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

Effects of acute sprint interval cycling and energy replacement on postprandial lipemia

High postprandial blood triglyceride (TG) levels increase cardiovascular disease risk. Exercise interventions may be effective in reducing postprandial blood TG. The purpose of this study was to determine the effects of sprint interval cycling (SIC), with and without replacement of the energy deficit, on postprandial lipemia. In a repeated-measures crossover design, six men and six women participated in three trials, each taking place over 2 days. On the evening of the first day of each trial, the participants either did SIC without replacing the energy deficit (Ex-Def), did SIC and replaced the energy deficit (Ex-Bal), or did not exercise (control). SIC was performed on a cycle ergometer and involved four 30-s all-out sprints with 4-min active recovery. In the morning of day 2, responses to a high-fat meal were measured. Venous blood samples were collected in the fasted state and at 0, 30, 60, 120, and 180 min postprandial. There was a trend toward a reduction with treatment in fasting TG ( P = 0.068), but no significant treatment effect for fasting insulin, glucose, nonesterified fatty acids, or betahydroxybutryrate ( P > 0.05). The postprandial area under the curve (mmol·l−1·3 h−1) TG response was significantly lower in Ex-Def (21%, P = 0.006) and Ex-Bal (10%, P = 0.044) than in control, and significantly lower in Ex-Def (12%, P = 0.032) than in Ex-Bal. There was no treatment effect ( P > 0.05) observed for area under the curve responses of insulin, glucose, nonesterified fatty acids, or betahydroxybutryrate. SIC reduces postprandial lipemia, but the energy deficit alone does not fully explain the decrease observed.

Physical activity and postprandial lipidemia: are energy expenditure and lipoprotein lipase activity the real modulators of the positive effect?

Historically, the link between elevated cholesterol and increased risk of cardiovascular disease has been based on fasting measurements. This is appropriate for total, low-density lipoprotein and high-density lipoprotein cholesterol. However, triglyceride concentrations vary considerably throughout the day in response to the regular consumption of food and drink. Recent findings indicate that postprandial triglyceride concentrations independently predict future cardiovascular risk. Potential modulators of postprandial lipidemia include meal composition and physical activity. Early cross sectional studies indicated that physically active individuals had a lower postprandial lipidemic response compared to inactive individuals. However, the effect of physical activity on postprandial lipidemia is an acute phenomenon, which dissipates within 60 h of a single bout of exercise. Total exercise induced energy expenditure, rather than duration or intensity of the physical activity is commonly reported to be a potent modulator of postprandial lipidemia. However, the pooled results of studies in this area suggest that energy expenditure exerts most of its influence on fasting triglyceride concentrations rather than on the incremental change in triglyceride concentrations seen following meal consumption. It seems more likely that energy expenditure is one component of a multifactorial list of mediators that may include local muscle contractile activity, and other yet to be elucidated mechanisms.

Is the beneficial effect of prior exercise on postprandial lipaemia partly due to redistribution of blood flow?

Preprandial aerobic exercise lowers postprandial lipaemia (a risk factor for coronary heart disease); however, the mechanisms responsible are still not clear. The present study investigated whether blood flow to skeletal muscle and/or the liver was increased in the postprandial period after exercise, relative to a control trial, and whether this resulted from increased cardiac output or redistribution of flow. Eight overweight inactive males, aged 49.4±10.5 years (mean±S.D.), acted as their own controls in a counterbalanced design, either walking briskly for 90 min at 60% V̇O2max (maximal oxygen uptake), or resting in the lab, on the evening of day 1. The following morning, a fasting blood sample was collected, participants consumed a high-fat breakfast, and further venous blood samples were drawn hourly for 6 h. Immediately after blood sampling, Doppler ultrasound was used to measure cardiac output and blood flow through both the femoral artery of one leg and the hepatic portal vein, with the ultrasonographer blinded to trial order. The total postprandial triacylglycerol response was 22% lower after exercise (P=0.001). Blood flow through the femoral artery and the hepatic portal vein was increased by 19% (P<0.001) and 16% (P=0.033), respectively, during the 6-h postprandial period following exercise; however, postprandial cardiac output did not differ between trials (P=0.065). Redistribution of blood flow, to both exercised skeletal muscle and the liver, may therefore play a role in reducing the plasma triacylglycerol response to a high-fat meal on the day after an exercise bout.

Lifestyle intervention leading to moderate weight loss normalizes postprandial triacylglycerolemia despite persisting obesity

Obesity is associated with impaired postprandial triacylglycerolemia, an independent risk factor for cardiovascular disease. Given that obesity is hard to treat, efforts should focus on treating its comorbidities. We aimed to investigate whether moderate weight loss normalizes postprandial triacylglycerol (TAG) concentrations, in the absence of the acute effects of negative energy balance. For this purpose, postprandial lipemia was investigated in eight obese but otherwise healthy, sedentary men (age: 41.3 ± 4.1 years, BMI: 36.5 ± 1.6 kg·m(-2)), once before and again after a 10% weight loss followed by ≥4 weeks of weight maintenance, and was compared with that of eight age-matched healthy lean men (BMI: 24.7 ± 0.6 kg·m(-2)). Dietary intervention consisted of reduced carbohydrate and saturated fat intake and increased monounsaturated fat intake. Obese volunteers were advised to increase physical activity using pedometers to record daily activity. Postprandial triacylglycerolemia after weight loss was reduced by 27-46% (P < 0.05), and became similar to that of lean men despite persisting obesity (BMI after weight loss: 32.9 ± 1.5 kg·m(-2)). Reduction in postprandial TAG responses was inversely correlated with the decrease in postprandial insulin sensitivity index (ISI) after weight loss (r = -0.714, P = 0.047). We conclude that moderate weight loss induced by a low-carbohydrate and saturated fat diet and a slight increase in daily physical activity normalizes postprandial triacylglycerolemia in obese men, independently of acute diet-induced negative energy balance, and possibly through enhancement of insulin action.

One day of moderate energy deficit reduces fasting and postprandial triacylglycerolemia in women: the role of calorie restriction and exercise

BACKGROUND & AIMS

Fasting and postprandial hypertriacylglycerolemia are important cardiovascular risk factors in women. We sought to examine the effects of acute (1 day), moderate ( approximately 2 MJ) energy deficit induced by calorie restriction, exercise, or combination of both on fasting and postprandial triacylglycerol (TAG) metabolism in women.

METHODS

Six healthy premenopausal women performed four oral fat tolerance tests in the morning after a day of a) rest (control), b) calorie restriction ( approximately 2 MJ), c) exercise (net deficit of approximately 2 MJ) and d) calorie restriction-plus-exercise (total energy deficit of approximately 2 MJ).

RESULTS

All energy deficit trials significantly reduced fasting and postprandial total plasma TAG concentrations by 15-23% and 12-23%, respectively, and triacylglycerol-rich lipoprotein TAG concentrations by 37-43% and 25-39%, respectively, compared with the control condition (P<0.05). Postprandial, but not fasting, total TAG concentrations were approximately 12% lower after exercise compared with diet-induced energy deficit (P=0.05).

CONCLUSIONS

Acute, moderate energy deficit independently of its origin (i.e. diet or exercise or combination of both) reduces fasting and postprandial triacylglycerolemia in women. Exercise elicits a somewhat greater effect than calorie restriction in the postprandial state. The acute effect of diet and exercise should be taken into account when studying the long-term effects of weight loss and exercise training on TAG metabolism.

Effects of energy balance on postprandial triacylglycerol metabolism

PURPOSE OF REVIEW

To present the effect of negative energy balance on postprandial triacylglycerol concentrations (pTAG), an independent risk factor for the development of cardiovascular disease.

