Short-term interruption of training affects both fasting and post-prandial lipoproteins

Effect of Moderate-Intense Training and Detraining on Glucose Metabolism, Lipid Profile, and Liver Enzymes in Male Wistar Rats: A Preclinical Randomized Study

Exercise training positively regulates glucose metabolism. This study investigated the impact of training and detraining on glucose metabolism, lipid profiles, and liver enzymes. Twenty-six rats completed an initial 4-week moderate-intense training (T0-T4). Then, the animals were randomly assigned to two groups at the end of week 4: AT4: detraining for 8 weeks; AT8: training for 8 weeks and 4-week detraining. Six animals were sacrificed at T0 and T4, four animals/group at T8, and three/group at T12. The study continued for 12 weeks, and all parameters were assessed at T0, T4, T8, and T12. IPGTT significantly improved after 4 weeks of training (p < 0.01) and was further reduced in AT8 at T8. In AT8, 8-week training significantly reduced total cholesterol at T4 and T12 vs. T0 (p < 0.05), LDL at T4, T8, and T12 vs. T0 (p < 0.01), ALP at T8, T12 vs. T0 (p < 0.01), and increased HDL at T8 and ALT at T8 and T12 vs. T0 (p < 0.05). Triglycerides and hexokinase activity increased significantly at T4 and T8 (p < 0.05) and then decreased at T12 in AT8. Pyruvate and glycogen increased at T12 in AT8 vs. AT4. Eight-week training improved LPL and ATGL expressions. Training positively modulated insulin, glucose metabolism, and lipid profiles, but detraining reduced the benefits associated with the initial training.

Exposure to Normobaric Hypoxia Combined with a Mixed Diet Contributes to Improvement in Lipid Profile in Trained Cyclists

This study aimed to analyze the effects of live high-train low method (LH-TL) and intermittent hypoxic training (IHT) with a controlled mixed diet on lipid profile in cyclists. Thirty trained male cyclists at a national level with at least six years of training experience participated in the study. The LH-TL group was exposed to hypoxia (FiO2 = 16.5%) for 11-12 h a day and trained under normoxia for 3 weeks. In the IHT group, participants followed the IHT routine three times a week under hypoxia (FiO2 = 16.5%) at lactate threshold intensity. The control group (N) lived and trained under normoxia. The results showed that the 3-week LH-TL method significantly improved all lipid profile variables. The LH-TL group showed a significant increase in HDL-C by 9.0% and a decrease in total cholesterol (TC) by 9.2%, LDL-C by 18.2%, and triglycerides (TG) by 27.6%. There were no significant changes in lipid profiles in the IHT and N groups. ∆TG and ∆TC were significantly higher in the LH-TL group compared to the N group. In conclusion, hypoxic conditions combined with a mixed diet can induce beneficial changes in lipid profile even in highly trained athletes. The effectiveness of the hypoxic stimulus is closely related to the hypoxic training method.

Lipoprotein(a) and Cardiovascular Disease Prevention across Diverse Populations

Lipoprotein(a) (Lp(a)) is a highly proatherogenic lipid fraction that is genetically determined and minimally responsive to lifestyle or behavior changes. Mendelian randomization studies have suggested a causal link between elevated Lp(a) and heart disease, stroke, and aortic stenosis. There is substantial inter-ethnic variation in Lp(a) levels, with persons of African descent having the highest median values. Monitoring of Lp(a) has historically been limited by lack of standardization of assays. With the advent of novel therapeutic modalities to lower Lp(a) levels including proprotein convertase subtilisin/kexin 9 (PCSK9) inhibitors and targeted antisense oligonucleotides, it is increasingly important to screen patients who have family or personal history of atherosclerotic cardiovascular disease for elevations in Lp(a). Further study is needed to establish a causal relationship between elevated Lp(a) and cardiovascular disease across diverse ethnic populations.

Influence of aerobic training and detraining on serum BDNF, insulin resistance, and metabolic risk factors in middle-aged men diagnosed with metabolic syndrome

OBJECTIVE

To study the influence of aerobic exercise training on brain-derived neurotrophic factor (BDNF), insulin resistance, and lipid profile in middle-aged men diagnosed with metabolic syndrome (MetS).

DESIGN

This is an experimental repeated measure study.

SETTING

Subjects participated in aerobic training programs (18 sessions of 25-40 minutes per session) in Guilan University gymnasium and court.

PARTICIPANTS

A total of 21 middle-aged men (50-65 years old) diagnosed with MetS participated.

