Nine months aerobic fitness induced changes on blood lipids and lipoproteins in untrained subjects versus controls

Estimating the Effect of Aerobic Exercise Training on Novel Lipid Biomarkers: A Systematic Review and Multivariate Meta-Analysis of Randomized Controlled Trials

BACKGROUND

Aerobic exercise training (AET) prescribed as lipid management treatment positively affects the standard lipid profile and reduces cardiovascular disease (CVD) risk. Apolipoproteins, lipid and apolipoprotein ratios, and lipoprotein sub-fractions may more effectively predict CVD risk than the standard lipid profile but an AET response in these biomarkers has not been established.

OBJECTIVES

We conducted a quantitative systematic review of randomised controlled trials (RCTs) to (1) determine the effects of AET on lipoprotein sub-fractions, apolipoproteins and relevant ratios; and (2) identify study or intervention covariates associated with change in these biomarkers.

METHODS

We searched PubMed, EMBASE, all Web of Science and EBSCO health and medical online databases from inception to 31 December 2021. We included published RCTs of adult humans with ≥ 10 per group of participants; an AET intervention duration ≥ 12 weeks of at least moderate intensity (> 40% maximum oxygen consumption); and reporting pre/post measurements. Non-sedentary subjects, or those with chronic disease other than Metabolic Syndrome factors, or pregnant/lactating, as well as trials testing diet/medications, or resistance/isometric/unconventional training interventions, were excluded.

RESULTS

Fifty-seven RCTs totalling 3194 participants were analysed. Multivariate meta-analysis showed AET significantly raised antiatherogenic apolipoproteins and lipoprotein sub-fractions (mmol/L mean difference (MD) 0.047 (95% confidence interval (CI) 0.011, 0.082), P = .01); lowered atherogenic apoliproteins and lipoprotein sub-fractions (mmol/L MD - 0.08 (95% CI - 0.161, 0.0003), P = .05); and improved atherogenic lipid ratios (MD - 0.201 (95% CI - 0.291, - 0.111), P < .0001). Multivariate meta-regression showed intervention variables contributed to change in lipid, sub-fraction, and apoliprotein ratios.

CONCLUSION

Aerobic exercise training positively impacts atherogenic lipid and apolipoprotein ratios, alipoproteins, and lipoprotein sub-fractions; and antiatherogenic apolipoproteins and lipoprotein sub-fractions. Cardiovascular disease risk predicted by these biomarkers may be lowered when AET is prescribed as treatment or prevention.

PROSPERO ID

CRD42020151925.

School health programs of physical education and/or diet among pupils of primary and secondary school levels I and II linked to body mass index: A systematic review protocol within the project From Science 2 School

The most common causes of death in Western countries today are preventable diseases mainly attributed to daily behavior. It has been well documented that genetics are influential but not the deciding factor for developing non-communicable diseases. Ideally, the public should be educated to perform methods of optimal health and wellbeing independently, meaning that individuals should be in control of their health without relying on others. As behavior is known to be consistent over time, good or poor health behavior will track from childhood into adulthood. Physical activity and diet are permanently linked to the individual's state of health, and when properly balanced, the effects on personal health summate, resulting in greater benefits from this dual-approach for public health. The objective is to highlight the different approaches (physical intervention, nutritional intervention, and dual-approach of diet and exercise) and identify effective interventions for sustainable body weight and healthy body mass index in school children. A systematic review will be conducted following the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines. The review will assess school-based diet and exercise interventions on children in primary and secondary school levels I and II. Overweight and obesity develop as a result of a prolonged imbalance in the energy balance model, with both physical activity and diet being influential in the fluctuation of body weight. A dual-approach including physical activity and diet could therefore be a very promising method to promote sustainable healthy body weight in school children.

L-arginine Improves Plasma Lipid Profile and Muscle Inflammatory Response in Trained Rats After High-Intense Exercise

Purpose: This study aimed to evaluate whether supplementation with L-arginine alone or in combination with physical exercise training can modulate rats' lipid and inflammatory profiles after a single intense exercise session. Methods: Male Wistar rats were divided into four different groups: control (C), trained (T), supplemented with L-arginine (C + A) and trained and supplemented (T + A). Animals from supplemented groups (C + A and T + A groups) received 300 mg/kg animal body weight L-arginine diluted in 30 mL of drinking water for 8 weeks. Exercise training protocol (moderate intensity-70% achieved in the maximum effort test) was held 5 days/week for 8 weeks. Results: Exercise training induced a decrease in the amount of plasma, cholesterol and triglyceride totals, and skeletal muscle VEGF and CINC. Supplementation alone showed a benefit by reducing LDL levels. Conclusion: Training combined with supplementation showed a pronounced reduction in skeletal muscle VEGF and CINC amount. L-arginine supplementation, especially when associated with the regular aerobic physical exercise at moderate intensity was able to improve not only plasma lipid profile but also the inflammatory response of skeletal muscle immediately after an exhaustive physical exercise session.

