Effects of low and moderate intensity treadmill walking on postprandial lipaemia in healthy young adults

Acute effects of premeal versus postmeal exercise on postprandial hypertriglyceridemia

OBJECTIVE

The objective of this study was to examine the effects of the timing of exercise relative to the consumption of a fat-rich meal (81% fat) on postprandial hypertriglyceridemia.

DESIGN

A single bout of exercise was either completed 30 minutes before the fat meal (EM trial) or initiated 90 minutes after the fat meal (ME trial). A third trial, fat meal only, served as a control (CON trial). The trials performed in a random order, and venous blood samples were drawn before and 1.5, 3.5, 5.5, and 7.5 hours after the meal for the determination of triglycerides, glycerol, insulin, glucose, and free fatty acids.

PARTICIPANTS

Ten untrained healthy males 25.2 +/- 0.9 years old (mean +/- SE) with maximal oxygen uptake (VO2max) of 46.6 +/- 3.0 mL.kg(-1).min(-1).

INTERVENTION

Walking exercise performed at 50% VO2max for 90 minutes.

MAIN OUTCOME MEASURE

Postprandial hypertriglyceridemia, which was quantified by calculating the area under the triglycerides curve over the 7.5-hour postprandial period.

RESULTS

The mean incremental area under the curve (total area adjusted to baseline) describing postprandial hypertriglyceridemia was lower both in the EM trial (3.16 +/- 0.99 mmol.L(-1).8 h) and in the ME trial (2.96 +/- 0.69 mmol.L(-1).8 h) compared with CON trial (6.18 +/- 1.10 mmol.L(-1).8 h; P<0.05). The corresponding areas under the curve describing the postprandial insulinemia were not different between trials (ME: 38.56 +/- 8.36 uIU.mL(-1).8 h; EM: 21.65 +/- 3.80 uIU.mL(-1).8 h; CON: 25.06 +/- 5.15 uIU.mL(-1).8 h; P>0.05).

CONCLUSION

A single bout of moderate intensity exercise decreases postprandial hypertriglyceridemia irrespective of the timing of the exercise relative to a high-fat meal.

Effects of low and moderate exercise intensity on postprandial lipemia and postheparin plasma lipoprotein lipase activity in physically active men

This study was designed to assess differences in the intensity of exercise to attenuate postprandial lipemia (PPL). Thirteen healthy men (age 23.8 +/- 0.9 yr) participated in three random-ordered trials: in low-(25% peak oxygen consumption; Low) and moderate-intensity (65% peak oxygen consumption; Mod) exercise trials, which were completed 1 h before a high-fat meal (1.3 g fat/kg body mass), and a control (Con), fat meal only, trial. Venous blood samples were obtained before the fat meal, and at 2, 4, 6, 8, and 20 h after the fat meal. PPL in the Mod trial (267 +/- 50 mg.dl-1.8 h) was lower compared with that in either Con (439 +/- 81 mg.dl-1.8 h) or Low (403 +/- 91 mg.dl-1.8 h) trials (P < 0.05), whereas there was no difference in PPL between Con and Low trials (P > 0.05). High-density lipoprotein cholesterol (HDL-C) and HDL subtype 2 cholesterol were not different between or within trials (P > 0.05). Postprandial insulinemia was lower in the Mod trial (20.5 +/- 5.7 microIU.ml-1.8 h; P < 0.05), but not in the Low trial (31.4 +/- 4.7 microIU.ml-1.8 h), compared with that in the Con trial (34.9 +/- 5.0 microIU.ml-1.8 h). Postheparin lipoprotein lipase activity at 8 h was higher in the Low trial compared with that in either Con or Mod trials, whereas there were no differences between trials at 20 h. These results suggest that, when exercise is performed 1 h before a fat meal, only exercise of moderate but not of low intensity attenuates PPL and that this effect is not associated with changes in postheparin lipoprotein lipase activity.