INTERVENTIONS

We randomly divided 21 middle-aged men with MetS into exercise and control groups. The exercise group followed an aerobic training program (18 sessions, 3/wk) at 50% to 60% of V[Combining Dot Above]O2 peak (25-40 minutes per session) and 6 weeks of detraining. Blood samples were collected at baseline, end of the training, and detraining.

MAIN OUTCOME MEASURES

High BDNF level in patients with MetS and its reduction after chronic aerobic exercise.

RESULTS

Aerobic training significantly decreased all the metabolic risk factors, including overall MetS z score, insulin resistance, and lipid profile (P < 0.05). After the detraining period, plasma triglyceride, high-density lipoprotein, and also overall MetS z score remained unchanged (P < 0.05); however, serum BDNF, which was decreased by aerobic training (P = 0.013), restored to the baseline at the end of the detraining (P = 0.018).

CONCLUSIONS

Improved metabolic risk factors along with decreased serum BDNF in response to aerobic training and the opposite direction during the detraining emphasize the importance of physical activity in the treatment of MetS and prevention of related diseases.

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.

Inactivity, exercise training and detraining, and plasma lipoproteins. STRRIDE: a randomized, controlled study of exercise intensity and amount

Exercise has beneficial effects on lipoproteins. Little is known about how long the effects persist with detraining or whether the duration of benefit is effected by training intensity or amount. Sedentary, overweight subjects ( n = 240) were randomized to 6-mo control or one of three exercise groups: 1) high-amount/vigorous-intensity exercise; 2) low-amount/vigorous-intensity exercise; or 3) low-amount/moderate-intensity exercise. Training consisted of a gradual increase in amount of exercise followed by 6 mo of exercise at the prescribed level. Exercise included treadmill, elliptical trainer, and stationary bicycle. The number of minutes necessary to expend the prescribed kilocalories per week (14 kcal·kg body wt−1·wk−1for both low-amount groups; 23 kcal·kg body wt−1·wk−1for high-amount group) was calculated for each subject. Average adherence was 83–92% for the three groups; minutes per week were 207, 125, and 203 and sessions per week were 3.6, 2.9, and 3.5 for high-amount/vigorous-intensity, low-amount/vigorous intensity, and low-amount/moderate-intensity groups, respectively. Plasma was obtained at baseline, 24 h, 5 days, and 15 days after exercise cessation. Continued inactivity resulted in significant increases in low-density lipoprotein (LDL) particle number, small dense LDL, and LDL-cholesterol. A modest amount of exercise training prevented this deterioration. Moderate-intensity but not vigorous-intensity exercise resulted in a sustained reduction in very-low-density lipoprotein (VLDL)-triglycerides over 15 days of detraining ( P < 0.05). The high-amount group had significant improvements in high-density lipoprotein (HDL)-cholesterol, HDL particle size, and large HDL levels that were sustained for 15 days after exercise stopped. In conclusion, physical inactivity has profound negative effects on lipoprotein metabolism. Modest exercise prevented this. Moderate-intensity but not vigorous-intensity exercise resulted in sustained VLDL-triglyceride lowering. Thirty minutes per day of vigorous exercise, like jogging, has sustained beneficial effects on HDL metabolism.

Lipoprotein subfraction changes after continuous or intermittent exercise training

PURPOSE

This study compared total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C) and their respective subfractions after completing 4 wk of either intermittent (INT-EX) or continuous (CON-EX) aerobic exercise training (TRAIN).

METHODS

Untrained males (N = 7) and females (N = 11) completed 4 wk of TRAIN of supervised treadmill jogging occurring 5 d.wk(-1) for 30 min per session at 60% VO2max (75% HRmax). CON-EX was a single 30-min bout. INT-EX consisted of three 10-min bouts separated by 20 min of seated rest. Pre- and post-TRAIN fasting plasma samples were collected after subjects had followed 48 h of activity restriction and a 24-h repeated diet including a 12-h dietary fast. Postprandial lipemia was measured for 8 h following a standardized high-fat meal.

RESULTS

Fasting triglycerides and very LDL-C were not affected by TRAIN, and TRAIN did not change postprandial area under the curve or peak in either group. With groups combined, TRAIN significantly decreased TC, total LDL-C, and the TC:HDL ratio, and increased HDL-C subfraction 2 and LDL mean particle size. Total intermediate-density lipoprotein cholesterol remained unchanged at post-TRAIN, and was not different between groups.

CONCLUSIONS

To prevent dyslipidemia, our findings suggest that persons who are normolipidemic can improve the lipoprotein profile equally with CON-EX and INT-EX by lowered TC through the sum of changes in LDL-C subfractions, increased mean LDL particle size, and increased HDL-C subfraction 2 concentration.