RECENT FINDINGS

Aerobic exercise reduces pTAG; however, recent findings confirm that this effect is only evident with an accompanying energy deficit. Moreover, a recent study showed that acute diet-induced energy deficit also reduces pTAG. The extent of energy deficit required to significantly attenuate pTAG depends on the type of given meal, the type of deficit (aerobic/resistance exercise, diet, or combination of diet and exercise), and patients' health status. Apart from the acute effects, prolonged energy deficit leading to moderate weight loss attenuates pTAG, when it is combined with other known hypotriacylglycerolemic agents, such as carbohydrate restriction.

SUMMARY

For healthy population, it seems that it is up to patient's preference and ability which type of energy deficit will follow to attenuate pTAG; an energy deficit of approximately 30 kJ/kg of body mass is required; for resistance exercise a smaller deficit is probably sufficient. More studies are needed to investigate dose-response/plateau effects, the effects of energy deficit-energy surplus every other day, and the threshold of energy deficit-weight loss in diabetics and other high-risk populations. Finally, investigation of the underlying mechanisms may be clinicall helpful in individualizing the appropriate intervention.

The ABC of Physical Activity for Health: a consensus statement from the British Association of Sport and Exercise Sciences

Our understanding of the relationship between physical activity and health is constantly evolving. Therefore, the British Association of Sport and Exercise Sciences convened a panel of experts to review the literature and produce guidelines that health professionals might use. In the ABC of Physical Activity for Health, A is for All healthy adults, B is for Beginners, and C is for Conditioned individuals. All healthy adults aged 18-65 years should aim to take part in at least 150 min of moderate-intensity aerobic activity each week, or at least 75 min of vigorous-intensity aerobic activity per week, or equivalent combinations of moderate- and vigorous-intensity activities. Moderate-intensity activities are those in which heart rate and breathing are raised, but it is possible to speak comfortably. Vigorous-intensity activities are those in which heart rate is higher, breathing is heavier, and conversation is harder. Aerobic activities should be undertaken in bouts of at least 10 min and, ideally, should be performed on five or more days a week. All healthy adults should also perform muscle-strengthening activities on two or more days a week. Weight training, circuit classes, yoga, and other muscle-strengthening activities offer additional health benefits and may help older adults to maintain physical independence. Beginners should work steadily towards meeting the physical activity levels recommended for all healthy adults. Even small increases in activity will bring some health benefits in the early stages and it is important to set achievable goals that provide success, build confidence, and increase motivation. For example, a beginner might be asked to walk an extra 10 min every other day for several weeks to slowly reach the recommended levels of activity for all healthy adults. It is also critical that beginners find activities they enjoy and gain support in becoming more active from family and friends. Conditioned individuals who have met the physical activity levels recommended for all healthy adults for at least 6 months may obtain additional health benefits by engaging in 300 min or more of moderate-intensity aerobic activity per week, or 150 min or more of vigorous-intensity aerobic activity each week, or equivalent combinations of moderate- and vigorous-intensity aerobic activities. Adults who find it difficult to maintain a normal weight and adults with increased risk of cardiovascular disease or type 2 diabetes may in particular benefit from going beyond the levels of activity recommended for all healthy adults and gradually progressing towards meeting the recommendations for conditioned individuals. Physical activity is beneficial to health with or without weight loss, but adults who find it difficult to maintain a normal weight should probably be encouraged to reduce energy intake and minimize time spent in sedentary behaviours to prevent further weight gain. Children and young people aged 5-16 years should accumulate at least 60 min of moderate-to-vigorous-intensity aerobic activity per day, including vigorous-intensity aerobic activities that improve bone density and muscle strength.

Physical activity, fitness and fatness: relations to mortality, morbidity and disease risk factors. A systematic review

The purpose of this systematic review was to study the relative health risks of poor cardio-respiratory fitness (or physical inactivity) in normal-weight people vs. obesity in individuals with good cardio-respiratory fitness (or high physical activity). The core inclusion criteria were: publication year 1990 or later; adult participants; design prospective follow-up, case-control or cross-sectional; data on cardio-respiratory fitness and/or physical activity; data on BMI (body mass index), waist circumference or body composition; outcome data on all-cause mortality, cardiovascular disease mortality, cardiovascular disease incidence, type 2 diabetes or cardiovascular and type 2 diabetes risk factors. Thirty-six publications filled the criteria for inclusion. The data indicate that the risk for all-cause and cardiovascular mortality was lower in individuals with high BMI and good aerobic fitness, compared with individuals with normal BMI and poor fitness. In contrast, having high BMI even with high physical activity was a greater risk for the incidence of type 2 diabetes and the prevalence of cardiovascular and diabetes risk factors, compared with normal BMI with low physical activity. The conclusions of the present review may not be applicable to individuals with BMI > 35.

Cardiorespiratory fitness and metabolic risk factors in obesity

PURPOSE OF REVIEW

An increase in cardiorespiratory fitness (CRF) through exercise training appears to partly ameliorate the health hazards of obesity and a number of mechanisms might explain the potential benefits. We review recent evidence about the relationships between CRF, exercise training and metabolic risk factors in obesity.

RECENT FINDINGS

Epidemiological data have shown that the anti-inflammatory effects of exercise could be an important mechanism in explaining cardio-protective effects of physical activity. Emerging evidence suggests that exercise training reduces markers of inflammation and improves glucose control in obesity, independent of weight loss. Novel mechanisms appear to involve exercise-induced changes in CD14+CD16+ cell populations, expression of toll-like receptors, and key changes in the metabolic regulation of visceral white adipose tissue. Other promising recent research has focused on exercise-induced signalling pathways governing glucose metabolism, such as insulin receptor substrate and Akt substrate. Using novel imaging techniques, studies have demonstrated exercise-induced improvements in lipoprotein subfraction particle size, and reduction in visceral adipose tissue and liver fat, independent of weight loss. These effects appear to be mostly restricted to interventions consisting of relatively high doses of exercise or exercise combined with calorie restriction, although further work is required to elucidate the dose-response relationships.

SUMMARY

Physical activity and the pursuit of physical fitness are important in the treatment of obesity because exercise training can improve a number of metabolic risk factors independent of weight loss. Thus exercise can provide important health benefits irrespective of weight loss in obese and overweight individuals.

Exercise training, lipid regulation, and insulin action: a tangled web of cause and effect

Lipids are a strong mediator of coronary artery disease and cardiovascular risk. Although the effects of exercise to improve high-density lipoprotein (HDL) cholesterol and serum triglycerides (TGs) have been known for some time, the effects of different amounts and intensities of exercise on fasting and postprandial serum lipids are little understood. Normal lipid physiology is perturbed in insulin resistant states, where inhibition of lipolysis is impaired, particularly in the postprandial period when excursions in insulin and serum TGs are particularly high. In our STRRIDE (Studies of a Targeted Risk Reduction Intervention through Defined Exercise) study, three important metabolic cardiovascular risk-related variables were improved more by moderate intensity than vigorous-intensity exercise. Moderate-intensity exercise was significantly more effective at lowering TGs and improving insulin sensitivity than was vigorous exercise. Additionally, a composite score for metabolic syndrome improved significantly with low-amount/moderate, but did not with low-amount/vigorous-intensity exercise. That all three of these strong, independent, cardiovascular risk factors were significantly affected by moderate-intensity exercise suggests that regular walking exercise might be as effective, if not more so, than more vigorous exercise in favorably modifying cardiovascular risk. Despite the impressive effects of regular exercise on fasting lipids and atherogenic dyslipidemia, they are more impressive when compared with the trajectory of changes that occur in individuals that remain inactive, without regular exposure to regular exercise. A scientific priority for future investigations should be to study the independent and combined effects of exercise intensity and amount on exercise responses through a direct comparison between two groups matched on amount but differing in intensity.

