The Effect of Water Physical Exercise Program in Thermal Water and Hydropinotherapy on Cardiovascular Health

The Effect of Water Physical Exercise Program in Thermal Water and Hydropinotherapy on Cardiovascular Health

The goal of this randomized four-arm clinical trial is to determine the effect of 16-week water physical exercise program in thermal water and hydroponotherapy on lipide profile in middle-aged and elderly people, with controlled health conditions.

Participants will be randomizate into four arms:

• Arm I: Control
• Arm II: Water Physical Exercise Program (WPEP) in thermal water
• Arm III: Hydropinotherapy with thermal water combined with bay leaf (L. nobilis)
• Arm IV: WPEP in thermal water and hydropinotherapy with thermal water combined with bay leaf (L. nobilis)

Primary outcome:

1. Lipid profile (cholesterol total, low-density lipoprotein cholesterol (c-LDL), high-density lipoprotein cholesterol (c-HDL), triglycerides)

   Secondary parameters:

2. Inflammatory biomarkers: interleukin-6 (IL-6), C-reactive protein (CRP)

3. Glucose metabolisc: fasting plasma glucose, insulin, Hemoglobin A1c (HbA1c)

4. Aspartate transaminase (AST), alanine transaminase (ALT), alkaline phosphatase, bilirubin, creatinine.

5. Anthropometric and clinical variables: weight, waist to hip ratio, body composition and bone mineral density

6. Systolic and diastolic blood pressure

7. Physical function

8. Lifestyle parameters: sleep quality, quality of life and eating habits

Inclusion Criteria:

• Men or women
• Age: >45 years
• Written informed consent prior to participation
• Physical condition suitable for participating in physical exercise activities
• Controlled health conditions

Exclusion Criteria:

• History of chronic or severe diseases that may affect study outcomes or limit study participation, such as:
• Decompensated cardiovascular disease, renal insufficiency, or severe liver disease
• Conditions preventing the ability in physical activity (e.g., severe respiratory issues, reduced mobility, severe arthritis)
• Severe psychiatric or cognitive disorders that could affect comprehension or adherence to the study
• Use of Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) or corticosteroids
• Pregnancy or lactation
• Less than 80% attendance at the 16-week aquatic exercise program