Effects of exercise training and detraining on oxidized low-density lipoprotein-potentiated platelet function in men

OBJECTIVE

To investigate how exercise training and detraining affect oxidized low-density lipoprotein (Ox-LDL)-potentiated platelet function in men.

DESIGN

Cohort study.

SETTING

Department of physical medicine and rehabilitation.

PARTICIPANTS

Ten sedentary men (mean age +/- standard error of the mean, 21.6+/-0.2 y) who did not engage in any regular physical activity for at least 1 year before the study.

INTERVENTIONS

Subjects cycled on an ergometer at about 50% of maximal oxygen consumption for 30 minutes daily, 5 days a week, for 8 weeks, then detrained for 12 weeks.

MAIN OUTCOME MEASURES

During the experimental period, blood samples from the subjects were collected before and immediately after a progressive exercise test (ie, strenuous, acute exercise) every 4 weeks. The following measurements were taken when the subjects were at rest and immediately after exercise: plasma lipid profile, plasma Ox-LDL level, and platelet aggregation and intracellular calcium concentration ([Ca2+]i) elevation induced by adenosine disphosphate (ADP) alone or simultaneous ADP and Ox-LDL addition.

RESULTS

Analytical results indicated that: (1) plasma total cholesterol and LDL levels were reduced after exercise training from 151+/-7 mg/dL and 58+/-2 mg/dL to 133+/-6 mg/dL and 46+/-2 mg/dL (P<.05), respectively, whereas the plasma Ox-LDL level remained unchanged; (2) platelet aggregation and [Ca2+]i elevation promoted by 100 microg/mL of Ox-LDL were significantly increased from 70%+/-5% and 91%+/-7% of resting level to 108%+/-4% and 125%+/-3% after strenuous, acute exercise (P<.05); (3) exercise training decreased resting and postexercise 100 microg/mL Ox-LDL-potentiated platelet aggregation (ie, 31%+/-4% and 82%+/-4%, respectively; P<.05) and [Ca2+]i elevation (ie, 35%+/-6% and 71%+/-4%, respectively; P<.05); (4) detraining reversed the training effects on lipid profile and platelet function; and (5) treating the platelet with L-arginine-inhibited Ox-LDL-potentiated platelet activation during the experimental period.

CONCLUSIONS

Our results suggest that 8 weeks of exercise training decreased the plasma LDL level, but failed to influence production of plasma Ox-LDL. Importantly, resting and exercise-induced Ox-LDL-potentiated platelet activation was decreased by exercise training. However, this was reversed by detraining to the pretraining level.

Effects of exercise training and detraining on cutaneous microvascular function in man: the regulatory role of endothelium-dependent dilation in skin vasculature

This study investigated how exercise training and detraining affect the cutaneous microvascular function and the regulatory role of endothelium-dependent dilation in skin vasculature. Ten healthy sedentary subjects cycled on an ergometer at 50% of maximal oxygen uptake (VO(2max)) for 30 min daily, 5 days a week, for 8 weeks, and then detrained for 8 weeks. Plasma nitric oxide (NO) metabolites (nitrite plus nitrate) were measured by a microplate fluorometer. The cutaneous microvascular perfusion responses to six graded levels of iontophoretically applied 1% acetylcholine (ACh) and 1% sodium nitroprusside (SNP) in the forearm skin were determined by laser Doppler. After training, (1) resting heart rate and blood pressure were reduced, whereas VO(2max), skin blood flow and cutaneous vascular conductance to acute exercise were enhanced; (2) plasma NO metabolite levels and ACh-induced cutaneous perfusion were increased; (3) skin vascular responses to SNP did not change significantly. However, detraining reversed these effects on cutaneous microvascular function and plasma NO metabolite levels. The results suggest that endothelium-dependent dilation in skin vasculature is enhanced by moderate exercise training and reversed to the pretraining state with detraining.

Effects of prior exercise on postprandial lipemia: a quantitative review

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

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

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

Response of Blood Lipids to Physical Exercise in Elderly Subjects

Regular physical activity plays an important role in nonpharmacologic management of hyperlipidemia, in both the primary and secondary prevention of coronary heart disease. Training intensity and duration, health status (especially the presence of cardiovascular disease), and concomitant changes in body mass and dietary habits are the most important factors that can modify the physical activity-blood lipid profile relationship in the elderly. The benefit of regular exercise goes beyond direct influence on blood lipids; it aids in reducing weight, decreasing fat mass, increasing lean body mass, reducing elevated blood pressure, and increasing insulin sensitivity. Regular physical activity has become widely recommended as an important element of healthy and successful aging and should be encouraged in individuals without contraindications. (c)2001 CHF, Inc.