Gender differences in lipid metabolism and the effect of obesity

There are many differences between men and women, and between lean and obese subjects, in fatty acid and very low-density lipoprotein triglyceride and apolipoprotein B-100 metabolism. Currently, observations in this area are predominantly descriptive. The mechanisms responsible for sexual dimorphism in lipid metabolism are largely unknown.

Effect of prior exercise on postprandial lipemia and markers of inflammation and endothelial activation in normal weight and overweight adolescent boys

Postprandial lipemia (PPL) is associated with impaired endothelial function and inflammation. Acute exercise reduces PPL in adults. This investigation examined the effect of an acute bout of exercise on postprandial changes in triglycerides (TG), glucose, insulin, inflammation [white blood cell count (WBC), interleukin-6 (IL-6) tumor necrosis factor-alpha, C-reactive protein (CRP)] and endothelial activation [soluble intercellular adhesion molecule-1 (sICAM-1), vascular adhesion molecule-1 (sVCAM-1)] following a high-fat meal in adolescents. Ten normal weight (NW) (BMI, 20.9 +/- 1.7 kg m(-2); 15.6 +/- 0.7 years) and eight overweight (OW) (BMI, 28.3 +/- 3.6 kg m(-2); 15.9 +/- 0.4 years) adolescent boys underwent two 6-h oral fat tolerance tests (OFTT) separated by 7-10 days. On the evening prior to each OFTT, subjects either rested or completed a treadmill exercise bout (65% V(O)(2max); 600 kcal expended). Exercise reduced (P < 0.01) the postprandial TG area under the curve by approximately 20% in the NW and OW groups. The postprandial glucose and insulin response did not differ between the control and exercise trials or between the NW and OW groups. Circulating leukocytes and plasma IL-6 levels increased (P < 0.01) in the NW and OW groups 6 h following the OFTT in both experimental conditions. There were no changes in CRP, sVCAM-1 or sICAM-1 following the OFTT and there were no differences between experimental condition or NW and OW groups. In conclusion, a moderate exercise bout prior to a high-fat meal effectively reduces postprandial TG concentrations to a similar degree in both NW and OW adolescents, but does not reduce the concomitant postprandial increase in WBC or IL-6.

Postprandial lipemia 16 and 40 hours after low-volume eccentric resistance exercise

PURPOSE

There is evidence to suggest that muscle damage caused by resistance exercise (RE) may increase postprandial lipemia (PPL). This study examined PPL for two consecutive days after a protocol of low-volume eccentric RE that caused muscle damage.

METHODS

Nine healthy, untrained male volunteers aged 27.2 +/- 1.1 yr performed a session of eccentric RE consisting of eight sets of inclined leg presses at six repetition maximum with 3-min rest intervals. A high-fat meal (1.2 g fat, 1.2 g carbohydrate, 0.22 g protein, and 68.6 kJ kg(-1) body mass) was administered 16 h (day 1) and 40 h (day 2) after exercise as well as after an overnight fast with no prior exercise (control condition [C]). Venous blood samples were obtained before and hourly for 6 h after each meal.

RESULTS

The duration of the exercise session (including rest intervals) was 25.6 +/- 0.2 min, whereas net exercise time was 4.6 +/- 0.2 min. Total energy expenditure was 0.64 +/- 0.04 MJ. Serum creatine kinase and ratings of perceived muscle soreness were significantly elevated on day 1 and peaked on day 2. Triacylglycerol total area under the curve was 12.1% lower on day 1 compared with C (7.51 +/- 0.99 vs. 8.54 +/- 1.07 mmol L(-1) 6h(-1), P < 0.02), whereas no difference existed between C and day 2. Serum insulin incremental area under the curve was significantly elevated on day 2 compared with C, indicating transient insulin resistance.

CONCLUSION

These results show that low-volume eccentric RE is effective in reducing postprandial triacylglycerol concentration despite the low energy expenditure. Muscle damage does not have a detrimental effect on PPL.

Physical Activity, Blood Lipids, and Lipoproteins

Dyslipidemia is a major modifiable cardiovascular disease (CVD) risk factor. While pharmacological treatment has been a focal point of dyslipidemia management for several years, increasing physical activity is a safe, cost-effective treatment option that should also be recommended by health care practitioners. Moderate aerobic exercise consistently increases high-density lipoprotein cholesterol (HDL-C) and reduces triglycerides (TG), independent of changes in body weight. However, reductions in total and low-density lipoprotein cholesterol are reported less often following aerobic exercise. Therefore, clinicians should understand that aerobic exercise is not likely to be an effective treatment option for their management. Recent empirical evidence also indicates that aerobic exercise may be of benefit for treating emerging lipid and lipoprotein risk factors such as lipoprotein particle size and number and triglyceride-rich lipoproteins. Further work is needed to clarify the impact of aerobic exercise on apolipoproteins. Based on current evidence, prescribing aerobic exercise as a means of increasing HDL-C and lowering TG is usually an efficacious strategy for treating these aspects of dyslipidemia. These effects are likely to be accompanied by changes in emerging lipid and lipoprotein risk factors.

Independent and combined effects of aerobic exercise and pharmacological strategies on serum triglyceride concentrations: a qualitative review

Elevated fasting and postprandial serum triglyceride concentrations are associated with cardiovascular disease morbidity and mortality. Aerobic exercise reduces serum triglyceride concentrations in the presence or absence of weight loss. Although pharmacological interventions are often used in combination with aerobic exercise to achieve target triglyceride concentrations, information on the combined effects of aerobic exercise and lipid-modifying agents on serum triglycerides is limited. This review examines the independent and combined effects of both interventions on serum fasting and postprandial triglyceride concentrations from the available literature. Reductions in serum triglycerides after aerobic exercise are associated with an increase in skeletal muscle lipoprotein lipase activity and a decrease in hepatic triglyceride and very-low-density lipoprotein (VLDL) synthesis and secretion. Lipid-modifying agents such as niacin, omega-3 fatty acids, and statins also decrease fasting and postprandial triglycerides by increasing lipoprotein lipase (LPL) activity and/or decreasing VLDL synthesis. When combined, lipid-modifying agents may reduce fasting and postprandial triglyceride secretion to an extent in which aerobic exercise cannot provide any additional benefit. These observations indicate that aerobic exercise and pharmacological strategies reduce serum triglycerides by similar mechanisms, which may attenuate the triglyceride-lowering capacity of the concordant treatment.

Aerobic exercise and postprandial lipemia in men with the metabolic syndrome

INTRODUCTION

It is currently unclear as to how exercise prescription variables influence attenuations of postprandial lipemia (PPL) in men with the metabolic syndrome (MetS) after exercise. Therefore, the purposes of this investigation were to compare the effects of low- and moderate-intensity exercise and accumulated versus continuous exercise on PPL in males with MetS.

METHODS

Fourteen males with MetS (waist circumference (WC) = 110.2 +/- 10.9 cm; triglycerides (TG) = 217 +/- 84 mg dL(-1); fasting blood glucose = 105 +/- 7 mg dL(-1); high-density lipoprotein cholesterol (HDL-C) = 44 +/- 7 mg dL(-1); systolic blood pressure (SBP) = 120 +/- 12 mm Hg; diastolic blood pressure (DBP) = 76 +/- 10 mm Hg) completed a control condition consisting of a high-fat meal and blood sampling at 2 h intervals for 6 h. Next, participants completed the following exercise conditions: 1) continuous moderate-intensity (MOD-1), 2) continuous low-intensity (LOW-1), and 3) two accumulated moderate-intensity sessions (MOD-2). The test meal and blood sampling were repeated 12-14 h after exercise. Area under the curve (AUC) scores and temporal postprandial responses were analyzed using repeated-measures ANOVA for TG and insulin.