Effects of prior exercise on postprandial lipemia: a quantitative review

The purpose of this report is to synthesize the results from studies examining the effect of exercise on postprandial lipemia to summarize the existing data and provide direction for future research. A quantitative review of the literature was performed using meta-analytic methods to quantify the effect sizes. Moderator analyses were performed to examine features of the studies that could potentially influence the effect of exercise on postprandial lipemia. Thirty-eight effects from 555 people were retrieved from 29 studies. The mean weighted effect was moderate as indicated by Cohen's d (d = -0.57; 95% confidence interval [CI], -0.71 to -0.43), indicating that people who perform exercise before meal ingestion exhibit a 0.5 standard deviation reduction in the postprandial triglyceride (TG) response relative to persons in comparison groups. There was no significant effect of study design, gender, age, type of meal ingested, exercise intensity, exercise duration, or timing of exercise on the postprandial response (P >.05). There was, however, significant variation in the effect sizes, for women for exercise performed within 24 hours of meal ingestion, and for exercise performed more than 24 hours before meal ingestion (P <.01). For studies that reported the energy expenditure of exercise, there was a significant relationship between effect size and energy expenditure (r = -.62, P =.02). Results from this quantitative review of the literature suggest that exercise has a moderate effect on the postprandial lipemic response and that the energy expenditure of prior exercise may play a role in the magnitude of this effect. Other factors that may affect the response remain to be clarified.

Exercise and postprandial lipid metabolism: an update on potential mechanisms and interactions with high-carbohydrate diets (review)

Endurance trained people exhibit low levels of postprandial lipemia. However, this favorable situation is rapidly reversed with de-training and it is likely that the triglyceride (TG) lowering effects of exercise are mainly the result of acute metabolic responses to recent exercise rather than long-term training adaptations. A large body of evidence suggests that postprandial lipemia can be attenuated following an individual exercise session, with the energy expended during exercise being an important determinant of the extent of TG lowering. Increased lipoprotein lipase-mediated TG clearance and reduced hepatic TG secretion are both likely to contribute to the exercise-induced TG reductions. These changes may occur in response to post-exercise substrate deficits in skeletal muscle and/or the liver. In addition, regular exercise can oppose the hypertriglyceridaemia sometimes seen with low-fat, high-carbohydrate diets. Levels of physical activity should therefore be taken into account when considering nutritional strategies for reducing the risk of cardiovascular disease.

Effect of resistance exercise on postprandial lipemia

The purpose of this study was to examine the effect of resistance exercise on postprandial lipemia. Fourteen young men and women participated in each of three treatments: 1) control (Con), 2) resistance exercise (RE), and 3) aerobic exercise (AE) estimated to have an energy expenditure (EE) equal that for RE. Each trial consisted of performing a treatment on day 1 and ingesting a fat-tolerance test meal 16 h later (day 2). Resting metabolic rate and fat oxidation were measured at baseline and at 3 and 6 h postprandial on day 2. Blood was collected at baseline and at 0.5, 1, 2, 3, 4, 5, and 6 h after meal ingestion. RE and AE were similar in EE [1.7 +/- 0.1 vs. 1.6 +/- 0.1 (SE) MJ, respectively], as measured by using the Cosmed K4b(2). Baseline triglycerides (TG) were significantly lower after RE than after Con (19%) and AE (21%). Furthermore, the area under the postprandial response curve for TG, adjusted for baseline differences, was significantly lower after RE than after Con (14%) and AE (18%). Resting fat oxidation was significantly greater after RE than after Con (21%) and AE (28%). These results indicate that resistance exercise lowers baseline and postprandial TG, and increases resting fat oxidation, 16 h after exercise.

Lipids, lipoproteins, and exercise

PURPOSE

Dose-response relationships between exercise training volume and blood lipid changes suggest that exercise can favorably alter blood lipids at low training volumes, although the effects may not be observable until certain exercise thresholds are met.

METHODS AND RESULTS

Plasma triglyceride reductions are often observed after exercise training regimens requiring energy expenditures similar to those characterized to increase high-density lipoprotein cholesterol (HDL-C). Thresholds established from cross-sectional and longitudinal exercise training studies indicate that 15 to 20 miles/week of brisk walking or jogging, which elicit between 1,200 to 2,200 kcals of energy expenditure per week, is associated with triglyceride reductions of 5 to 38 mg/dL and HDL-C increases of 2 to 8 mg/dL. Exercise training seldom alters total cholesterol and low-density lipoprotein cholesterol (LDL-C) unless dietary fat intake is reduced and body weight loss is associated with the exercise training program, or both. Thus, for most individuals, the positive effects of regular exercise are exerted on blood lipids at low training volumes and accrue so that noticeable differences frequently occur with energy expenditures of 1,200 to 2,200 kcals/week.