Diurnal triglyceride profiles: a novel approach to study triglyceride changes

Fasting plasma triglycerides (TG) show a high intra-individual variability, and therefore, repeated measurements and alternative methodology are necessary when studying TG metabolism. In search for novel approaches to study TG changes, we evaluated the feasibility of determining ambulatory capillary TG. In addition, well-known characteristics (e.g. gender differences) of TG metabolism in healthy subjects were determined. In 18 subjects with a wide range of fasting plasma TG, the results of standardised oral fat loading tests (50 g m(-2)) were compared to their diurnal capillary TG profiles, measured on 3 different days, six times each day in an out-patient clinic setting. The diurnal TG-profile was calculated as area under the capillary TG curve (TGc-AUC) and as incremental area (dTGc-AUC). Clearance of plasma TG after the acute oral fat load correlated well with the diurnal TGc-AUC (r=0.77; P<0.01). In addition, hypertriglyceridemic subjects (plasma TG >2.0 mmol l(-1)) had a higher diurnal triglyceridemia (49.83+/-15.37 h mmol l(-1)) as well as a higher response of plasma TG to the oral fat load (42.10+/-15.37 h mmol l(-1)), than the subjects with normal fasting plasma TG (29.83+/-11.75 h mmol l(-1) (P<0.05) and 20.75+/-5.89 h mmol l(-1) (P<0.01), respectively). In an observational study, 106 volunteers (54 females and 52 males) measured capillary triglycerides. Food intake was recorded and fasting blood was drawn once at the start of the study. Body composition was assessed by anthropometric parameters and body-impedance. Repeated measurements of diurnal triglyceridemia tended to be less variable than fasting capillary triglycerides (mean coefficients of variation 15.1% (range: 0.60-45.9%) and 24.9% (range: 1.44-72.7%), respectively; P=0.09) for the whole group and in males (18.6% (0.60-45.9%) and 24.0% (1.4-58.2%), respectively; P=0.07). The mean diurnal TGc-AUC and dTGc-AUC were lower in females (16.50+/-4.85 and 1.82+/-3.46 h mmol l(-1), respectively) than in males (23.44+/-6.50 and 6.93+/-4.67 h mmol l(-1); P<0.001 for each). The total daily energy intake was lower in females (8911+/-1905 kJ) than in males (11042+/-2604 kJ, P<0.001) because of a lower intake of all nutrients. In females, estrogen status determined significantly the capillary TG profiles. Stepwise multiple regression analysis for females and males, with TGc-AUC as the dependent variable, showed that the best predictors were fasting capillary TG, gender, systolic blood pressure and mean daily energy intake, explaining 72% of the variation. Incremental triglyceridemia was best described by gender, mean daily protein intake and systolic blood pressure, explaining 42% of the variation. Diurnal capillary TG profiles may be used to estimate the total daily load of potential atherogenic particles to which individuals are subjected during the day without the need for metabolic ward studies.

Interaction of physical activity and diet: implications for lipoprotein metabolism

OBJECTIVE

To consider how physical activity interacts with diet to modify lipoprotein metabolism and comment on implications for human health.

DESIGN

An overview of lipoprotein metabolism is followed by a summary of the main effects of physical activity on lipoprotein metabolism. Interactions with dietary practice and the disposition of dietary lipid are reviewed, with comment on links with body fatness.

SETTING

Literature is reviewed in relation to the risk of atherosclerotic disease.

SUBJECTS

Although some data are presented on athletic groups, evidence relating to individuals with normal physical activity habits is mainly discussed.

RESULTS

Physical inactivity is a risk factor for cardiovascular disease and one mechanism may involve changes to lipoprotein metabolism. The consensus is that aerobic activity involving an expenditure of > or = 8 MJ week(-1) results in an increase in HDL cholesterol and probably decreases in fasting triacylglycerol. These changes Occur despite the spontaneous increase in the proportion of dietary energy from carbohydrate which accompanies increased exercise. For this reason, exercise may be a means of reducing the hypertriglyceridaemic and HDL-lowering effects of low fat (high carbohydrate) diets. Decreases in total and low density lipoprotein cholesterol are sometimes, but not always, reported in sedentary individuals beginning exercise. One mechanism linking all these changes may be alterations to the dynamics of triacylglycerol-rich particles, particularly in the fed state.

CONCLUSION

The expenditure of considerable amounts of energy through regular, frequent physical activity increases the turnover of lipid substrates, with effects on their transport and disposition which may reduce the progression of atherosclerosis.

Relationship of physical activity and fitness to lipid and lipoprotein (a) in elderly subjects

PURPOSE

To determine, both by a cross-sectional and longitudinal study design, the relationship of maximal oxygen consumption (VO2max) and physical activity (PA) to blood lipids and lipoprotein(a) [Lp(a)] in a population of healthy and weight-stable elderly volunteers aged 66-84 yr.