RESULTS

The TG AUC decreased by 27% after LOW-1. TG concentrations were also reduced by 22% and 21% at 4 h postmeal after LOW-1 and MOD-1, yet TG parameters were no different from the control condition after MOD-2 (P < 0.05 for all).

CONCLUSION

These findings indicate that 500 kcal of continuous aerobic exercise before a meal attenuates PPL in men with MetS. This outcome can be achieved through low- or moderate-intensity exercise performed in a single session. Accumulating moderate-intensity exercise does not appear to effectively modulate PPL in men with MetS.

Effect of intensity of resistance exercise on postprandial lipemia

The purpose of this study is to determine whether moderate-intensity resistance exercise (MOD) lowers postprandial lipemia (PPL) as much as high-intensity resistance exercise (HI) of equal work. Ten healthy men performed three trials, each conducted over 2 days. On day 1 of each treatment, they either did not exercise (CON), performed 3 sets of 16 repetitions of 10 exercises at 50% of 8 repetitions maximum (MOD), or performed 3 sets of 8 repetitions of 10 exercises at 100% of 8 repetitions maximum (HI). On the morning of day 2 at 15.5 h postexercise, participants ate a high-fat meal. Venous blood samples were collected, and metabolic rate was measured at rest and 3 h postprandial. HI reduced fasting triglyceride (TG) and TG area under the curve (AUC) (36%, P = 0.011 and 35%, P = 0.014) compared with CON. MOD tended to reduce fasting TG and TG AUC (21%, P = 0.054 and 26%, P = 0.052) compared with CON, but MOD and HI did not differ in fasting TG or TG AUC. Incremental TG AUC did not differ among treatments. MOD and HI did not change resting metabolic rate. HI increased fat oxidation at rest (21%, P = 0.021) and at 3 h postprandial (39%, P = 0.009) relative to CON. MOD tended to increase fat oxidation at rest (18%, P = 0.060) relative to CON. Fat oxidation and metabolic rate did not differ in MOD and HI. MOD and HI increased the fasting quantitative insulin-sensitivity check index (4%, P = 0.001 and P = 0.004) relative to CON. As MOD and HI resulted in similar reductions in PPL and increases in fat oxidation, resistance exercise intensity does not influence PPL.

Endothelial dysfunction induced by post-prandial lipemia: complete protection afforded by high-intensity aerobic interval exercise

OBJECTIVES

This study was designed to study the effect of exercise and a high-fat meal (HFM) on endothelial function.

BACKGROUND

Post-prandial lipemia and exercise oppose each other in terms of cardiovascular risk; however, the mechanism of their interaction is not well understood.

METHODS

Endothelial function was assessed by brachial artery flow-mediated dilation (FMD) in 8 healthy men before and after an HFM preceded (16 to 18 h) by rest, a single bout of continuous moderate-intensity exercise (CME), and high-intensity interval exercise (HIIE).

RESULTS

Before the HFM, initial brachial artery diameters were similar in all trials (0.43 +/- 0.04 cm), but after the HFM, basal diameter decreased only in the control (0.39 +/- 0.03 cm) and CME (0.38 +/- 0.04 cm) trials. Before the HFM, FMD/shear was improved by a single bout of CME (+20%, p < 0.01) and HIIE (+45%, p < 0.01; group differences, p < 0.01), with no effect in the control trial. After the HFM (30, 120, and 240 min), FMD decayed to a lesser extent with CME, but in a similar fashion to the control trial. In contrast, FMD in the HIIE trial remained elevated following the exercise despite a clear meal-induced lipemia. Although there were no correlations between vascular function and food-induced markers of cardiovascular risk, antioxidant status was strongly correlated with FMD (r = 0.9, p < 0.001).

CONCLUSIONS

These findings reveal a clinically relevant protective effect of acute exercise on the vasculature that is clearly exercise intensity dependent and tightly related to exercise-induced antioxidant capacity. (Endothelial Dysfunction Induced by Postprandial Lipemia; NCT00660491).

Physical inactivity differentially alters dietary oleate and palmitate trafficking

OBJECTIVE

Obesity and diabetes are characterized by the incapacity to use fat as fuel. We hypothesized that this reduced fat oxidation is secondary to a sedentary lifestyle.

RESEARCH DESIGN AND METHODS

We investigated the effect of a 2-month bed rest on the dietary oleate and palmitate trafficking in lean women (control group, n = 8) and the effect of concomitant resistance/aerobic exercise training as a countermeasure (exercise group, n = 8). Trafficking of stable isotope-labeled dietary fats was combined with muscle gene expression and magnetic resonance imaging-derived muscle fat content analyses.

RESULTS

In the control group, bed rest increased the cumulative [1-(13)C]oleate and [d(31)]palmitate appearance in triglycerides (37%, P = 0.009, and 34%, P = 0.016, respectively) and nonesterified fatty acids (NEFAs) (37%, P = 0.038, and 38%, P = 0.002) and decreased muscle lipoprotein lipase (P = 0.043) and fatty acid translocase CD36 (P = 0.043) mRNA expressions. Plasma NEFA-to-triglyceride ratios for [1-(13)C]oleate and [d(31)]palmitate remained unchanged, suggesting that the same proportion of tracers enters the peripheral tissues after bed rest. Bed rest did not affect [1-(13)C]oleate oxidation but decreased [d(31)]palmitate oxidation by -8.2 +/- 4.9% (P < 0.0001). Despite a decreased spontaneous energy intake and a reduction of 1.9 +/- 0.3 kg (P = 0.001) in fat mass, exercise training did not mitigate these alterations but partially maintained fat-free mass, insulin sensitivity, and total lipid oxidation in fasting and fed states. In both groups, muscle fat content increased by 2.7% after bed rest and negatively correlated with the reduction in [d(31)]palmitate oxidation (r(2) = 0.48, P = 0.003).

CONCLUSIONS

While saturated and monounsaturated fats have similar plasma trafficking and clearance, physical inactivity affects the partitioning of saturated fats toward storage, likely leading to an accumulation of palmitate in muscle fat.

Body fat distribution, serum glucose, lipid and insulin response to meals in Alström syndrome

BACKGROUND

Alström syndrome is an autosomal recessive condition characterized by obesity, insulin resistance and hypertriglyceridaemia. Responses to fat and carbohydrate ingestion are important in planning dietetic advice and may help to explain the mechanism of metabolic disorder in the syndrome.

METHODS

After a 12-h fast, five Alström subjects received a 3.1 MJ (742 kcal), 75.8% fat breakfast on day 1, and a 3.3 MJ (794 kcal), 77.5% carbohydrate breakfast on day 2. Serum glucose, triglyceride and insulin levels were measured at baseline, and 2 and 3.5 h post-meal. Abdominal computerized tomography in three subjects and magnetic resonance imaging in one demonstrated distribution of abdominal fat.

RESULTS

Body fat was distributed subcutaneously, as well as viscerally. There were no changes in serum glucose, insulin or triglycerides after the high fat meal. Triglycerides remained stable after the high carbohydrate meal but glucose and log insulin levels increased [8.4 +/- 4.1 to 13.4 +/- 6.9 mmol L(-1) (P < 0.05) and 2.6 +/- 0.27 to 3.15 +/- 0.42 pmol L(-1) (P < 0.05), respectively].

