{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,19]],"date-time":"2026-02-19T23:08:46Z","timestamp":1771542526316,"version":"3.50.1"},"reference-count":71,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2025,1,30]],"date-time":"2025-01-30T00:00:00Z","timestamp":1738195200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100019370","name":"FCT (Foundation for Science and Technology)","doi-asserted-by":"publisher","award":["2020.06520.BD"],"award-info":[{"award-number":["2020.06520.BD"]}],"id":[{"id":"10.13039\/501100019370","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100019370","name":"FCT (Foundation for Science and Technology)","doi-asserted-by":"publisher","award":["UIDB\/00617\/2020"],"award-info":[{"award-number":["UIDB\/00617\/2020"]}],"id":[{"id":"10.13039\/501100019370","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100019370","name":"FCT (Foundation for Science and Technology)","doi-asserted-by":"publisher","award":["UIDP\/00617\/2020"],"award-info":[{"award-number":["UIDP\/00617\/2020"]}],"id":[{"id":"10.13039\/501100019370","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100019370","name":"FCT (Foundation for Science and Technology)","doi-asserted-by":"publisher","award":["UID\/04045\/2020"],"award-info":[{"award-number":["UID\/04045\/2020"]}],"id":[{"id":"10.13039\/501100019370","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Background\/Objectives: Type 2 diabetes mellitus (T2DM) is a chronic condition marked by hyperglycemia, which can affect metabolic, vascular, and hematological parameters. A low-carbohydrate, high-fat (LCHF) diet has been shown to improve glycemic control and blood pressure regulation. Exercise in hypoxia (EH) enhances insulin sensitivity, erythropoiesis, and angiogenesis. The combination of LCHF and EH may offer a promising strategy for managing T2DM and hypertension (HTN), although evidence remains limited. This study aimed to assess the effects of an eight-week normobaric EH intervention at 3000 m simulated altitude combined with an LCHF diet on hematological and lipid profiles, inflammation, and blood pressure in older patients with T2DM and HTN. Methods: Forty-two diabetic patients with HTN were randomly assigned to three groups: (1) control group (control diet + exercise in normoxia), (2) EH group (control diet + EH), and (3) intervention group (EH+LCHF) Baseline and eight-week measurements included systolic, diastolic, and mean blood pressure (SBP, DBP, MAP), hematological and lipid profiles, and inflammation biomarkers. Results: Blood pressure decreased after the intervention (p &lt; 0.001), with no significant differences between groups (SBP: p = 0.151; DBP: p = 0.124; MAP: p = 0.18). No differences were observed in lipid profile or C-reactive protein levels (p &gt; 0.05). Mean corpuscular hemoglobin (MCH) increased in the EH group (p = 0.027), while it decreased in the EH+LCHF group (p = 0.046). Conclusions: Adding hypoxia or restricting carbohydrates did not provide additional benefits on blood pressure in T2DM patients with HTN. Further elucidation of the mechanisms underlying hematological adaptations is imperative. Trial registration number: NCT05094505.<\/jats:p>","DOI":"10.3390\/nu17030522","type":"journal-article","created":{"date-parts":[[2025,1,31]],"date-time":"2025-01-31T04:05:47Z","timestamp":1738296347000},"page":"522","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Evaluating the Therapeutic Potential of Exercise in Hypoxia and Low-Carbohydrate, High-Fat Diet in Managing Hypertension in Elderly Type 2 Diabetes Patients: A Novel Intervention Approach"],"prefix":"10.3390","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2720-0603","authenticated-orcid":false,"given":"Raquel","family":"Kindlovits","sequence":"first","affiliation":[{"name":"Faculty of Nutrition and Food Sciences (FCNAUP), University of Porto, 4200-465 Porto, Portugal"}]},{"given":"Ana Catarina","family":"Sousa","sequence":"additional","affiliation":[{"name":"Research Center in Sports Sciences, Health Sciences and Human Development (CIDESD), University of Maia, 4475-690 Maia, Portugal"}]},{"given":"Jo\u00e3o Lu\u00eds","family":"Viana","sequence":"additional","affiliation":[{"name":"Research Center in Sports Sciences, Health Sciences and Human Development (CIDESD), University of Maia, 4475-690 Maia, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-7393-0599","authenticated-orcid":false,"given":"Jaime","family":"Milheiro","sequence":"additional","affiliation":[{"name":"Exercise Medical Centre Laboratory (CMEP), 4150-044 Porto, Portugal"},{"name":"Centre of Research, Education, Innovation and Intervention in Sport (CIFI2D), Faculty of Sport, University of Porto, 4200-540 Porto, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7710-4284","authenticated-orcid":false,"given":"Bruno M. P. M.","family":"Oliveira","sequence":"additional","affiliation":[{"name":"Faculty of Nutrition and Food Sciences (FCNAUP), University of Porto, 4200-465 Porto, Portugal"},{"name":"Laboratory of Artificial Intelligence and Decision Support, Institute for Systems and Computer Engineering, Technology and Science (LIAAD, INESC-TEC), 4200-465 Porto, Portugal"}]},{"given":"Franklim","family":"Marques","sequence":"additional","affiliation":[{"name":"Laboratory of Biochemistry, Department of Biological Sciences, UCIBIO, REQUIMTE, Faculty of Pharmacy, University of Porto, 4050-313 Porto, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0706-5301","authenticated-orcid":false,"given":"Alejandro","family":"Santos","sequence":"additional","affiliation":[{"name":"Faculty of Nutrition and Food Sciences (FCNAUP), University of Porto, 4200-465 Porto, Portugal"},{"name":"Institute for Research and Innovation in Health (i3S), 4200-135 Porto, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9286-4716","authenticated-orcid":false,"given":"Vitor Hugo","family":"Teixeira","sequence":"additional","affiliation":[{"name":"Faculty of Nutrition and Food Sciences (FCNAUP), University of Porto, 4200-465 Porto, Portugal"},{"name":"Research Center in Physical Activity, Health and Leisure (CIAFEL), Faculty of Sports (FADEUP), University of Porto, 4200-540 Porto, Portugal"},{"name":"Laboratory for Integrative and Translational Research in Population Health (ITR), 4050-600 Porto, Portugal"}]}],"member":"1968","published-online":{"date-parts":[[2025,1,30]]},"reference":[{"key":"ref_1","unstructured":"Magliano, D.J., and Boyko, E.J. 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