Is It Time to Rethink Our Weight Loss Paradigms?

Strategies aiming to promote weight loss usually include anything that results in an increase in energy expenditure (exercise) or a decrease in energy intake (diet). However, the probability of losing weight is low and the probability of sustained weight loss is even lower. Herein, we bring some questions and suggestions about the topic, with a focus on exercise interventions. Based on the current evidence, we should look at how metabolism changes in response to interventions instead of counting calories, so we can choose more efficient models that can account for the complexity of human organisms. In this regard, high-intensity training might be particularly interesting as a strategy to promote fat loss since it seems to promote many physiological changes that might favor long-term weight loss. However, it is important to recognize the controversy of the results regarding interval training (IT), which might be explained by the large variations in its application. For this reason, we have to be more judicious about how exercise is planned and performed and some factors, like supervision, might be important for the results. The intensity of exercise seems to modulate not only how many calories are expended after exercise, but also where they came from. Instead of only estimating the number of calories ingested and expended, it seems that we have to act positively in order to create an adequate environment for promoting healthy and sustainable weight loss.

The Impact of Cardiorespiratory Fitness Levels on the Risk of Developing Atherogenic Dyslipidemia

BACKGROUND

Low cardiorespiratory fitness has been established as a risk factor for cardiovascular-related morbidity. However, research about the impact of fitness on lipid abnormalities, including atherogenic dyslipidemia, has produced mixed results. The purpose of this investigation is to examine the influence of baseline fitness and changes in fitness on the development of atherogenic dyslipidemia.

METHODS

All participants completed at least 3 comprehensive medical examinations performed by a physician that included a maximal treadmill test between 1976 and 2006 at the Cooper Clinic in Dallas, Texas. Atherogenic dyslipidemia was defined as a triad of lipid abnormalities: low high-density-lipoprotein cholesterol ([HDL-C] <40 mg/dL), high triglycerides ([TGs] ≥200 mg/dL), and high low-density-lipoprotein cholesterol ([LDL-C] ≥160 mg/dL).

RESULTS

A total of 193 participants developed atherogenic dyslipidemia during an average of 8.85 years of follow-up. High baseline fitness was protective against the development of atherogenic dyslipidemia in comparison with those with low fitness (odds ratio [OR] 0.57; 95% confidence interval [CI], 0.37-0.89); however, this relationship became nonsignificant after controlling for baseline HDL-C, LDL-C, and TG levels. Participants who maintained fitness over time had lower odds of developing atherogenic dyslipidemia than those with a reduction in fitness (OR 0.56; 95% CI, 0.34-0.91) after adjusting for baseline confounders and changes in known risk factors.

CONCLUSIONS

High fitness at baseline and maintenance of fitness over time are protective against the development of atherogenic dyslipidemia.

Meta-Analyses of the Effects of Habitual Running on Indices of Health in Physically Inactive Adults

Background

In order to implement running to promote physical activity, it is essential to quantify the extent to which running improves health.

Objective

The aim was to summarise the literature on the effects of endurance running on biomedical indices of health in physically inactive adults.

Data Sources

Electronic searches were conducted in October 2014 on PubMed, Embase, CINAHL, SPORTDiscus, PEDro, the Cochrane Library and LILACS, with no limits of date and language of publication.

Study Selection

Randomised controlled trials (with a minimum of 8 weeks of running training) that included physically inactive but healthy adults (18–65 years) were selected. The studies needed to compare intervention (i.e. endurance running) and control (i.e. no intervention) groups.

Study Appraisal and Synthesis Methods

Two authors evaluated study eligibility, extracted data, and assessed risk of bias; a third author resolved any uncertainties. Random-effects meta-analyses were performed to summarise the estimates for length of training and sex. A dose-response analysis was performed with random-effects meta-regression in order to investigate the relationship between running characteristics and effect sizes.