CONCLUSIONS

Dietetic advice in Alström syndrome must include calorie restriction to reduce obesity, which is predominantly subcutaneous. This study has shown that low carbohydrate advice may prove more effective than fat restriction in control of hyperglycaemia and hyperinsulinism. A single high energy meal does not exacerbate hypertriglyceridaemia.

Postprandial triglyceride responses to aerobic exercise and extended-release niacin

BACKGROUND

Aerobic exercise and niacin are frequently used strategies for reducing serum triglycerides, and, yet, there is no information regarding the combined effects of these strategies on postprandial triglycerides.

OBJECTIVE

We compared the effects of aerobic exercise and 6 wk of extended-release niacin on postprandial triglycerides in men with the metabolic syndrome.

DESIGN

Fifteen participants underwent each of 4 conditions: control--high-fat meal only (100 g fat); exercise--aerobic exercise performed 1 h before a high-fat meal; niacin--high-fat meal consumed after 6 wk of niacin; and niacin + exercise--high-fat meal consumed after 6 wk of niacin and 1 h after aerobic exercise. Temporal responses for triglyceride and insulin concentrations were measured and total (AUC(T)) and incremental (AUC(I)) areas under the curve were calculated. Differences were determined by using a 2-factor repeated-measures analysis of variance (P < 0.05 for all).

RESULTS

Exercise lowered the triglyceride AUC(I) by 32% compared with control (724 +/- 118 and 1058 +/- 137, respectively). Niacin had no influence on the triglyceride AUC(I) and attenuated the triglyceride-lowering effect of exercise when combined. Niacin + exercise had no effect on the triglyceride AUC(I) but decreased the insulin AUC(I) after niacin administration.

CONCLUSIONS

Aerobic exercise lowers the postprandial triglyceride response to a high-fat meal. Niacin lowers fasting but not postprandial triglycerides and appears to influence the triglyceride-lowering effect of aerobic exercise when combined. However, exercise decreases postprandial insulin concentrations after niacin administration, which illustrates the potential metabolic benefits of exercise in persons taking niacin.

Exercise of low energy expenditure along with mild energy intake restriction acutely reduces fasting and postprandial triacylglycerolaemia in young women

A single bout of prolonged, moderate-intensity endurance exercise lowers fasting and postprandial TAG concentrations the next day. However, the TAG-lowering effect of exercise is dose-dependent and does not manifest after light exercise of low energy cost ( < 2 MJ). We aimed to investigate whether superimposing mild energy intake restriction to such exercise, in order to augment total energy deficit, potentiates the hypotriacylglycerolaemic effect. Eight healthy, sedentary, premenopausal women (age 27.1 (sem 1.3) years; BMI 21.8 (sem 0.9) kg/m2) performed two oral fat tolerance tests in the morning on two different occasions: once after a single bout of light exercise (100 min at 30 % of peak oxygen consumption; net energy expenditure 1.04 (sem 0.01) MJ) coupled with mild energy intake restriction (1.39 (sem 0.22) MJ) on the preceding day, and once after resting coupled with isoenergetic feeding on the preceding day (control). Fasting plasma TAG, TAG in the TAG-rich lipoproteins (TRL-TAG) and serum insulin concentrations were 18, 34 and 30 % lower, respectively, after exercise plus diet compared with the control trial (P < 0.05). Postprandial concentrations of plasma TAG and TRL-TAG were 19 and 27 % lower after exercise plus diet compared with the control condition (P < 0.01), whereas postprandial insulin concentrations were not different. It is concluded that a combination of light exercise along with mild hypoenergetic diet may be a practical and feasible intervention to attenuate fasting and postprandial triacylglycerolaemia, especially for people who cannot exercise for prolonged periods of time at moderate-to-high intensities, such as many sedentary individuals.

Effects of continuous versus accumulated activity patterns on postprandial triacylglycerol concentrations in obese men

OBJECTIVE

There is limited information regarding the effects of short (<10 min) bouts of activity on postprandial lipaemia and no studies are available regarding the effects of short bouts of activity on postprandial lipaemia in obese men. The objective of this study was to compare the effects of accumulating ten, 3-min bouts of exercise versus one 30 min bout of exercise on postprandial serum triacylglycerol (TAG) concentrations in obese men.

DESIGN

Each subject completed three 2-day trials at least 1 week apart in a randomized, repeated-measures design. On day 1, subjects rested (no exercise) or cycled at 60% of maximum heart rate in either ten, 3-min bouts (30 min rest between each), or one continuous 30-min bout. On day 2 of each trial, after an overnight fast, the subjects consumed a standardized test meal for breakfast. Venous blood samples were obtained in the fasted state (0 h), and 2, 4 and 6 h postprandially on day 2.

SUBJECTS

Eight sedentary men (age: 27+/-2 years) with body mass index between 25 and 37 kg/m(2).

MEASUREMENTS

Postprandial TAG, non-esterified fatty acids, 3-hydroxybutyrate, insulin and glucose were determined.

RESULTS

Total area under the postprandial serum TAG concentrations versus time curve was 18% (P=0.042) and 15% (P=0.032) lower throughout day 2 of both the accumulated exercise trial and the continuous exercise trial, respectively, compared with the control trial with little difference between exercise trials.

CONCLUSION

At 30 min of moderate cycling (0.87 MJ per 30 min) accumulated in short bouts is equally effective in reducing postprandial serum TAG concentrations as one continuous 30 min bout of cycling in obese men.

Raisins and additional walking have distinct effects on plasma lipids and inflammatory cytokines

Background

Raisins are a significant source of dietary fiber and polyphenols, which may reduce cardiovascular disease (CVD) risk by affecting lipoprotein metabolism and inflammation. Walking represents a low intensity exercise intervention that may also reduce CVD risk. The purpose of this study was to determine the effects of consuming raisins, increasing steps walked, or a combination of these interventions on blood pressure, plasma lipids, glucose, insulin and inflammatory cytokines.

Results

Thirty-four men and postmenopausal women were matched for weight and gender and randomly assigned to consume 1 cup raisins/d (RAISIN), increase the amount of steps walked/d (WALK) or a combination of both interventions (RAISINS + WALK). The subjects completed a 2 wk run-in period, followed by a 6 wk intervention. Systolic blood pressure was reduced for all subjects (P = 0.008). Plasma total cholesterol was decreased by 9.4% for all subjects (P < 0.005), which was explained by a 13.7% reduction in plasma LDL cholesterol (LDL-C) (P < 0.001). Plasma triglycerides (TG) concentrations were decreased by 19.5% for WALK (P < 0.05 for group effect). Plasma TNF-α was decreased from 3.5 ng/L to 2.1 ng/L for RAISIN (P < 0.025 for time and group × time effect). All subjects had a reduction in plasma sICAM-1 (P < 0.01).

Conclusion

This research shows that simple lifestyle modifications such as adding raisins to the diet or increasing steps walked have distinct beneficial effects on CVD risk.

Energy replacement attenuates the effects of prior moderate exercise on postprandial metabolism in overweight/obese men

BACKGROUND

The extent to which exercise-induced changes to postprandial metabolism are dependant on the associated energy deficit is not known.

OBJECTIVE

To determine the effects of exercise, with and without energy replacement, on postprandial metabolism.

DESIGN

Each subject underwent three 2-day trials in random order. On day 1 of each trial subjects rested (control), walked at 50% maximal oxygen uptake to induce a net energy expenditure of 27 kJ kg(-1) body mass (energy-deficit) or completed the same walk with the net energy expended replaced (energy-replacement). On day 2 subjects completed an 8.5-h metabolic assessment. For 3 days prior to day 2, subjects consumed an isocaloric diet, avoided planned exercise (apart from exercise interventions) and alcohol.

SUBJECTS

A total of 13 overweight/obese men (age: 40+/-8 years, body mass index: 31.1+/-3.0 kg m(-2)).