METHODS

In a cross-sectional study in 52 subjects (23 men and 29 women), all independent variables (age, anthropometric, VO2max, and PA indices) were used in a multiple stepwise regression analysis to select variables influencing lipid and lipoprotein parameters. In a prospective nonintervention study, 38 subjects (17 men and 21 women) were reexamined after 6 months.

RESULTS

In a cross-sectional study, sports activity index contributed significantly to total cholesterol (TC), low density lipoprotein (LDL) cholesterol (LDL-C), TC/high density lipoprotein (HDL) cholesterol (HDL-C) ratio, and LDL-C/HDL-C ratio variance in men, whereas VO2max accounted for 23% variance of apolipoprotein A-I in women. In a prospective study, there was no indication that any measured variable was correlated with absolute or relative changes in PA indices in the total group or when analyzed by gender.

CONCLUSIONS

These data confirm that favorable relationship between PA/fitness and blood lipid profile is visible in elderly people but spontaneous changes in habitual PA are not a sufficient stimulus to alter serum lipid and lipoprotein levels in this population. Furthermore, there is no direct association between Lp(a) levels and PA, fitness, or body composition in the elderly men and women.

Effects of exercise on lipoprotein(a)

Lipoprotein(a) [Lp(a)] is a unique lipoprotein complex in the blood. At high levels (> 30 mg/dl), Lp(a) is considered an independent risk factor for cardiovascular diseases. Serum Lp(a) levels are largely genetically determined, remain relatively constant within a given individual, and do not appear to be altered by factors known to influence other lipoproteins (e.g. lipid-lowering drugs, dietary modification and change in body mass). Since regular exercise is associated with favourable changes in lipoproteins in the blood, recent attention has focused on whether serum Lp(a) levels are also influenced by physical activity. Population and cross-sectional studies consistently show a lack of association between serum Lp(a) levels and regular moderate physical activity. Moreover, exercise intervention studies extending from 12 weeks to 4 years indicate that serum Lp(a) levels do not change in response to moderate exercise training, despite improvements in fitness level and other lipoprotein levels in the blood. However, recent studies suggest the possibility that serum Lp(a) levels may increase in response to intense load-bearing exercise training, such as distance running or weight lifting, over several months to years. Cross-sectional studies have reported abnormally high serum Lp(a) levels in experienced distance runners and body builders who train for 2 to 3 hours each day. However, the possible confounding influence of racial or ethnic factors in these studies cannot be discounted. Recent intervention studies also suggest that 9 to 12 months of intense exercise training may elevate serum Lp(a) levels. However, these changes are generally modest (10 to 15%) and, in most individuals, serum Lp(a) levels remain within the recommended range. It is unclear whether increased serum Lp(a) levels after intense exercise training are of clinical relevance, and whether certain Lp(a) isoforms are more sensitive to the effects of exercise training. Since elevation of both low density lipoprotein cholesterol (LDL-C) and Lp(a) levels in the blood exerts a synergistic effect on cardiovascular disease risk, attention should focus on changing lifestyle factors to decrease LDL-C (e.g. dietary intervention) and increase high density lipoprotein cholesterol (e.g. exercise) levels in the blood.

Predictors of plasma lipoprotein(a) concentration in the West of Scotland Coronary Prevention Study cohort

An elevated plasma lipoprotein(a) (Lp(a)) concentration is an independent risk factor for coronary heart disease (CHD). Plasma Lp(a) levels are believed to be predominantly controlled by the APO(a) gene, which encodes the apo(a) glycoprotein moiety of the Lp(a) particle. However, other parameters in the lipoprotein profile as well as co-existing disease states or personal traits have been proposed as co-varieties. In order to examine these potential controlling factors in greater detail than previously possible, 1760 unrelated Caucasian subjects were studied, from which were identified 907 with a single expressing APO(a) allele. This strategy was followed to obviate the difficulty in dealing with the co-expression of different apo(a) isoforms and the resulting compound plasma Lp(a) level. After cube-root transformation of the plasma Lp(a) levels to normalise their distribution, a series of correlates were computed. There was no good correlation between Lp(a) concentration and any other measured lipid or lipoprotein in the lipid profile or with any other variable examined, with the important exception of the length of the expressed apo(a) isoform (r = -0.491, P = 0.0001). We conclude that in this population the plasma Lp(a) concentration is not predicted by the plasma lipid profile, alcohol intake, or smoking status but is predicted, albeit incompletely, by the length polymorphism of the APO(a) gene.