Results

After screening 22,380 records, 49 articles were included, of which 35 were used to combine data on ten biomedical indices of health. On average the running programs were composed of 3.7 ± 0.9 sessions/week, 2.3 ± 1.0 h/week, 14.4 ± 5.4 km/week, at 60–90 % of the maximum heart rate, and lasted 21.5 ± 16.8 weeks. After 1 year of training, running was effective in reducing body mass by 3.3 kg [95 % confidence interval (CI) 4.1–2.5], body fat by 2.7 % (95 % CI 5.1–0.2), resting heart rate by 6.7 min⁻¹ (95 % CI 10.3–3.0) and triglycerides by 16.9 mg dl⁻¹ (95 % CI 28.1–5.6). Also, running significantly increased maximal oxygen uptake (VO_2max) by 7.1 ml min⁻¹ kg⁻¹ (95 % CI 5.0–9.1) and high-density lipoprotein (HDL) cholesterol by 3.3 mg dl⁻¹ (95 % CI 1.2–5.4). No significant effect was found for lean body mass, body mass index, total cholesterol and low-density lipoprotein cholesterol after 1 year of training. In the dose-response analysis, larger effect sizes were found for longer length of training.

Limitations

It was only possible to combine the data of ten out the 161 outcome measures identified. Lack of information on training characteristics precluded a multivariate model in the dose-response analysis.

Conclusions

Endurance running was effective in providing substantial beneficial effects on body mass, body fat, resting heart rate, VO_2max, triglycerides and HDL cholesterol in physically inactive adults. The longer the length of training, the larger the achieved health benefits. Clinicians and health authorities can use this information to advise individuals to run, and to support policies towards investing in running programs.

Electronic supplementary material

The online version of this article (doi:10.1007/s40279-015-0359-y) contains supplementary material, which is available to authorized users.

Physical activity in obesity and metabolic syndrome

Biological aging is typically associated with a progressive increase in body fat mass and a loss of lean body mass. Owing to the metabolic consequences of reduced muscle mass, it is understood that normal aging and/or decreased physical activity may lead to a higher prevalence of metabolic disorders. Lifestyle modification, specifically changes in diet, physical activity, and exercise, is considered the cornerstone of obesity management. However, for most overweight people it is difficult to lose weight permanently through diet or exercise. Thus, prevention of weight gain is thought to be more effective than weight loss in reducing obesity rates. A key question is whether physical activity can extenuate age-related weight gain and promote metabolic health in adults. Current guidelines suggest that adults should accumulate about 60 minutes of moderate-intensity physical activity daily to prevent unhealthy weight gain. Because evidence suggests that resistance training may promote a negative energy balance and may change body fat distribution, it is possible that an increase in muscle mass after resistance training may be a key mediator leading to better metabolic control.

Differential responses of adiposity, inflammation and autonomic function to aerobic versus resistance training in older adults

BACKGROUND

Increased body fat, autonomic dysfunction and low-grade chronic inflammation are interrelated risk factors implicated in the etiology of several chronic conditions normally presented by older adults.

OBJECTIVE

This study aims to assess the effectiveness of different training protocols on reducing body fat, improving autonomic function, and decreasing low-grade systemic inflammation in community-dwelling elderly adults.

METHODS

Fifty participants (11 men, 68±5.5years) were randomly allocated into resistance or aerobic training or control groups. Evaluations were done at baseline and following the 8-month intervention period on their body composition (assessed by DXA), inflammatory biomarkers (high-sensitivity C-reactive protein [hs-CRP], tumor necrosis-alpha [TNF-α], interferon-gamma [IFN-γ], interleukins-6 and -10 [IL-6, IL-10]), lipoproteic profile, fasting glycemia, blood pressure, heart rate variability (HRV; frequency and time domains) and aerobic fitness (assessed by six-minute walk distance [6MWD]). A paired t-test was used to detect changes (%Δ=[(post-test score-pretest score)/pre-test score]×100) within groups, while between-group differences were analyzed using the one-way ANOVA or General Linear Models.

RESULTS

A significant change (Δ%) both in total (-5.4±6.3% and -3.3±2.9%, respectively) and central body fat (8.9±11.3% and -4.8±4.5%) was observed in resistance and aerobic training groups, respectively; along with a change in resting systolic and diastolic blood pressures (-9.2±9.8% and -8.5±9.6%), heart rate (-4.6±6.5%), hs-CRP (-18.6±60.6%), and 6MWD (9.5±6.9%) in response to aerobic training.

CONCLUSIONS

The present findings provide further evidence for the benefits of aerobic and resistance training on reducing body fat. Aerobic training was demonstrated to reduce hs-CRP and blood pressure in community-dwelling elderly participants with no serious medical conditions.