MEASUREMENTS

Postprandial triglyceride, insulin, glucose, non-esterified fatty acid and 3-hydroxybutyrate concentrations and substrate utilization rates were determined.

RESULTS

Energy-deficit lowered postprandial triglyceride concentrations by 14 and 10% compared with control and energy-replacement (P<0.05 for both). Energy-deficit increased postprandial 3-hydroxybutyrate concentrations by 40 and 19% compared with control and energy-replacement (P<0.05 for both). Postprandial insulin concentrations were 18 and 10% lower for energy-deficit and energy-replacement compared with control and 10% lower for energy-deficit than energy-replacement (P<0.05 for all). Postprandial fat oxidation increased by 30 and 14% for energy-deficit and energy-replacement compared to control and was 12% higher for energy-deficit than energy-replacement (P<0.05 for all).

CONCLUSION

Exercise with energy replacement lowered postprandial insulinaemia and increased fat oxidation. However an exercise-induced energy deficit augmented these effects and was necessary to lower postprandial lipaemia.

Moderate exercise reduces serum triacylglycerol concentrations but does not affect pre-heparin lipoprotein lipase concentrations after a moderate-fat meal in young men

Aerobic exercise has been shown to lower postprandial TAG concentrations after a meal(s) of high-fat content. This study examined the effects of moderate-intensity cycling on postprandial TAG concentrations and pre-heparin lipoprotein lipase concentrations after subjects consumed a meal of moderate-fat content (45 % of total energy). Twelve male subjects, aged 24 (sem 1) years, completed two 2 d trials (exercise and control) at least 1 week apart in a randomised, repeated measures design. On day 1, subjects either cycled for 30 min at 65 % of maximum heart rate in the afternoon or rested (no exercise). On day 2 of both trials, after an overnight stay with an 11 h fast, subjects consumed a test meal of moderate-fat content (0.61 g fat, 1.34 g carbohydrate, 0.37 g protein and 51 kJ energy/kg body mass) for breakfast. Blood samples were collected at baseline (before the exercise or at an equivalent time-point during the control trial on day 1), in the fasted state (0 h) and at 2, 4 and 6 h postprandially on day 2. The total and incremental areas under the serum TAG concentration v. time curve were 30 % (P = 0.039) and 33 % (P = 0.012) lower on the exercise trial compared with the control trial, respectively. Serum pre-heparin lipoprotein lipase concentrations did not differ between the exercise and control trials. These findings demonstrate that 30 min of moderate-intensity cycling performed the day before a meal of moderate-fat content is effective at lowering postprandial serum TAG concentrations but does not affect serum pre-heparin lipoprotein lipase concentrations in young men.

Influence of aging and menopause on postprandial lipoprotein responses in healthy adult women

AIM

To analyze the influence of menopause and age on postprandial lipoprotein responses in healthy adult women.

METHOD

Twenty-seven healthy young and middle-aged pre- and postmenopausal female volunteers aged 21-53 y were enrolled. They ingested OFTT cream(Jomo, Takasaki, Japan). Fasting and postprandial blood samples were obtained for up to 6 h, and serum concentrations of lipoproteins were analyzed.

RESULTS

In the postprandial phase, serum triglycerides(TG), remnant-like particle(RLP)-TG(RLP-TG), RLP-cholesterol(RLP-C), and TG-rich lipoprotein-TG(TRL-TG)concentrations in all groups peaked after 2 h. After 4 h, the TG, RLP-C, RLP-TG and TRL-TG concentrations in the young women returned to the fasting concentrations. However, at 6 h, these parameters in the pre- and postmenopausal women had barely returned to the fasting concentrations.

CONCLUSION

The present results suggest that:(1)the magnitude of postprandial TG concentrations is dependent on age, but not on menopause;(2)clearance of remnant lipoproteins is delayed with age in pre- and postmenopausal women compared to young women, and(3)menopause is associated with an increase of RLP-C, but may not influence LDL particle size.

A single bout of brisk walking increases basal very low-density lipoprotein triacylglycerol clearance in young men

Very low-density lipoprotein triacylglycerol (VLDL-TG) turnover rate was evaluated in the morning, 12 hours after a single bout of brisk walking (90 minutes at approximately 60% of VO2max; EXE), compared to a resting control period (CON) in 10 recreationally active men. VLDL-TG fractional catabolic rate was calculated from the decay in isotopic enrichment after a bolus injection of [2H5]glycerol. Plasma VLDL-TG concentration was 24% lower in the morning after the EXE trial compared to control (0.47+/-0.04 and 0.36+/-0.04 mmol L(-1), for CON and EXE, respectively; P<.01). Serum insulin (7.4+/-0.7 and 5.6+/-0.4 mIU L(-1), CON and EXE, respectively; P<.05) and plasma glucose (5.6+/-0.1 and 5.4+/-0.1 mmol/L, CON and EXE, respectively; P<.05) concentrations were also significantly lower in the EXE trial. Insulin sensitivity (homeostasis model assessment [HOMA] index) was improved by 27% in EXE compared with the CON trial (P<.05).VLDL-apolipoprotein B-100 and plasma fatty acid concentrations were similar in the two trials. Hepatic VLDL-TG secretion rates were not significantly affected by exercise (13.1+/-1.2 and 13.2+/-1.6 micromol.min(-1) for the CON and EXE trials, respectively), whereas VLDL-TG clearance rate increased by 36% (28.1+/-1.3 and 38.1+/-3.5 mL.min(-1) for the CON and EXE trials, respectively; P<.05). It is concluded that the decrease in fasting plasma VLDL-TG concentration observed 12 hours after brisk walking is related mainly to increased VLDL-TG clearance from plasma.

Development of a novel method to determine very low density lipoprotein kinetics

Isotopic tracer methods of determining triglyceride-rich lipoprotein (TRL) kinetics are costly, time-consuming, and labor-intensive. This study aimed to develop a simpler and cost-effective method of obtaining TRL kinetic data, based on the fact that chylomicrons compete with large VLDL (VLDL(1); S(f) = 60-400) for the same catalytic pathway. Ten healthy subjects [seven men; fasting triglyceride (TG), 44.3-407.6 mg/dl; body mass index, 21-35 kg/m(2)] were given an intravenous infusion of a chylomicron-like TG emulsion (Intralipid; 0.1 g/kg bolus followed by 0.1 g/kg/h infusion) for 75-120 min to prevent the clearance of VLDL(1) by lipoprotein lipase. Multiple blood samples were taken during and after infusion for separation of Intralipid, VLDL(1), and VLDL(2) by ultracentrifugation. VLDL(1)-apolipoprotein B (apoB) and TG production rates were calculated from their linear increases in the VLDL(1) fraction during the infusion. Intralipid-TG clearance rate was determined from its exponential decay after infusion. The production rates of VLDL(1)-apoB and VLDL(1)-TG were (mean +/- SEM) 25.4 +/- 3.9 and 1,076.7 +/- 224.7 mg/h, respectively, and the Intralipid-TG clearance rate was 66.9 +/- 11.7 pools/day. Kinetic data obtained from this method agree with values obtained from stable isotope methods and show the expected relationships with indices of body fatness and insulin resistance (all P < 0.05). The protocol is relatively quick, inexpensive, and transferable to nonspecialist laboratories.