The influence of exercise on postprandial triacylglycerol metabolism

Trained people exhibit low plasma concentrations of triacylglcyeride (TAG) in both fasted and postprandial states. This mainly reflects enhanced uptake of TAG into skeletal muscle, via enhanced activity of lipoprotein lipase, the rate-limiting step in TAG removal. Endurance athletes possess a large, well-vascularised muscle mass and this may contribute through the increased availability of endothelial binding sites for LPL. However, each session of exercise stimulates a delayed increase in LPL activity so that prior exercise enhances uptake into muscle. Intramuscular TAG is one source of energy for muscular contraction so this may serve to replenish muscle nutrient stores which have been diminished by exercise. Regular, frequent aerobic exercise may oppose the atherogenic disturbances to lipoprotein metabolism evident during the postprandial period. It may also, by favouring the disposition of dietary fatty acids in muscle, improve the matching of fat oxidation to fat intake and hence help with maintenance of a desirable level of body fatness.

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

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

Postprandial lipemia in endurance-trained people during a short interruption to training

This study examined changes in postprandial lipemia in endurance-trained people during a short interruption to training. Nine men and one woman (ages 18-55 yr) undertook fat tolerance tests after 15 h, 60 h, and 6.5 days without exercise. The test meal (1.2 g fat, 1.1 g carbohydrate, 66 kJ/kg body mass) was consumed after a 12-h fast. Postprandial lipemia increased rapidly with detraining (area under plasma triacylglycerol vs. time curve: 8.42 +/- 1.40, 11. 35 +/- 1.38, and 11.97 mM x 6 h at 15 h, 60 h and 6.5 days, respectively). In the fasted state, plasma triacylglycerol concentration (0.85 +/- 0.15, 1.09 +/- 0.12, and 1.10 +/- 0.11 mM at 15 h, 60 h and 6.5 days, respectively) and the ratio of total cholesterol to high-density-lipoprotein cholesterol increased with detraining. Values were significantly higher at 60 h and 6.5 days than values at 15 h ( P < 0.05) for each of these three variables. The serum insulin response was higher ( P < 0.05) at 6.5 days than at 15 h (81.6 +/- 11.3, 87.6 +/- 11.4, and 94.5 +/- 9.4 microIU/ml x 6 h at 15 h, 60 h, and 6.5 days, respectively). Frequent exercise is needed to maintain a low level of postprandial lipemia and insulinemia in trained people.

Effects of chronic exercise and deconditioning on platelet function in women

To investigate the effects of chronic exercise and deconditioning on platelet function in women, 16 healthy sedentary women were divided into control and exercise groups. The exercise group cycled on an ergometer at 50% maximal oxygen consumption for 30 min/day, 5 days/wk, for two consecutive menstrual cycles and then were deconditioned for three menstrual cycles. During this period, platelet adhesiveness on a fibrinogen-coated surface, ADP-induced platelet aggregation and intracellular calcium concentration elevation, guanosine 3',5'-cyclic monophosphate (cGMP) content in platelets, and plasma nitric oxide metabolite levels were measured before and immediately after a progressive exercise test in the midfollicular phase. Our results indicated that, after exercise training, 1) resting heart rates and blood pressures were reduced, and exercise performance was improved; 2) resting platelet function was decreased, whereas plasma nitrite and nitrate levels and platelet cGMP contents were enhanced; and 3) the potentiation of platelet function by acute strenuous exercise was decreased, whereas the increases in plasma nitrite and nitrate levels and platelet cGMP contents were enhanced by acute exercise. Furthermore, deconditioning reversed these training effects. This implies that training-induced platelet functional changes in women in the midfollicular phase may be mediated by nitric oxide.

Effects of physical activity and diet on lipoprotein(a)

Lipoprotein(a) [Lp(a)] represents a class of lipoproteins with some structural similarity to low density lipoprotein (LDL), but containing a unique apoprotein, apoprotein(a). First reported in 1963, Lp(a) is now considered to have an independent role in the development of atherosclerotic lesions. The level of Lp(a) in the blood is under strong genetic influence and does not appear to be alterable by lifestyle factors known to influence other lipoproteins. Regular moderate exercise has been shown to favorably alter other lipoproteins, and recent attention has focused on whether Lp(a) level can be influenced by physical activity. Current data from cross-sectional and intervention studies show little effect of moderate exercise on serum Lp(a) concentration. One possible exception may be an elevation of serum Lp(a) concentration in adult endurance and power athletes who exercise intensely on a daily basis. However, not all studies have taken into account possible racial or ethnic differences in Lp(a) concentrations and the skewed distribution observed within most populations. Standard dietary intervention such as a low fat diet recommended for weight loss and control of other blood lipids has little effect on serum Lp(a) level. At present, serum Lp(a) concentration does not appear to be significantly altered by realistic dietary changes and moderate physical activity as recommended for health. The synergistic effect on cardiovascular disease risk when both LDL-cholesterol and Lp(a) are elevated highlight the importance of attending to those risk factors that can be modified by exercise and other lifestyle changes.