Lipid transfer to HDL is higher in marathon runners than in sedentary subjects, but is acutely inhibited during the run

Although exercise increases HDL-cholesterol, exercise-induced changes in HDL metabolism have been little explored. Lipid transfer to HDL is essential for HDL's role in reverse cholesterol transport. We investigated the effects of acute exhaustive exercise on lipid transfer to HDL. We compared plasma lipid, apolipoprotein and cytokine levels and in vitro transfer of four lipids from a radioactively labeled lipid donor nanoemulsion to HDL in sedentary individuals (n = 28) and in marathon runners (n = 14) at baseline, immediately after and 72 h after a marathon. While HDL-cholesterol concentrations and apo A1 levels were higher in marathon runners, LDL-cholesterol, apo B and triacylglycerol levels were similar in both groups. Transfers of non-esterified cholesterol [6.8 (5.7-7.2) vs. 5.2 (4.5-6), p = 0.001], phospholipids [21.7 (20.4-22.2) vs. 8.2 (7.7-8.9), p = 0.0001] and triacylglycerol [3.7 (3.1-4) vs. 1.3 (0.8-1.7), p = 0.0001] were higher in marathon runners, but esterified-cholesterol transfer was similar. Immediately after the marathon, LDL- and HDL-cholesterol concentrations and apo A1 levels were unchanged, but apo B and triacylglycerol levels increased. Lipid transfer of non-esterified cholesterol [6.8 (5.7-7.2) vs. 5.8 (4.9-6.6), p = 0.0001], phospholipids [21.7 (20.4-22.2) vs. 19.1 (18.6-19.3), p = 0.0001], esterified-cholesterol [3.2 (2.2-3.8) vs. 2.3 (2-2.9), p = 0.02] and triacylglycerol [3.7 (3.1-4) vs. 2.6 (2.1-2.8), p = 0.0001] to HDL were all reduced immediately after the marathon but returned to baseline 72 h later. Running a marathon increased IL-6 and TNF-α levels, but after 72 h these values returned to baseline. Lipid transfer, except esterified-cholesterol transfer, was higher in marathon runners than in sedentary individuals, but the marathon itself acutely inhibited lipid transfer. In light of these novel observations, further study is required to clarify how these metabolic changes can influence HDL composition and anti-atherogenic function.

Benefits of pedometer-measured habitual physical activity in healthy women

This cross-sectional study aimed at (i) characterizing pedometer-determined physical activity and (ii) examining its associations with dietary intake and anthropometric and metabolic profile in healthy women. Anthropometric and metabolic profile was evaluated in 68 healthy women of reproductive age. Habitual physical activity was assessed using a pedometer for 6 consecutive days, including weekends. Participants were stratified into active and inactive according to the mean steps·day–1(≥6000 and <6000, respectively). Food consumption was evaluated by 24-h recall in a subsample of 35 participants. Thirty-eight women were defined as active and had significantly lower body mass index (BMI), fat percentage, waist circumference, sum of skinfold thickness, insulin, and HOMA than the sedentary group. Mean BMI was 27 kg·m–2(overweight) in active participants and 31 kg·m–2(class I obesity) in inactive participants. Active women consumed more carbohydrates (55.5% ± 9.4% vs. 46.3% ± 7.6%) and calories (2138 ± 679 vs. 1664 ± 558 kcal), and less protein (15.4% ± 4.2% vs. 19.9% ± 5.8%) and lipids (29.0% ± 7.2% vs. 33.8% ± 6.2%) than inactive individuals (p < 0.05). Fiber, cholesterol, and fatty acid intake was similar in both groups. The number of steps was lower on Sunday than on weekdays for the overall group. Using a pedometer for 3 days was sufficient to determine habitual physical activity (sensitivity: 94%; specificity 91% vs. 6 days of pedometer use). In the present study, nonstructured physical activity was associated with more adequate dietary consumption and contributed toward a healthier anthropometric and metabolic profile in young women, despite the high prevalence of overweight.

Non-traditional markers of metabolic risk in prepubertal children with different levels of cardiorespiratory fitness

OBJECTIVE

To assess classical and non-classical metabolic risk biomarkers in prepubertal children with different levels of cardiorespiratory fitness (CRF).

