fixed wall-mounted stadiometer.
• BMI — Baseline (Week 0) and Week 12
  Calculated as weight (kg) divided by height squared (m²), using measurements taken as above.
• Waist circunference — Baseline (Week 0) and Week 12
  Measured in centimeters using a flexible, non-elastic anthropometric tape at the midpoint between the last rib and the iliac crest.
• Body fat percentage — Baseline (Week 0) and Week 12
  Measured using multifrequency bioelectrical impedance.
• Health-related quality of life (SF-36 score) — Baseline (Week 0) and Week 12
  Measured using the 36-Item Short Form Health Survey (SF-36), validated in Spanish (Vilagut, 2005), which assesses 8 domains of quality of life. Scores range from 0 to 100, with higher scores indicating better health-related quality of life.
• Fatigue and perceived effort — Baseline (Week 0) and Week 12
  Measured with the Fatigue Severity Scale (FSS), a validated questionnaire that includes 9 items rated on a 7-point Likert scale. Scores range from 1 to 7, with higher scores indicating greater fatigue and perceived effort.
• Energy intake (kcal/day) — Baseline (Week 0) and Week 12
  Total daily energy intake assessed through 3-day dietary records and a validated food frequency questionnaire for the Spanish population. Energy intake will be calculated in kilocalories per day (kcal/day) using standardized nutrient databases.
• Carbohydrate intake — Baseline (Week 0) and Week 12
  Average daily carbohydrate intake measured through 3-day dietary records, expressed in grams. Higher values indicate greater carbohydrate consumption.
• Protein intake — Baseline (Week 0) and Week 12
  Average daily protein intake measured through 3-day dietary records, expressed in grams. Higher values indicate greater protein consumption.
• Fat intake — Baseline (Week 0) and Week 12
  Average daily fat intake measured through 3-day dietary records, expressed in grams. Higher values indicate greater fat consumption.
• Daily step count — Baseline (Week 0) and Week 12
  Average number of steps per day measured with an accelerometer-based activity tracker. Higher scores indicate higher physical activity levels.
• Active minutes per day — Baseline (Week 0) and Week 12
  Daily time spent in moderate to vigorous physical activity, measured in minutes per day using an accelerometer. Higher scores indicate higher physical activity levels.
• Sedentary time per day — Baseline (Week 0) and Week 12
  Average number of minutes per day spent in sedentary behavior (e.g., sitting or lying down), measured via accelerometer. Higher scores indicate greater sedentary behavior (worse outcome).
• Sleep quality (PSQI total score) — Baseline (Week 0) and Week 12
  Measured using the Pittsburgh Sleep Quality Index (PSQI), which provides a global score based on 19 items grouped into 7 components. Total scores range from 0 to 21, where higher scores indicate poorer sleep quality. PSQI score (range: 0-21).
• Gait speed (10-meter walk test) — Baseline (Week 0) and Week 12
  Assessed by measuring the time to walk 10 meters at usual pace using infrared photocells (Chronojump, Barcelona, Spain).
• Cardiovascular endurance (6-minute walk test) — Baseline (Week 0) and Week 12
  Evaluated using the 6-minute walk test (6MWT). Distance walked in 6 minutes on a flat surface, timed with a chronometer. Conducted on the athletics track at the University of Alicante.
• Handgrip strength — Baseline (Week 0) and Week 12
  Measured using a digital hand dynamometer. Maximum isometric voluntary contraction recorded in the dominant hand.
• Lower-limb isometric strength — Baseline (Week 0) and Week 12
  Assessed through maximum isometric voluntary contraction of the lower limbs using Kinvent force sensors and biofeedback platform.
• Sarcopenia diagnosis — Baseline (Week 0) and Week 12
  Assessed according to the European Working Group on Sarcopenia in Older People criteria (EWGSOP, Cruz-Jentoft et al., 2010), using muscle strength, muscle mass and functional performance.
• Basal metabolic rate — Baseline (Week 0) and Week 12
  Measured using indirect calorimetry
• Systolic and diastolic blood pressure — Baseline (Week 0) and Week 12
  Assessed using an automatic digital sphygmomanometer (Omron Healthcare, Osaka, Japan), following standardized measurement protocol.
• Cholesterol — Baseline (Week 0) and Week 12
  Measured using the Accutrend Plus analyzer (Roche Diagnostic, Mannheim, Germany) from capillary blood samples.
• Triglycerides — Baseline (Week 0) and Week 12
  Measured using the Accutrend Plus analyzer (Roche Diagnostic, Mannheim, Germany) from capillary blood samples.
• Glucose — Baseline (Week 0) and Week 12
  Measured using the Accutrend Plus analyzer (Roche Diagnostic, Mannheim, Germany) from capillary blood samples.

Trial sites (1)

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