Effects of low- and high-volume resistance exercise on postprandial lipaemia

Postprandial lipaemia (PL) is associated with the metabolic syndrome, CVD and endothelial dysfunction. Aerobic exercise has been shown to reduce PL. Although resistance exercise is recommended for the improvement of the quality of life, management of body weight and prevention of several disorders, its effect on PL has received little attention. The present study examined the effects of low-volume resistance exercise (LVRE) and high-volume resistance exercise (HVRE) on PL. Ten healthy young men performed three trials, each conducted over 2 d. On the afternoon of day 1, they either refrained from exercise (control), performed LVRE (two sets of eight exercises, twelve repetitions at twelve repetitions maximum (RM) in each set; energy expenditure 0 x 76 MJ), or performed HVRE (four sets of eight exercises, twelve repetitions at 12 RM in each set; energy expenditure 1 x 40 MJ). On the morning of day 2 they consumed a meal containing 67 kJ/kg body weight, of which 65 % energy was from fat. Blood samples were obtained in the fasted state and for 6 h postprandially. The total area under the TAG curve (AUC; mmol/l x h) was lower (P<0 x 05) in HVRE (8 x 76 (sd 3 x 20)) and LVRE (9 x 29 (sd 3 x 64)) compared with control (11 x 60 (sd 4 x 35)). The incremental AUC was lower in HVRE compared with control (3 x 07 (sd 2 x 53) v. 5 x 58 (sd 3 x 72)), but not different between LVRE (3 x 86 (sd 2 x 29)) and control. In conclusion, resistance exercise of 1 x 40 MJ (four sets - eight exercises - twelve RM) or 0 x 76 MJ (two sets - eight exercises - twelve RM) before a high-fat meal reduces the total postprandial lipaemic response.

Prior exercise does not affect chylomicron particle number following a mixed meal of moderate fat content

Background

A single session of exercise has been reported to reduce fasting and postprandial triacylglycerol concentrations on the subsequent day. It is possible that exercise also reduces chylomicron particle number, which may underlie the observed reduction in postprandial triacylglycerol concentration. In the present study we aimed to determine whether a single session of exercise reduces fasting and postprandial chylomicron particle number on the subsequent day. In a randomised crossover design eight lean and healthy male and female subjects attended two postprandial testing days. On the previous day the subjects either performed 90 minutes of moderate intensity exercise or did not perform any exercise. Fasting blood samples were then collected prior to ingestion of a moderate fat mixed meal (0.44 g fat, 0.94 g carbohydrate, 0.27 g protein/kg body weight), blood was then collected after 1 h, 2 h, 4 h, 6 h, and 8 h.

Results

The fasting and postprandial apolipoprotein B48 concentration (marker of chylomicron particle number) was not affected by prior exercise. However exercise reduced fasting triacylglycerol concentration by 16% (P < 0.05) and there was a trend towards a reduction in the total area under the postprandial triacylglycerol curve (23%; P = 0.053). However when corrected for baseline concentration postprandial triacylglycerol concentration was not affected by prior exercise.

Conclusion

A single session of exercise of moderate intensity and 90 minutes duration reduces fasting triacylglycerol levels, however fasting and postprandial chylomicron particle number was unaffected. Furthermore it appears that previously observed reductions in postprandial triacylglycerol levels following exercise are only mediated following consumption of high, non-physiologically relevant doses of fat.

The effect of acute aerobic exercise on pulse wave velocity and oxidative stress following postprandial hypertriglyceridemia in healthy men

Oxidative stress is postulated to be responsible for the postprandial impairments in vascular function. The purpose of this study was to measure pulse wave velocity (PWV) and markers of postprandial oxidative stress before and after an acute bout of moderate exercise. Ten trained male subjects (age 21.5 +/- 2.5 years, VO2 max 58.5 +/- 7.1 ml kg(-1) min(-1)) participated in a randomised crossover design: (1) high-fat meal alone (2) high-fat meal followed 2 h later by a bout of 1 h moderate (60% max HR) exercise. PWV was examined at baseline, 1, 2, 3, and 4 h postprandially. Blood Lipid hydroperoxides (LOOHs), Superoxide dismutase (SOD) and other biochemical markers were measured. PWV increased at 1 h (6.49 +/- 2.1 m s(-1)), 2 h (6.94 +/- 2.4 m s(-1)), 3 h (7.25 +/- 2.1 m s(-1)) and 4 h (7.41 +/- 2.5 m s(-1)) respectively, in the control trial (P < 0.05). There was no change in PWV at 3 h (5.36 +/- 1.1 m s(-1)) or 4 h (5.95 +/- 2.3 m s(-1)) post ingestion in the exercise trial (P > 0.05). LOOH levels decreased at 3 h post ingestion in the exercise trial compared to levels at 3 h (P < 0.05) in the control trial. SOD levels were lower at 3 h post ingestion in the control trial compared to 3 h in the exercise trial (0.52 +/- 0.05 vs. 0.41 +/- 0.1 units mul(-1); P < 0.05). These findings suggest that a single session of aerobic exercise can ameliorate the postprandial impairments in arterial function by possibly reducing oxidative stress levels.

Regulation of postprandial lipemia: an update on current trends

People spend a large percentage of their waking hours in the postprandial state. Postprandial lipemia is associated with disruptions in lipoprotein metabolism and inflammatory factors, cardiovascular disease, MetS, and diabetes. Commonly, the dietary sources of fat exceed the actual needs and the tissues are faced with the excess, with accumulation of chylomicrons and remnant particles. This review will summarize recent findings in postprandial lipemia research with a focus on human studies. The effects of dietary factors and other meal components on postprandial lipemia leads to the following question: do we need a standardized oral lipid tolerance test (OLTT)? An overview of recent findings on FABP2, MTP, LPL, apoAV, and ASP and the effects of body habitus (sex influence and body size), as well as exercise and weight loss, on postprandial lipemia will be summarized.

Effects of intermittent games activity on postprandial lipemia in young adults

PURPOSE

To investigate whether a single session of intermittent games activity would reduce postprandial lipemia.

METHODS

Twelve male volunteers completed three 2-d trials: rest, continuous exercise, and intermittent games activity. Trials were performed a minimum of 6 d apart in a balanced crossover design. In the rest trial, subjects took no exercise on day 1. On day 1 of the continuous and intermittent games trials, subjects completed four blocks (approximately 15 min per block) of uphill treadmill walking or intermittent games activity with 3 min of rest between each block. On day 2, subjects came to the laboratory for an oral fat tolerance test (blood taken fasted and for 6 h following a high-fat test meal (1.25 g of fat and 1.07 g of carbohydrate per kilogram of body mass)).

RESULTS

The intermittent games protocol elicited a higher exercise intensity than the continuous trial (lactate: 4.3+/-0.6 vs 2.4+/-0.3 mmol.L; % VO2max: 72+/-2 vs 62+/-1, respectively; mean+/-SE). The total area under the plasma triacylglycerol (TAG) concentration versus time curve was lower in both the intermittent games (25%, P=0.001) and the continuous (19%, P=0.028) trials than in the rest trial.

CONCLUSION

These findings show for the first time that intermittent games activity can reduce postprandial lipemia, and confirm that continuous exercise reduces postprandial lipemia in young adults.