DESIGN

CRF was assessed by the 20 m shuttle run test. To estimate physical activity, participants were observed while engaged in an after-school programme. Additionally, a short test based on a validated questionnaire was used to obtain information about physical activity practice and sedentary habits. Anthropometric parameters, blood pressure, and classical and non-traditional metabolic risk biomarkers--plasma lipid profile, glucose and insulin, homeostasis model assessment-insulin resistance index (HOMA-IR), plasma uric acid, transaminases and C-reactive protein (CRP)--were measured.

SETTING

The study was conducted in local elementary schools in Córdoba, Spain.

SUBJECTS

One hundred and forty-one healthy children (eighty-eight boys, fifty-three girls) aged 7-12 years, in Tanner stage I, were recruited. They were divided into two groups after they performed the 20 m shuttle run test: equal or higher cardiovascular fitness (EHCF) group and low cardiovascular fitness (LCF) group.

RESULTS

The LCF group displayed significantly higher TAG (P = 0.004) and lower HDL cholesterol levels (P = 0.001), as well as significantly lower values for the non-traditional lipid marker apo-A1 (P = 0.001) compared with the EHCF group. The LCF children displayed higher plasma glucose (P = 0.003) and insulin levels, higher HOMA-IR scores (P < 0.001) and higher plasma uric acid and CRP levels (P < 0.05). After adjustment for BMI, age and sex, no statistically significant differences were found between groups for the biomarkers analysed.

CONCLUSIONS

The study provides new information to understand the role not only of weight status but also of the level of CRF on the metabolic health profile of prepubertal children.

Effects of physical activity on cardiovascular disease

Much attention has been directed toward lifestyle modifications as effective means of reducing cardiovascular disease risk. In particular, physical activity has been heavily studied because of its well-known effects on metabolic syndrome, insulin sensitivity, cardiovascular disease risk, and all-cause mortality. However, data regarding the effects of exercise on various stages of the atherosclerosis pathway remain conflicting. The investigators review previously published reports for recent observational and interventional trials investigating the effects of physical activity on markers of (or causal factors for) atherosclerotic burden and vascular disease, including serum lipoproteins, systemic inflammation, thrombosis, coronary artery calcium, and carotid intima-media thickness. In conclusion, the data show a correlation between physical activity and triglyceride reduction, apolipoprotein B reduction, high-density lipoprotein increase, change in low-density lipoprotein particle size, increase in tissue plasminogen activator activity, and decrease in coronary artery calcium. Further research is needed to elucidate the effect of physical activity on inflammatory markers and intima-media thickness.

American College of Sports Medicine position stand. Quantity and quality of exercise for developing and maintaining cardiorespiratory, musculoskeletal, and neuromotor fitness in apparently healthy adults: guidance for prescribing exercise

The purpose of this Position Stand is to provide guidance to professionals who counsel and prescribe individualized exercise to apparently healthy adults of all ages. These recommendations also may apply to adults with certain chronic diseases or disabilities, when appropriately evaluated and advised by a health professional. This document supersedes the 1998 American College of Sports Medicine (ACSM) Position Stand, "The Recommended Quantity and Quality of Exercise for Developing and Maintaining Cardiorespiratory and Muscular Fitness, and Flexibility in Healthy Adults." The scientific evidence demonstrating the beneficial effects of exercise is indisputable, and the benefits of exercise far outweigh the risks in most adults. A program of regular exercise that includes cardiorespiratory, resistance, flexibility, and neuromotor exercise training beyond activities of daily living to improve and maintain physical fitness and health is essential for most adults. The ACSM recommends that most adults engage in moderate-intensity cardiorespiratory exercise training for ≥30 min·d on ≥5 d·wk for a total of ≥150 min·wk, vigorous-intensity cardiorespiratory exercise training for ≥20 min·d on ≥3 d·wk (≥75 min·wk), or a combination of moderate- and vigorous-intensity exercise to achieve a total energy expenditure of ≥500-1000 MET·min·wk. On 2-3 d·wk, adults should also perform resistance exercises for each of the major muscle groups, and neuromotor exercise involving balance, agility, and coordination. Crucial to maintaining joint range of movement, completing a series of flexibility exercises for each the major muscle-tendon groups (a total of 60 s per exercise) on ≥2 d·wk is recommended. The exercise program should be modified according to an individual's habitual physical activity, physical function, health status, exercise responses, and stated goals. Adults who are unable or unwilling to meet the exercise targets outlined here still can benefit from engaging in amounts of exercise less than recommended. In addition to exercising regularly, there are health benefits in concurrently reducing total time engaged in sedentary pursuits and also by interspersing frequent, short bouts of standing and physical activity between periods of sedentary activity, even in physically active adults. Behaviorally based exercise interventions, the use of behavior change strategies, supervision by an experienced fitness instructor, and exercise that is pleasant and enjoyable can improve adoption and adherence to prescribed exercise programs. Educating adults about and screening for signs and symptoms of CHD and gradual progression of exercise intensity and volume may reduce the risks of exercise. Consultations with a medical professional and diagnostic exercise testing for CHD are useful when clinically indicated but are not recommended for universal screening to enhance the safety of exercise.

