The aging effect on microvascular integrity, marked by endothelial dysfunction and reduction in exercise tolerance, is a major cause of CVD (cardiovascular disease). Improved dietary habits, known to reduce morbidity and mortality, are also known to attenuate those aging effects. The present study investigated the effects of combined MD (Mediterranean diet) and exercise intervention on lower- and upper-limb cutaneous microvascular functions in an older healthy population. A total of 22 sedentary healthy participants (age, 55±4 years) underwent cardiopulmonary exercise tolerance test, and were assessed for their upper- and lower-limb vascular endothelial CVC (cutaneous vascular conductance) using LDF (laser Doppler fluximetry) with endothelium-dependent [ACh (acetylcholine chloride)] and -independent [SNP (sodium nitroprusside)] vasodilation. Participants were then randomized into two groups: MD and non-MD, and followed an 8-week intervention programme, which included discontinuous treadmill running based on each individual's exertion, twice per week. Exercise training improved CVC in both groups (e.g. 0.42±0.19 compared with 1.50±1.05 and 0.47±0.26 compared with 1.15±0.59 at 1000 μCb for MD and non-MD respectively; P<0.001). This was also combined by improvement in the exercise tolerance indicated by increased VT (ventilatory threshold) in both groups [12.2±2.8 compared with 14.8±2.8 ml·(kg of body weight)−1·min−1 and 11.7±2.7 compared with 14.6±3.2 ml·(kg of body weight)−1·min−1 for MD and non-MD groups respectively; P<0.05]. However, the MD group showed greater improvement in endothelium-dependent vasodilation than non-MD [ANCOVA (analyses of co-variance), P=0.02]. The results of the present study suggest that compliance with MD, combined with regular moderate exercise, improves age-provoked microcirculatory endothelial dysfunction and increases exercise tolerance, both responsible for reducing cardiovascular risk in this age group.

To examine the participant experiences regarding perceived barriers and facilitators which impact on consuming the Mediterranean diet in the East of England. Qualitative methodology with focus groups. A healthy, middle-aged population situated in the East of England. Intervention: An 8-week Mediterranean dietary intervention trial. Eleven participants (including three co-habiting partners) in three focus groups, ranging between 50-65yrs with a mean age of 54.3yrs (±4.0) Thematic analysis from the focus groups revealed that participants considered that the MD intervention had introduced a better quality of food, widening the food-horizon and allowed them to re-define cultural eating habits. They also reported several physical benefits from adapting to this diet and found the experience as positive. Whilst claiming that the MD was an enjoyable and pleasurable, the participants did express difficulty adapting to the eating pattern, finding difficulty in purchasing food items, an increase in food costs and found work, stress and time pressures undermining adherence. The participants’ experiences suggested that the MD was an encouraging dietary change with a middle aged non-Mediterranean based population group. Future MD interventions should tailor interventions and support participants closely, particularly with the necessary planning, organisation and purchasing involved with implementing this diet in non-Mediterranean countries. Secondly, researchers should also challenge any erroneous assumptions regarding the consumption of Mediterranean food, which may hinder implementation.

Almost 70% of all leg ulcers have a venous component. Venous leg ulcers (VLU's) are typically painful and heal slowly, resulting in an impaired quality of life (QoL), social isolation and reduced work productivity. Compression therapy offers high healing rates, however, improvements aren't usually sustained. Exercise is a low-cost, low-risk, and effective strategy for improving physical and mental health. However, little is currently known about the feasibility and efficacy of supervised exercise training used in combination with compression therapy in this patient group. To assess the feasibility of a 12-week supervised exercise programme combining aerobic, resistance and flexibility exercises as an adjunct therapy to compression in patients with VLU's. This was a two-centre, two-arm, parallel-group, randomised feasibility trial. Thirty-nine patients with venous ulcers were recruited and randomised 1:1 either to exercise (3 sessions per week) and compression therapy or compression only. Progress/success criteria included exercise attendance rate, loss to follow-up and patients’ preference. Baseline assessments were repeated at 12 weeks, 6 months and 1 year following baseline, with healing rate and time, ulcer recurrence and infection incidents also being documented. Intervention and healthcare utilisation costs were calculated. Qualitative data was collected to assess participants’ experiences. Overall, 72% of the exercise group participants attended all scheduled exercise sessions. No serious adverse events, and only two exercise-related adverse events (e.g., increased ulcer discharge) were reported. Loss to follow-up was 5%. At 12-months median ulcer healing time was lower in the exercise group (13 vs 34.7 weeks). Total NHS costs were calculated as £813.27 for the exercise and £2,298.57 for the control group. Our findings support the feasibility and acceptability of both the supervised exercise programme in conjunction with compression therapy and the study procedures. The next step will be the design and implementation of an appropriately-powered, multi-centre trial.

Static stretching prior to sport has been shown to decrease force production in comparison to the increasing popularity of dynamic warm-up methods. However some athletes continue to use a bout of static stretching following dynamic methods. The purpose of this study was to investigate the effects on speed, agility and power following a period of additional static stretching following a dynamic warm-up routine. Twenty-five male University students who participated in team sports performed two warm-up protocols concentrating on the lower body one week apart through a randomised cross over design. The dynamic warm-up (DW) protocol used a series of specific progressive exercises lasting 10 minutes over a distance of 20m. The dynamic warm-up plus static stretching (DWS) protocol used the same DW protocol followed by a 5 minute period during which 7 muscle groups were stretched. Following each warm-up the subjects performed a countermovement vertical jump, 20m sprint and Illinois agility test, 1 minute apart. The results demonstrated no significant differences in speed, agility and jump performance following the two protocols DW and DWS. The study concludes that performing static stretching following a dynamic warm-up prior to performance does not significantly affect speed, agility and vertical jump performance

Recent literature indicates the potential of community-based obesity prevention programmes in the endeavour to reduce the prevalence of obesity in developed nations. Considerable suggestion and advocacy come from theoretical standpoints and little is known on actual practical application of this type of multi-component health promotion programme. This article explores the experiences of ‘implementation’ by stakeholders of a large community-based obesity prevention programme, facilitated by a National Health Service Care Trust in the north-east of England, UK. Three stakeholder groups (senior health officials, public health workers and community members) who had administrated and experienced the programme since its conception in 2006 provide perspectives on the aspects of local delivery and receipt. Semi-structured interviews and focus groups were conducted with stakeholders (28 participants in total). The participants felt there were three broad aspects which shaped and constrained the delivery and receipt of the programme, namely partnership working, integration of services and quality issues. Data indicated that it had taken time to establish working partnerships between the multi-agencies involved in the community-based obesity programme. Strategic management would aid the processes of communication and collaboration between agencies and also the local community involved in the administration, delivery and participation of interventions in the programme. Secondly, the way in which the programme is justified and sustained will have to be reviewed, with the intention of using a suitable evaluative framework or tool for monitoring purposes.