Influence of fitness status on very-low-density lipoprotein subfractions and lipoprotein(a) in men and women

The purpose of this study was to examine the influence of the physical activity level of men and women on the very-low-density lipoprotein (VLDL) subfractions and lipoprotein(a) [Lp(a)]. Fifty-four men (n = 30) and women (n = 24) aged 30 to 53 years were recruited based on their level of activity over the past 2 years, and formed three groups: sedentary (S), no routine activity; recreational exercise (R), routine moderate exercise three to five times per week; and trained (T), competition-based, high-volume aerobic training five to seven times per week. Each subject underwent a maximal oxygen consumption (VO2max) test and was measured for body composition (skinfolds) and waist to hip ratio (WHR). Following a prescribed 24-hour diet and abstinence from activity, a blood sample was obtained from each subject and the plasma was analyzed for cholesterol and triglycerides (TGs) in VLDL1, VLDL2, and VLDL3 subfractions. High-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C) and Lp(a) also were analyzed. Total VLDL-C was higher in men than in women, but no gender differences were observed in VLDL subfractions. VLDL1-TG and VLDL2-TG were elevated in the S group compared with groups R and T, even though total VLDL-TG, LDL-C, and HDL-C values were not different among the groups. Values for Lp(a) were not significantly different between men and women or among the groups. The two exercising groups were not different on any lipoprotein variable or WHR. VLDL1-TG was inversely correlated with VO2max and HDL-C. These results suggest that life-style activity is associated with a favorable VLDL subfraction pattern and WHR, but not Lp(a). In addition, long-term recreational activity is associated with a lipoprotein profile and WHR similar to those obtained with higher-volume exercise training.

Acute effects of treadmill running on lipoprotein(a) levels in males and females

This investigation examined the acute response of serum lipoprotein(a) (Lp(a)) concentration immediately after, and during several days following, level and downhill motorized treadmill running. Eight males ran for 1 h on a level motorized treadmill at an intensity producing 90% maximum heart rate (MHR). On a separate occasion, three males and three females performed downhill (negative 13.4% incline) treadmill running at an intensity producing 75-80% MHR. For both protocols, serial blood samples were taken pre- and post-exercise and at the same time of day 1, 3, 5, and 7 days following exercise. Levels of Lp(a), creatine kinase (CK), C-reactive protein (CRP), and ferritin were measured. Repeated measures statistical analysis (Friedman ANOVA) showed no significant change in the median level of Lp(a) (level run, 5.0 mg.dl-1; downhill run, 7.45 mg.dl-1) across time following either protocol. After level running, ferritin levels 5 and 7 d post-exercise were significantly (P < 0.05) lower compared with immediately and 1 d post-exercise measures (Friedman ANOVA). Following level running, the Wilcoxon signed rank test showed significant (P < 0.05) elevations in CK levels immediately, 1 and 5 d post-exercise compared with pre-exercise values. Following downhill running. CK level was significantly elevated up to 3 d post-exercise (Wilcoxon signed rank). Calculated plasma volume did not change significantly following either protocol. These data suggest that Lp(a) does not change acutely in response to level or downhill treadmill running up to 60 min duration.

Lipoprotein(a) in endurance athletes, power athletes, and sedentary controls

Elevated concentrations of lipoprotein(a) [Lp(a)] have been shown to be an independent risk factor for atherosclerotic disease. Physical activity and physical fitness have been shown to improve lipoprotein metabolism and reduce the risk of coronary artery disease. Studies on the influence of physical activity and physical fitness on Lp(a) levels including a large number of endurance as well as power athletes have not been performed before. Therefore, we determined parameters of physical fitness (maximal oxygen consumption), physical activity, and lipoproteins in 105 endurance athletes, 57 power athletes, and 87 sedentary young men. As expected, we found that endurance athletes with a good physical fitness had significantly higher concentrations of high-density lipoprotein cholesterol than power athletes and sedentary controls. Regarding mean Lp(a) levels (rocket immunoelectrophoresis), however, there were no significant differences between endurance athletes, power athletes, and sedentary controls. Even when including only those with Lp(a) values > 10 mg.dl-1, no differences were observed between the groups. These findings indicate that intensive training over years and good aerobic fitness improve the ratio of low-density lipoprotein to high-density lipoprotein cholesterol but have no or only minor effects on Lp(a) concentrations.