Effects of aerobic exercise on selected physiological parameters and quality of life in patients with type 2 diabetes mellitus

BACKGROUND

The aim of this study was to evaluate the effects of an 8-week aerobic exercise program on physiological parameters and quality of life in patients with type 2 diabetes mellitus.

METHODS

Patients attending a diabetes clinic participated in this randomized control trial. They were randomly assigned to an intervention or control group by ballot. The intervention group, in addition to regular conventional treatment, received individually prescribed aerobic exercise for 30 minutes, at 50%-75% of maximum heart rate three times weekly. Main outcome measures included fasting blood sugar, glycosylated hemoglobin (HbA(1c)), high-density lipoprotein, low-density lipoprotein, and a World Health Organization quality of life questionnaire (WHOQoL-BREF). Data analysis involved paired and unpaired t-tests and mixed-design two-way analysis of variance.

RESULTS

Eighteen patients with type 2 diabetes and of mean age 46.22 ± 9.79 years participated in the study. Mean duration since onset of diabetes in the intervention and control groups was 4.44 ± 3.33 years and 3.92 ± 2.66 years, respectively. Both groups were similar for duration since onset, baseline physiological parameters, and quality of life. Within-group comparison did not show any significant differences (P > 0.05) for HbA(1c), fasting blood sugar, low-density lipoprotein, or high-density lipoprotein. The intervention group improved significantly (P < 0.05) in their postexercise quality of life compared with baseline. Between-group comparison did not show any significant differences in physiological parameters or quality of life.

CONCLUSION

Patients with type 2 diabetes improved in fasting blood sugar, low-density lipoprotein, high-density lipoprotein, and quality of life following 8 weeks of aerobic exercise training. These perceived improvements were not reflected by statistically significant differences in between-group comparison for any parameters.

Effects of aerobic exercise on lipid profiles and high molecular weight adiponectin in Japanese workers

BACKGROUND

The metabolic syndrome is characterized by the accumulation of several metabolic risk factors. It is important to improve physical activity and dietary habits to reduce the risk of cardiovascular disease in humans.

METHODS

The study participants participated in a weekly aerobic exercise program that included a session composed of a brief meeting, warm-up exercises, and primary exercises (low and high impact, stretch, muscle training, and cooling down). To evaluate the effect of this intervention we measured body fat composition, holding power, and quality of life assessment. Blood tests were also carried out before and every 3 months during the study.

RESULTS

Of the 37 participants enrolled in the exercise group, 31 (83.8%) completed the 12-week program. The control group consisted of 42 subjects, 36 (85.7%) of whom were available for follow-up at the end of the 12-week study period. In the exercise group, weight, body fat percentage, waist circumference, the World Health Organization quality of life 26 (WHO-QOL 26) score, triglyceride, total cholesterol, high density lipoprotein cholesterol and low density lipoprotein cholesterol had improved significantly at the end of three months. The high molecular weight adiponectin concentration of the participants in the exercise group increased during the 9-month period of the study, although this change did not reach statistical significance compared with pre-exercise.

CONCLUSION

Aerobic exercise led to an improvement in body composition and lipid profiles. High molecular weight adiponectin concentrations tended to improve compared with pre-aerobic exercise levels.

Exercise training accelerates the removal from plasma of LDL-like nanoemulsion in moderately hypercholesterolemic subjects

OBJECTIVE

Exercise training improves plasma lipid profile and diminishes risk of coronary heart disease. Previously, we showed that training increases LDL plasma clearance, as tested by an artificial LDL-like nanoemulsion method, presumably by increasing LDL receptor activity. In this study, we investigated whether training could also improve LDL clearance in hypercholesterolemic subjects (HCh) that are exposed to increased risk of cardiovascular events.

METHODS

Twenty sedentary HCh and 20 normolipidemic (NL) sedentary volunteers were divided into four groups: 12 HCh submitted to 4-month training program, 8 HCh with no exercise program, 12 NL submitted to 4-month training and 8 NL with no exercise program. An LDL-like nanoemulsion labeled with (14)C-cholesteryl ester was injected intravenously into all subjects and plasma samples were collected during 24 h after injection to determine the fractional clearance rate (FCR, in h(-1)) by compartmental analysis. The study was performed on the first and on the last day of the 4-month study period.