CONCLUSIONS

It appears that weekly exercise caloric expenditures that meet or exceed the higher end of this range are more likely to produce the desired lipid changes. Regarding hyperlipidemic disorders, the primary means for intervention is pharmacologic, whereas diet modification, weight loss, and exercise, although important, are viewed as adjunctive therapies. Because much is known about the exercise training-induced plasma lipid and lipoprotein modifications as well as the mechanisms responsible for these changes, rehabilitation professionals can better develop a comprehensive medical management plan that optimizes pharmacologic, reduced dietary fat intake, weight loss, and exercise interventions.

Exercise prevents the augmentation of postprandial lipaemia attributable to a low-fat high-carbohydrate diet

There is concern that replacement of dietary fat with carbohydrate may not reduce the overall risk of CHD because this replacement strategy elevates postprandial plasma triacylglycerol (TAG) concentrations. The present study was designed to test the hypothesis that daily exercise can offset the augmented postprandial lipaemia associated with a short-term high-carbohydrate diet. Nine healthy, normolipidaemic men aged 33 (sd 4) years consumed a test meal (g/kg body mass; 1.2 fat, 1.1 carbohydrate, 0.2 protein) on three occasions: after 3 d on a typical Western diet (46, 38 and 16 % energy from carbohydrate, fat and protein respectively); after 3 d on an isoenergetic high-carbohydrate diet (corresponding values: 70, 15 and 15 % energy); after 3 d on the same high-carbohydrate diet with 30 min moderate exercise daily. Fasting plasma TAG concentration was higher after the high-carbohydrate diet (1.15 (se 0.16) mmol/l) than after the Western diet (0.83 (se 0.10) mmol/l; ). Similarly, postprandial lipaemia (6 h total area under plasma TAG concentration v. time curve) was higher after the high-carbohydrate diet (12.54 (se 2.07) mmol/l.h) than after the Western diet (9.30 (se 1.30) mmol/l.h; ). The addition of exercise to the high-carbohydrate diet significantly reduced postprandial lipaemia (9.95 (se 1.94) mmol/l.h; when compared with the high-carbohydrate diet) but not fasting TAG concentration (1.02 (se 0.24) mmol/l). In conclusion, daily exercise prevented the augmentation of postprandial lipaemia attributable to the short-term high-carbohydrate diet and, thus, exercise may be a powerful adjunct to dietary change.

Exercise in the treatment of lipid disorders

As a result of scientific evaluation, we know that exercise has a positive impact on the lipid and lipoprotein profile, and we have a greater understanding for the necessary amount of exercise needed to cause these changes. In the case of hyperlipidemic disorders, we know the primary means for intervention is pharmacological, and that diet, weight loss, and exercise are viewed as adjunctive therapies. Because much is known about the exercise training-induced plasma lipid and lipoprotein modifications as well as the lipoprotein enzyme changes, future research should continue to focus on the molecular basis for these changes. For example by knowing a person's apo E genotype, we gain better comprehension as to why some individuals respond to exercise, while others do not. Another area for further investigation is the assessment of drug and exercise interaction. Presently, little is known regarding the use of lipid-lowering drugs and the impact of exercise. Finally, these investigations could provide new insights for better understanding the exercise CAD protective effects. The future challenge is to better understand the impact that regular exercise participation has in optimizing the lipid and lipoprotein profile with individuals with special lipid disorders.

Effect of exercise and medium-chain fatty acids on postprandial lipemia

The purpose of this study was to evaluate the effect of medium-chain triglycerides (MCT) with and without exercise on postprandial lipemia (PPL). Subjects were 25 young men and women. Each subject performed three trials: 1) control (fat meal only, 1.5 g fat/kg) 2) MCT (substitution of MCT oil, 30% of fat calories), and 3) MCT + Ex (exercise 12 h before the MCT meal). Before each trial, the subject underwent consistent dietary preparation. Blood was collected on 2 separate days for baseline measurements of postheparin lipases and, in each trial, at 0 h (premeal), at 2, 4, 6, and 8 h after the fat meal for triglycerides and cholesterol ester transfer protein (CETP), and at 8 h for postheparin lipoprotein lipase (LPL) and hepatic lipase activities (HL). ANOVA indicated that the partial substitution of MCT oil to the fat meal did not affect the PPL response. However, the PPL was significantly lower after the MCT + Ex trial vs. the other trials. LPL activity was significantly elevated after all trials compared with baseline, whereas HL was lower in the MCT + Ex trial only. CETP mass was significantly lower at 4 and 8 h than 0 h during all trials but relatively higher in the MCT + Ex trial vs. the nonexercise trials. These results suggest that MCT does not affect the TG response to a fat meal. LPL and CETP are affected by a fat meal with or without exercise, but HL is affected only when exercise is included.