Effect of prior moderate exercise on postprandial metabolism in men with type 2 diabetes: heterogeneity of responses

Prior moderate exercise has been shown consistently to reduce postprandial triglyceride (TG) concentrations in non-diabetic adults, but its effects in men with type 2 diabetes are not known. This study aimed to determine the effect of moderate exercise on postprandial metabolism in men with type 2 diabetes. Ten middle-aged men with type 2 diabetes underwent two oral fat tolerance tests (blood taken fasting and for 8 h after a meal containing 80 g fat, 70 g carbohydrate) in random order. On the afternoon before one test, participants performed a 90-min treadmill walk (Exercise); no exercise was performed before the CONTROL test. Exercise significantly reduced fasting glucose (

CONTROL

9.08+/-0.75 mmol l(-1), Exercise: 8.40+/-0.72 mmol l(-1), p=0.033) and insulin (

CONTROL

8.01+/-0.98 microU ml(-1), Exercise: 6.81+/-0.93 microU ml(-1), p=0.046) and increased fasting 3-hydroxybutyrate (

CONTROL

87.1+/-19.2 micromol l(-1), Exercise: 134.3+/-28.4 micromol l(-1), p=0.011); reduced postprandial insulin by 11.0% (p=0.04) and increased postprandial 3-hydroxybutyrate by 31.8% (p=0.03); but did not significantly change fasting or postprandial triglyceride or NEFA concentrations. However, the exercise-induced change in postprandial triglyceride concentration ranged from -32.3 to +28.3% and the exercise-induced change in fasting 3-hydroxybutyrate concentration (a marker of hepatic fatty acid oxidation) was highly correlated with the exercise-induced changes in fasting and postprandial triglyceride (r=0.68, p=0.03 for both). Thus, inter-individual variation in propensity to increase hepatic fatty acid oxidation following exercise may account for the considerable heterogeneity in triglyceride responses to moderate exercise observed in men with type 2 diabetes.

Physical activity, fitness and cardiovascular disease risk in adults: interactions with insulin resistance and obesity

There is a considerable body of evidence gathered from studies over the past half a century indicating that a high level of physical activity and a moderately high or high degree of cardiorespiratory fitness reduces the risk of CVD (cardiovascular disease). Recent data suggest that high levels of physical activity or fitness may be particularly beneficial to individuals with insulin-resistant conditions, such as the metabolic syndrome, Type II diabetes or obesity. These individuals, if unfit and sedentary, exhibit increased CVD risk, but their dose-response relationship for physical activity/fitness appears to be particularly steep such that, when they undertake high levels of activity (or have high fitness), their level of risk becomes closer to that of their normal weight or nondiabetic peers. This may be due to effects of physical activity in normalizing the metabolic dysfunction particularly associated with insulin-resistant conditions.

The influence of 30 minutes of light to moderate intensity cycling on postprandial lipemia

BACKGROUND

Elevated postprandial lipemia is an independent risk factor for coronary heart disease, and bouts of moderate intensity exercise of 60 min or more are often reported to lower postprandial lipemia. Information on moderate intensity exercise bouts of shorter duration corresponding to the current recommendations of health-maintaining exercise (i.e. 30 min or energy expenditure of approximately 630 kJ), however, is scarce. Therefore, we searched for the lowest exercise intensity during 30 min of light to moderate intensity cycling that still reduced postprandial lipemia.

DESIGN

We employed a repeated measures cross-over design.

METHODS

Twelve healthy, not endurance trained, young men performed three activity trials (30 min cycling with a target energy expenditure of 420, 630 and 840 kJ) before ingestion of two mixed meals with a macronutrient composition corresponding to current recommendations and a control trial (no physical activity before meal ingestion). Capillary triacylglycerol was measured in the fasting state and hourly for 6 h after the first meal. Respiratory gases were analyzed in the fasting state, and 3 and 6 h after the first meal. Triacylglycerol and respiratory responses between the trials were compared with analyses of variance.

RESULTS

Postprandial lipemia and the incremental area under the triacylglycerol curve were not significantly different with the activity trials compared with the control trial. The postprandial respiratory exchange ratio was also not significantly affected by activity.

CONCLUSIONS

Thirty minutes of light to moderate intensity cycling did not reduce postprandial lipemia after two mixed meals with a moderate fat content in healthy, not endurance trained, young men.

Diabetes prevention: is there more to it than lifestyle changes?

Over the past years, there has been an explosive increase in the prevalence of type 2 diabetes (T2DM) and this is expected to continue, entailing associated morbidity and mortality. An increasing number of studies explore the different ways T2DM could be prevented. On-going lifestyle modifications need to be addressed. High-risk patients should be given counselling on weight loss, possibly using a low glycaemic index diet, with a target of around 7-10% over 6-12 months, as well as instruction for increasing physical activity to around 150 min of physical exercise weekly (NNT = 4-8). Moderate alcohol consumption and coffee consumption may also be of benefit (NNT = 89 and 66, respectively). Metformin (NNT = 14), acarbose (NNT = 11) and troglitazone (NNT = 6) have been shown to prevent/delay T2DM and angiotensin-converting enzyme (ACE) inhibitors and statins appear to have an adjunctive role (NNT = 42 and 112, respectively). Trials with orlistat and bariatric surgery have also prevented T2DM (NNT = 36 and 6, respectively), and forthcoming treatment with GLP1 mimetics appears promising. Diabetes prevention studies should help create well-defined strategies for screening and treating high-risk populations in the real world, as prevention is our only chance to alleviate the ever growing burden of diabetes mellitus in the world.

Prescribing Aerobic Exercise for the Regulation of Postprandial Lipid Metabolism

Prolonged presence of elevated plasma triglycerides (TGs) during the postprandial period has been suggested to increase the risk for coronary artery disease. Aerobic exercise attenuates postprandial lipaemia and this has generally been described as a short-term effect of the exercise. Effects of exercise on postprandial lipaemia have mostly been investigated, and documented, with large exercise-induced energy expenditures (i.e. 1000 kcal). The exact mechanisms involved in the attenuation of postprandial lipaemia with exercise are not completely understood, but it appears that at least two mechanisms are involved: a decrease in TG secretion by the liver and an increase in plasma TG clearance by the muscle. Changes in the metabolism of other lipids, such as those in high-density lipoprotein cholesterol, have been documented only when the exercise is performed some hours before the fat meal. Although factors such as the physical fitness and percentage body fat of an individual are likely to also be involved, the most important factors determining the magnitude of the attenuation in postprandial lipaemia appear to be the magnitude of the exercise-induced energy expenditure and the intensity of exercise. To date, the evidence suggests that healthy individuals can generally induce favourable changes in postprandial lipaemia with aerobic exercise that: (i) is completed during the period extending from 16 hours before a meal through 1.5 hours after a meal; (ii) is of moderate intensity; and (iii) results in an energy expenditure of approximately 500 kcal (or more).

Exercise and postprandial lipemia: effect of continuous compared with intermittent activity patterns

BACKGROUND

Guidelines state that accumulated physical activity is beneficial for health, but a minimum duration of 10 min per activity bout is recommended. Limited information regarding the effects of short (< 10 min) bouts of activity on health is available, and no studies of the effects of such short bouts of activity on postprandial lipemia have been conducted.

OBJECTIVE

The objective was to compare the effects of accumulating ten 3-min bouts of exercise with those of one 30-min bout of exercise on postprandial plasma triacylglycerol concentrations.

DESIGN

Ten men aged 21-32 y completed three 2-d trials > or = 1 wk apart in a randomized repeated-measures design. On day 1, the subjects rested (no exercise) or ran at 70% of maximum oxygen uptake in either ten 3-min bouts (30 min rest between each) or one continuous 30-min bout. On day 2, the subjects rested and consumed test meals (0.69 g fat, 0.95 g carbohydrate, 0.31 g protein, and 46 kJ/kg body mass) for breakfast and lunch. Venous blood samples were obtained in the fasted state and for 7 h postprandially on day 2.

RESULTS

Postprandial plasma triacylglycerol concentrations were lower throughout day 2 of both the accumulation exercise trial and the continuous exercise trial than during the control trial (main effect of trial: P < 0.001, 2-factor analysis of variance).

CONCLUSIONS

Accumulating multiple short bouts of exercise throughout the day effectively reduce postprandial plasma triacylglycerol concentrations to an extent similar to that of a single 30-min session of exercise in healthy young men.