RESULTS

In both, trained HCh and NL groups, training increased nanoemulsion FCR by 36% (0.0443+/-0.0126; 0.0602+/-0.0187, p=0.0187 and 0.0503+/-0.0203; 0.0686+/-0.0216, p=0.0827, respectively). After training, LDL cholesterol diminished in both HCh and NL groups. In HCh, but not in NL group, LDL susceptibility to oxidation decreased, but oxidized LDL was unchanged. In both non-trained groups FCR was the same for the last and the 4-month previous evaluation.

CONCLUSION

In HCh, exercise training increased the removal of LDL as tested by the nanoemulsion, and this probably accounted for decreased LDL cholesterol and diminished LDL susceptibility to oxidation.

Exercise training ameliorates the effects of rosiglitazone on traditional and novel cardiovascular risk factors in patients with type 2 diabetes mellitus

The aim of the study was to investigate the effects of rosiglitazone and/or exercise training on novel cardiovascular risk factors in patients with type 2 diabetes mellitus. One hundred overweight/obese type 2 diabetes mellitus patients, with inadequate glycemic control (hemoglobin A(1c) >7%) despite combined treatment with gliclazide plus metformin, were randomized using a 2 x 2 factorial design to 4 equivalent (n = 25) groups, as follows: (1) CO: maintenance of habitual activities, (2) RSG: add-on therapy with rosiglitazone (8 mg/d), (3) EX: adjunctive exercise training, and (4) RSG + EX: supplementary administration of rosiglitazone (8 mg/d) plus exercise training. No participant had diabetic vascular complications or was receiving lipid-lowering therapy. Anthropometric parameters, cardiorespiratory capacity, glycemic and lipid profile, apolipoprotein (apo) A-I, apo B, interleukin (IL)-10, IL-18, insulin resistance, and blood pressure were measured before and after 12 months of intervention (P < .05). Both RSG and EX groups significantly reduced glycemic indexes, insulin resistance, blood pressure, and IL-18, whereas they significantly increased high-density lipoprotein, cardiorespiratory capacity, and IL-10, compared with CO group (P < .05). Besides this, exercise-treated patients conferred a remarkable down-regulation in the rest of lipid parameters (total cholesterol, low-density lipoprotein cholesterol, triglycerides, apo B) and body fat content (P < .05) in comparison with CO group. On the other hand, RSG group rather than CO group considerably increased apo A-I levels and body mass index (P < .05). Notably, the combined treatment group yielded pronounced beneficial changes in glycemic indexes, lipid profile, insulin resistance, blood pressure, IL-10, IL-18, apo A-I, and apo B (vs CO group, P < .05). Furthermore, the addition of exercise to rosiglitazone treatment counteracted the drug-related negative effects on body weight, low-density lipoprotein, and total cholesterol. Rosiglitazone plus exercise training elicited additive effects on body composition, glycemic control, and traditional and novel cardiovascular risk factors in type 2 diabetes mellitus patients, indicating complementary effects.

Beneficial effects of recreational football on the cardiovascular risk profile in untrained premenopausal women

The present study examined the cardiovascular health effects of 16 weeks of recreational football training in untrained premenopausal women in comparison with continuous running training. Fifty healthy women were matched and randomized to a football (FG, n=25) or a running (RG, n=25) group and compared with a control group with no physical training (CO, n=15). Training was performed for 1 h twice a week. After 16 weeks, systolic and diastolic blood pressure was reduced (P<0.05) in FG (7+/-2 and 4+/-1 mmHg) and systolic blood pressure was lowered (P<0.05) in RG (6+/-2 mmHg). After 16 weeks, resting heart rate was lowered (P<0.05) by 5+/-1 bpm both in FG and RG, and maximal oxygen uptake was elevated (P<0.05) by 15% in FG and by 10% in RG (5.0+/-0.7 and 3.6+/-0.6 mL/min/kg, respectively). Total fat mass decreased (P<0.05) by 1.4+/-0.3 kg in FG and by 1.1+/-0.3 kg in RG. After 16 weeks, pulse pressure wave augmentation index (-0.9+/-2.5 vs 4.2+/-2.4%), skeletal muscle capillarization (2.44+/-0.15 vs 2.07+/-0.05 cap/fib) and low-density lipoprotein/high-density lipoprotein cholesterol ratio were improved (P<0.05) in FG, but not altered in RG. No changes were observed in CO. In conclusion, regular recreational football training has significant favorable effects on the cardiovascular risk profile in untrained premenopausal women and is at the least as efficient as continuous running.