Effects of exercise and n-3 fatty acids on postprandial lipemia

Because n-3 fatty acid ingestion and aerobic exercise each has been associated with diminished postprandial lipemia (PPL), the purpose of this study was to evaluate the effect of a combination of these two factors on PPL. Sedentary men underwent a standard dietary preparation, including a 12-h fast before each trial. Six subjects performed a control trial (fat meal, 100 g fat) and an n-3 fatty acid trial (fat meal after 3 wk of n-3 fatty acid supplementation at 4 g/day). In a parallel experiment, six different subjects underwent a control trial and n-3 fatty acid supplementation + 60 min of exercise before ingestion of the fat meal. Supplementation with n-3 fatty acid significantly decreased baseline triglyceride (TG) concentrations but did not significantly affect PPL. The combination of n-3 fatty acid and exercise had no effect on the postprandial TG response. The present study suggests that n-3 fatty acid supplementation lowers resting TG concentrations but inhibits the beneficial effect of aerobic exercise on the postprandial TG response.

Postprandial lipemia: effects of exercise and restriction of energy intake compared

BACKGROUND

The mitigating effect of exercise on postprandial lipemia may be attributable to the energy deficit incurred.

OBJECTIVE

We aimed to compare the effects of prior exercise and an equivalent energy intake deficit on postprandial lipemia.

DESIGN

Eleven postmenopausal women participated in 3 oral-fat-tolerance tests after undergoing different treatments on the preceding day: control (subjects refrained from exercise and consumed a prescribed diet), exercise (subjects consumed the same diet but walked briskly for 90 min), and intake restriction (subjects' food intake was restricted to induce the same energy deficit, relative to control, as brought about by the 90-min walk). Venous blood samples were obtained after subjects fasted overnight, 30 min after they ate a mixed, high-fat meal (1.70 g fat, 1.65 g carbohydrate, and 99 kJ/kg fat-free body mass), and hourly for the next 6 h.

RESULTS

In the exercise trial, the mean fasting triacylglycerol concentration was 19% and 17% lower than the control and intake restriction values, respectively (P < 0.05 for both). Compared with the control trial, exercise reduced postprandial lipemia by a mean of 20% (P < 0.05), whereas intake restriction reduced it by 7% (NS). In the exercise trial, fasting and postprandial fatty acid concentrations were higher than control values (P < 0.05). Exercise, but not intake restriction, reduced postprandial insulin concentrations.

CONCLUSIONS

The results suggest that the effect of exercise on postprandial lipid metabolism was greater than and different from that attributable to the energy deficit incurred.

Effect of exercise timing on postprandial lipemia and HDL cholesterol subfractions

The purpose of the study was to examine the effect of exercise timing on postprandial lipemia responses. Subjects were 21 recreationally trained men (ages 27 +/- 1.7 yr). Each subject performed four trials: 1) Control (fat meal only), 2) Post (exercise 1 h after a fat meal), 3) 1 h-Pre (exercise 1 h before a fat meal), and 4) 12 h-Pre (exercise 12 h before a fat meal). In each trial, subjects had a standard fat meal to induce postprandial hypertriglyceridemia. Blood samples were taken at 0 h (immediately before the fat meal) and at 2, 4, 6, 8, and 24 h after the meal. In the exercise trials, each subject exercised at 60% of maximal O2 consumption for 1 h. The results indicated that triglyceride area under the curve scores in premeal-exercise trials were lower (P < 0. 05) than those in Post and Control. At 24 h, total high-density lipoprotein (HDL)-cholesterol in the premeal-exercise trials was higher (P < 0.05) than that at 0 h, whereas total HDL-cholesterol was not changed in Control and Post. At 24 h, HDL subtype 2-cholesterol was higher (P < 0.05) in the premeal-exercise trials than in Control, which did not differ from Post. These results suggest that exercising before a fat meal may have a beneficial effect on the triglyceride response and HDL metabolism, which may blunt atherosclerotic process induced by the fat meal.

Postprandial lipemia: effects of intermittent versus continuous exercise

PURPOSE

The purpose of this study was to assess whether exercise performed in continuous and discontinuous formats reduced postprandial lipemia to a similar degree.