The effect of endurance training on lipoprotein(a) [Lp(a)] levels in middle-aged males

Serum lipoprotein(a) [Lp(a)] levels were measured before and after a 12-wk program of moderate-intensity endurance training. The training program consisted of walking and/or jogging, at least three sessions.wk-1 of at least 30 min duration, at an intensity producing 60-85% HRmax reserve. Twenty-eight previously sedentary middle-aged Caucasian males matched for age, body mass, and body mass index (BMI) were randomly allocated to either an exercise (N = 17, mean age +/- SEM = 51.57 +/- 1.25 yr) or a control (N = 11, mean age +/- SEM = 50.0 +/- 1.15 yr) group. Pre- and post-training median Lp(a) levels, measured by immunoturbidimetric analysis, were not significantly different in either the exercise (pre 13.0, post 15.0 mg.dl-1) or the control subjects (pre 14.0, post 12.0 mg.dl-1) (P > 0.05). Kendall Rank correlation analysis revealed no significant relationship between the level of Lp(a) and any other variable in either group before or after training. In the exercisers, a significant increase (P < 0.05) was recorded in the estimated mean VO2max (pre 33.39 +/- 1.70, post 37.7 +/- 1.75 ml.kg-1 min-1). These data indicate that the level of Lp(a) was not influenced by a 12-wk program of moderate-intensity endurance training, and are consistent with previous reports suggesting that Lp(a) level is not altered by lifestyle factors.

Effects of exercise training and deconditioning on platelet function in men

Platelets play an important role in the pathogenesis of cardiovascular disease. It has also been noticed that regular exercise can reduce the risk of cardiovascular disease. This is the first study to demonstrate that endurance exercise training may suppress platelet adhesiveness and aggregation and that deconditioning may reverse the training effects. Healthy male sedentary subjects were randomly divided into control and training groups. The trained men were trained on a bicycle ergometer at about 60% of maximal oxygen consumption for 30 minutes per day, 5 days per week for 8 weeks, then deconditioned for 12 weeks. During the experimental period, blood samples of the trained subjects were collected before and immediately after a progressive exercise test every 4 weeks. The same experiments were applied to the controls at the beginning of this study and 8 weeks thereafter. A tapered parallel-plate chamber was used to assess platelet adhesiveness. Platelet aggregation induced by ADP was evaluated by the percentage of reduction in single platelet count. Our results showed that (1) platelet adhesiveness and aggregability were increased by short-term strenuous exercise in both control and trained groups, but the enhancement of platelet aggregability was decreased after exercise training in the trained subjects; (2) at rest and immediately after strenuous exercise, platelet adhesiveness and aggregability were decreased by training, whereas they were unchanged in the control group; and (3) deconditioning reversed the training effects on resting and postexercise platelet adhesiveness and aggregability back to the pretraining state. These results suggest that platelet adhesiveness and aggregability may be depressed by exercise training but be reversed back to the pretraining state after deconditioning.

Exercise training decreases plasma cholesteryl ester transfer protein

To assess the effect of exercise on the plasma concentration of cholesterol ester transfer protein (CETP) and its possible influence in mediating the exercise-associated redistribution of cholesterol among plasma lipoproteins, we measured plasma CETP in 57 healthy normolipidemic men and women before and after 9 to 12 months of exercise training. The training protocol resulted in significant changes in VO2max (mean +/- SD, +5.3 +/- 3.5 mL.kg-1 x min-1), body weight (-2.5 +/- 3.5 kg), plasma triglycerides (-25.7 +/- 36.3 mg/dL), high-density lipoprotein cholesterol (HDL-C) (+2.6 +/- 6.2 mg/dL), and ratios of total cholesterol to HDL-C (-0.30 +/- 0.52) and low-density lipoprotein cholesterol (LDL-C) to HDL-C (-0.18 +/- 0.45) (all P < or = .05) but no change in lipoprotein(a). CETP concentration (in milligrams per liter) fell significantly in response to training in both men (n = 28, 2.47 +/- 0.66 to 2.12 +/- 0.43; % delta = 14.2%; P < .005) and women (n = 29, 2.72 +/- 1.01 to 2.36 +/- 0.76; % delta = 13.2%; P < .047). The CETP change was observed both in subjects who lost weight (n = 28, delta mean weight = -5.0 kg; delta CETP = -0.42 +/- 0.79; % delta = 15.4%; P < .009) and in those who were weight stable (n = 29, delta mean weight = -0.12 kg; delta CETP = -0.29 +/- 0.78; % delta = 10.4%; P < .055).(ABSTRACT TRUNCATED AT 250 WORDS)