The utility of physical activity in the management of global cardiometabolic risk

Major health organizations promote the adoption of a healthy lifestyle, composed of sufficient daily physical activity and a balanced diet for the prevention and management of type 2 diabetes (T2D) and cardiovascular disease risk. In particular, it is recommended that adults accumulate 30 min of moderate-intensity aerobic physical activity on most days of the week. Despite these recommendations, a physically active lifestyle is seldom adopted, and the majority of the North American population remains sedentary. Although the optimal strategy for promoting physical activity in today's environment remains elusive, the evidence for the utility of physical activity in the management of risk factors for T2D and cardiovascular disease is overwhelming. This review examines the influence of aerobic-type physical activity on components of global cardiometabolic risk, that is, the traditional and emerging risk factors for cardiovascular disease and T2D, including visceral obesity, insulin resistance, hypertension, atherogenic dyslipidemia, thrombosis, inflammation, and cardiorespiratory fitness. Where possible, specific consideration is given to the independent effects of an acute bout of physical activity vs. chronic physical activity with weight loss vs. chronic physical activity without weight loss.

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.

Lipid profile in men and women with different levels of sports participation and physical activity

Objective

The purpose of the present study was to analyse the lipid profile in men and women differentiated according to energy expenditure during sports participation (EESPORT), energy expenditure during active leisure time (EEALT) and overall energy expenditure (EETOTAL).

Design

The subjects were grouped by sex, age, EESPORT, EEALT and EETOTAL. Group differences were analysed using analyses of covariance with BMI and alcohol consumption as covariates.

Setting

Physical activity was assessed using the Flemish Physical Activity Computerised Questionnaire. Fasting blood samples were taken to measure total cholesterol (TC), TAG, HDL-cholesterol (HDL-C), LDL-cholesterol (LDL-C) and the ratio TC:HDL-C.

Subjects

The study sample consisted of 1170 Flemish men and women between 18 and 75 years of age.

Results

Differences in lipid profile were observed in the younger age group (<45 years), all in favour of the most active group. More specifically, when differentiating by EEALT and EETOTAL, men had a healthier lipid profile for TAG, HDL-C and TC:HDL-C. Differentiation according to EESPORT revealed the same significant results except for TAG. In women significant results for HDL-C, LDL-C and TC:HDL-C were found when differentiated by EESPORT.

Conclusions

Men and women <45 years of age with higher levels of energy expenditure due to sport show a better lipid profile than their sedentary counterparts. When differentiating subjects according to energy expenditure during active leisure time or overall energy expenditure, only in men was a healthier lipid profile observed in favour of the most active subjects.

Enhanced removal from the plasma of LDL-like nanoemulsion cholesteryl ester in trained men compared with sedentary healthy men

The objective of this study was to evaluate the effects of exercise training on plasma removal of a cholesterol-rich nanoemulsion (LDE) that mimics low-density lipoprotein (LDL) lipid structure and binds to LDL receptors. LDE-derived cholesteryl ester plasma kinetics was studied in 24 exercise-trained and 20 sedentary male subjects. LDE labeled with [14C]cholesteryl ester was injected intravenously, and plasma samples were collected over a 24-h period to determine radioisotope decay curves. LDL cholesterol concentration was similar in both groups. Fractional clearance rate (FCR) of the nanoemulsion label was greater in the exercise-trained group compared with the sedentary group (0.138 ± 0.152 and 0.0261 ± 0.023 h−1, respectively). A positive correlation was found ( r = 0.60, P < 0.01) between FCR and peak O2consumption in trained subjects. Circulating oxidized LDL levels were lower in trained subjects compared with the sedentary group (9.0 ± 2.0 and 16.0 ± 3.0 mU/l). LDE was also injected into control and LDL receptor gene knockout mice submitted and not submitted to training. Muscle LDE uptake percentage was increased in the trained mice compared with the untrained mice (1.1 ± 0.8 and 0.2 ± 0.1, respectively, P < 0.0001) in the control group but not in the knockout animals, indicating that the LDL receptor is involved in the increased uptake elicited by exercise. These results show that exercise training increases LDE plasma removal, which in turn suggests that it also increases LDL receptors or LDL receptor activity.