Introduction:The cardio-protective benefits of exercise and healthy diets, especially Mediterranean Diet (MD) are well established.Combining MD with exercise training has been recently shown to reverse cardio-metabolic risk in ageing adults.This study tested whether the exercise and MD improvement in cardiorespiratory capacity are sustained after six-months in older participants.Methods: With institutional ethical approval, seventeen sedentary healthy participants (age = 54.7 ± 3.5) completed eight-weeks of moderate aerobic exercise training alone or combined with MD, assessed by MD adherence questionnaire.Cardiorespiratory capacity was assessed by ventilatory threshold (VT) before, after and six-months following the completion of training.Mixed-design ANOVA was used to assess within effects (training and follow-up) and between effects (MD-and Exercise-group). Results:The initial intervention-dependent cardiorespiratory improvement in VT (12.2 ± 3.0 vs. 15.1 ± 3.1 ml .kg -1.min -1 , p < 0.01), was maintained after six months compared with baseline (12.2 ± 3.0 vs. 13.2 ± 3.2ml .kg -1.min -1 , p < 0.05) with no significant deterioration in the six months after the completion of the intervention.However, no interaction effect was found between MD-group and exercise-group.Within groups comparisons showed a trend, though not significant, towards sustained benefits of the MD group (12.2 ± 2.7, 14.1 ± 3.8, 13.1 ± 3.7 ml .kg -1.min -1 , p = 0.078 for main ANOVA effects) in pre-, post-intervention and follow-up respectively.However, this trend was more prominent and significant in the exercise group (12.2 ± 3.3, 15.6 ± 3.0, 13.3 ± 3.2 ml .kg -1.min -1 , p = 0.010 for pre-, post-intervention and follow-up respectively. Conclusion:In older sedentary adults, exercise training provides sustained improvement in cardiorespiratory capacity.Combining MD with exercise, though initially effective, require further research to distinguish the specific long-term benefits and adherence to MD.