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Effects of a multi-modal resistance exercise program and calcium-vitamin D3 fortified milk on blood pressure and blood lipids in middle-aged and older men: secondary analysis of an 18-month factorial design randomised controlled trial

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Abstract

Purpose

Physical activity and dietary interventions are recommended as front-line therapy for prevention and management of cardiovascular disease. This study investigated the independent and combined effects of low-fat, calcium-vitamin D3 fortified milk and multi-modal exercise training on blood pressure (BP) and blood lipids in middle-aged and older men.

Methods

This was a pre-planned secondary analysis of an 18-month, randomised controlled trial. Community-dwelling men aged 50–79 years (n = 180) were randomised into (i) exercise + fortified milk; (ii) fortified milk; (iii) exercise; or (iv) control. The low-fat milk (400 mL/day) was fortified with 1,000 mg/day calcium and 800 IU/day of vitamin-D3, whilst the exercise intervention consisted of three sessions/week of resistance- and weight-bearing impact exercises. Resting BP and fasting lipids were assessed at baseline, 6 (lipids only), 12 and 18 months.

Results

Mean ± SD serum 25(OH)D and calcium intake for the entire cohort at baseline was 86 ± 36 nmol/L and 1002 ± 397 mg/day, respectively, with 10% classified as vitamin-D insufficient and 58% reporting a calcium intake below 1000 mg/day. There were no exercise-by-fortified milk interactions, nor any main-group effects for exercise or milk on BP or lipids at any time. However, there were significant reductions from baseline to 18 months in systolic (mean change, 5–8 mmHg) and diastolic (4–6 mmHg) BP in the exercise, fortified milk and control groups. All results remained largely unchanged after adjusting for use of anti-hypertensive or lipid lowering medication, weight or fat mass, or only including men with hypertension (n = 89) or dyslipidemia (n = 130) at baseline.

Conclusion

Supplementation with low-fat, calcium + vitamin D3 fortified milk and a multi-modal exercise program, alone or in combination, was not effective for improving BP or blood lipids in community-dwelling middle-aged and older men.

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Acknowledgements

We thank Murray Goulburn Co-operative Co Ltd, in particular Peter Hobman and Michelle Rowney for providing the calcium-vitamin D3 low-fat UHT-fortified milk used in the study. The authors also thank The City of Greater Geelong and Ocean View Health Club for their generous provision of the gymnasium facilities used throughout the study. The authors also thank the following people for contributions to the study: Nicole Petrass, Joanne Daly, Sam Kom.

Funding

This study was financially supported by a grant from the Australian Research Council (ARC) Linkage Scheme. Professor Robin Daly was supported by an Osteoporosis Australia Research Fellowship and a National Health and Medical Research Council (NHMRC) Career Development Award (ID 425849). Stephen Foulkes is supported by an Australian Government Research Training Program Scholarship (RTP 4635089552).

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Authors and Affiliations

  1. Institute for Physical Activity and Nutrition Research, School of Exercise and Nutrition Sciences, Deakin University, 221 Burwood Highway, Burwood, Melbourne, 3125, Australia

    Stephen Foulkes, Sonja Kukuljan, Caryl A. Nowson & Robin M. Daly

  2. Department of Medicine, The University of Melbourne, Melbourne, VIC, Australia

    Kerrie M. Sanders

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  1. Stephen Foulkes
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Contributions

The authors’ contributions were as follows: RMD, CAN and KS designed the research; SK conducted the research; SK and RMD created and managed the databases; SF and RMD analysed the data; SF and RMD wrote the paper; SF and RMD had primary responsibility for final content. All authors critically reviewed the manuscript and read and approved the final version.

Corresponding author

Correspondence to Robin M. Daly.

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Conflict of interests

The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Ethics approval

The study was approved by the Deakin University Human Ethics Committee and Barwon Health Research and Ethics Advisory Committee.

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All participants provided informed written consent.

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The datasets used and/or analysed during the current study are available from the corresponding author on reasonable request.

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Foulkes, S., Kukuljan, S., Nowson, C.A. et al. Effects of a multi-modal resistance exercise program and calcium-vitamin D3 fortified milk on blood pressure and blood lipids in middle-aged and older men: secondary analysis of an 18-month factorial design randomised controlled trial. Eur J Nutr 60, 1289–1299 (2021). https://doi.org/10.1007/s00394-020-02325-x

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