METHODS

Fifteen normolipidemic and three borderline hyperlipidemic healthy males (ages 30.6 +/- 9.0 (mean +/- SD) yr, BMI 23.1 +/- 1.4 kg.m-2) participated in three trials, each conducted over 2 d. Subjects refrained from exercise for the 2 d preceding each trial. On day one, subjects rested (control trial), or ran at 60% of maximal oxygen uptake in either one 90-min session (continuous exercise trial), or three 30-min sessions (intermittent exercise trial). On day two, subjects ingested a high-fat test breakfast (1.2 g fat, 1.2 g carbohydrate, 70 kJ energy per kilogram body mass). Blood samples were obtained in the fasted state and at intervals for 6 h postprandially.

RESULTS

Fasting plasma triacylglycerol (TAG) concentrations did not differ between trials. Areas under the TAG versus time curves were 18.1 +/- 6.7% (mean +/- SEM) and 17.7 +/- 7.6% (both P < 0.05) lower than control in the continuous exercise and intermittent exercise trials, respectively. Plasma glucose responses to the test meal did not differ between trials, but the serum insulin response was lower in the intermittent exercise trial compared with that in the control.

CONCLUSION

The results suggest that both intermittent and continuous exercise can reduce postprandial lipemia.

The effect of 13 weeks of running training followed by 9 d of detraining on postprandial lipaemia

The present study examined the influence of training, followed by a short period of detraining, on postprandial lipaemia. Fourteen normolipidaemic, recreationally active young adults aged 18-31 years participated, in two self-selected groups: three men and five women (BMI 21.7-27.6 kg/m2) completed 13 weeks of running training, after which they refrained from exercise for 9 d; three men and three women (BMI 21.5-25.6 kg/m2) maintained their usual lifestyle. Oral fat tolerance tests were conducted at baseline and again 15 h, 60 h and 9 d after the runners' last training session. Blood samples were drawn after an overnight fast and at intervals for 6 h after consumption of a high-fat meal (1.2 g fat, 1.4 g carbohydrate, 70.6 kJ energy/kg body mass). Heparin was then administered (100 IU/kg) and a further blood sample was drawn for measurement of plasma lipoprotein lipase (EC 3.1.1.34; LPL) activity. Endurance fitness improved in runners, relative to controls (maximal O2 uptake +3.2 (SE 1.1) ml/kg per min v. -1.3 (SE 1.2) ml/kg per min; P < 0.05). In the absence of the acute effect of exercise, i.e. 60 h after the last training session, there was no effect of training on either postprandial lipaemia or on post-heparin LPL activity. However, changes during 9 d of detraining in both these variables differed significantly between groups; after 2d without exercise (60 h test), the runners' lipaemic response was 37% higher than it was the morning after their last training session (15 h test; runners v. controls P < 0.05), with a reciprocal decrease in post-heparin LPL activity (P < 0.01). These findings suggest that improved fitness does not necessarily confer an effect on postprandial lipaemia above that attributable to a single session of exercise.

Reduction in postprandial lipemia after walking: influence of exercise intensity

This study compared the effects of low and moderate intensity walking on postprandial lipemia, holding energy expenditure constant. Nine healthy normolipidemic subjects (5 men, 4 women; age 27.7 +/- 0.9, fasting, plasma triacylglycerol 0.95 +/- 0.18 mmol.l-1, mean +/- SEM) who were physically active but not endurance-trained undertook three trials, each over 2 d, in a balanced design. On the afternoon of day 1 they either refrained from exercise (Control), walked for 3 h at low intensity (Walk low, 32 +/- 1% VO2max), or walked for 1.5 h at moderate intensity (Walk moderate, 63 +/- 1% VO2max). The following morning, after a 12-h fast, they consumed a high-fat meal (1.3 g fat, 1.2 g carbohydrate, 0.2 g protein, 76 kJ energy per kg body mass). Blood and expired air samples were obtained before the meal and for 6 h afterward. Postprandial lipemia (total area under triacylglycerol concentration vs time curve) was lower than control after low intensity walking as well as after moderate intensity walking (both P < 0.05) but did not differ between the two walking trials (Control, 8.09 +/- 1.09 mmol.l-1 h; Walk low, 5.46 +/- 0.63 mmol.l-1.h; Walk moderate, 5.53 +/- 0.58 mmol.l-1.h). The increase in energy production following the test meal did not differ between trials, but fat oxidation was increased in the fasting and postprandial states for both walking trials, compared with control (P < 0.05).