Increased removal rate of exogenous triglycerides after prolonged exercise in man: time course and effect of exercise duration

Effectiveness of statins vs. exercise on reducing postprandial hypertriglyceridemia in dyslipidemic population: A systematic review and network meta-analysis

BACKGROUND

Individuals at risk of suffering cardiovascular disease (CVD) present with larger increases in blood triglyceride (TG) concentration after a high-fat meal than do healthy individuals. These postprandial hypertriglyceride levels are an independent risk factor for CVD. Prescription of statins and a bout of prolonged exercise are both effective in lowering postprandial hypertriglyceride levels. We aimed to evaluate the comparative effectiveness of statins vs. a bout of aerobic exercise in reducing fasting and postprandial TG (PPTG) concentrations in individuals at high risk of developing CVD.

METHODS

Thirty-seven studies from a systematic literature search of the PubMed, EMBASE, and Cochrane databases were included in this review. The selected studies conducted trials involving statin therapy (n = 20) or a bout of aerobic exercise (n = 19) and measured their impact on PPTG levels as the outcome. Two studies analyzed both treatments and were included in duplicate. The meta-analysis was constructed using a random-effects model to calculate the mean difference (MD). The Student t test was used to compare the data sets for statins vs. exercise.

RESULTS

Overall, statin and exercise interventions showed similar reductions in PPTG levels, with an MD of -0.65 mmol/L for statins (95% confidence interval (95%CI): -0.54 to -0.77; p < 0.001) and -0.46 mmol/L for exercise (95%CI: -0.21 to -0.71; p < 0.01). However, statins lowered fasting TG levels more than exercise (MD = -1.54 mmol/L, 95%CI: -2.25 to -0.83; p = 0.009).

CONCLUSION

Although aerobic exercise is effective in lowering blood TG levels, statins seem to be more efficient, especially in the fasted state. A combination of exercise and statins might reveal a valuable approach to the treatment and prevention of CVD. More studies are required to determine the underlying mechanisms and the possible additive effects of these interventions.

The influence of menopause and cardiorespiratory fitness on lipoprotein particles in midlife women

Lipoprotein particles may provide better information about cardiovascular risk than standard cholesterol measures for women. Whether lipoprotein subclasses change with menopausal stage is unclear. Given the high prevalence of low cardiorespiratory fitness in midlife women and benefit of cardiovascular disease risk, it is also important to understand the effect of fitness on lipoprotein profiles. This study evaluated the influence of menopausal status and fitness on lipoprotein particles in healthy midlife women. Lipoprotein particles were measured in high- (n = 25) and low- (n = 13) fit perimenopausal and late postmenopausal women, and in high-fit premenopausal (n = 10), perimenopausal (n = 12), and late postmenopausal women (n = 13). There were larger low-density lipoprotein particles (LDL-P; 21.7 ± 0.06 vs. 21.3 ± 0.1 nm, p = 0.002), more large LDL-P (623.1 ± 32.8 vs. 500.2 ± 52.6 nmol/L, p = 0.045), and fewer small LDL-P (145.5 ± 31.4 vs. 311.5 ± 44.7 nmol/L, p = 0.001) in the high-fit group vs. the low-fit group. High-density lipoprotein particles (HDL-P) were larger (10.1 ± 0.1 vs. 9.7 ± 0.1 nm, p = 0.002) in the high-fit group, with more large (14.8 ± 0.7 vs. 11.0 ± 0.9 μmol/L, p = 0.002), medium (12.9 ± 0.8 vs. 8.4 ± 0.9 μmol/L, p = 0.002) HDL-P, and fewer small HDL-P (10.2 ± 1.1 vs. 15.4 ± 1.6 μmol/L, p = 0.009) compared with the low-fit group. High-fit postmenopausal women had more large LDL-P (662.9 ± 47.5 nmol/L) compared with premenopausal women (479.1 ± 52.6 nmol/L, p = 0.035), and more HDL-P (40.2 ± 1.1 µmol/L) compared with premenopausal (34.9 ± 1.5 μmol/L, p = 0.023) and perimenopausal women (35.4 ± 1.3 μmol/L, p = 0.033). High fitness positively influences lipoprotein particles in healthy perimenopausal and late postmenopausal women. In healthy fit women, menopause may not have a large influence on lipoprotein particles. Novelty: In highly fit women, menopause may not have a negative influence on lipoprotein particle subclasses. High fitness is associated with a less atherogenic lipoprotein profile in perimenopausal and late postmenopausal women.

Exercise regulation of hepatic lipid droplet metabolism

Lipid droplets (LD) are not just lipid stores. They are now recognized as highly dynamic organelles, having a life cycle that includes biogenesis, growth, steady-state, transport, and catabolism. Importantly, LD exhibit different features in terms of size, number, lipid composition, proteins, and interaction with other organelles, and all these features exert an impact on cellular homeostasis. The imbalance of LD function causes non-alcoholic fatty liver disease (NAFLD). Studies show that exercise attenuates NAFLD by decreasing LD content; however, reports show metabolic benefits without changes in LD amount (intrahepatic triglyceride levels) in NAFLD. Due to the multiple effects of exercise in LD features, we think that these metabolic benefits occur through changes in LD features in NAFLD, rather than only the reduction in content. Exercise increases energy mobilization and utilization from storages such as LD, and is one of the non-pharmacological treatments against NAFLD. Therefore, exercise modification of LD could be a target for NAFLD treatment. Here, we review the most up-to-date literature on this topic, and focus on recent findings showing that LD features could play an important role in the severity of NAFLD.

Blood Biochemical Variables Found in Lidia Cattle after Intense Exercise

Simple Summary

There are limited published data in cattle on blood biological variables in response to intense work or after significant physical exertion. Stress should be considered in addition to exercise in the Lidia breed due to their agonistic behavioral characteristics. Therefore, changes in blood biological variables in response to intense exercise and stress were evaluated. Specifically, 438 bulls of the Lidia breed were sampled after a bullfight in order to determine the concentrations of different blood variables. We found that most of the measured blood variables clearly increased. Thus, severe hyperglycemia and an increase in various enzymes (LDH, AST, GGT, ALT, and particularly CK) were observed. The increase in all these variables is justified by the mobilization of energy sources, tissue and muscle damage, and dehydration, due to intense exercise and stress.

Abstract

There are limited published data in the bovine species on blood biological variables in response to intense work or after significant physical exertion. Lidia cattle, in addition to their exercise components, have some behavioral agonistic features that make them more susceptible to stress. The bullfight involves stress and exercise so intense that it causes significant changes in some metabolic variables. The study objective was to evaluate changes in blood biological variables in response to intense exercise and stress. After the fight in the arena, and once the bulls were dead (n = 438), blood samples were taken, and some biochemical and hormonal variables were determined in venous blood. A descriptive analysis was performed using the Statistica 8.0. computer program. The mean (±s.d.) results obtained were: total protein (85.8 ± 10.8 g/dL), albumin (3.74 ± 4.3 g/dL), triglycerides (39.65 ± 0.16 mg/dL), cholesterol (2.44 ± 0.03 mmol/L), glucose (22.2 ± 9.6 mmol/L), uric acid (340 ± 80 µmol/L), creatinine (236.9 ± 0.4 µmol/L), urea (5.93 ± 1.27 mmol/L), LDH (2828 ± 1975 IU/L), CK (6729 ± 10,931 IU/L), AST (495 ± 462 IU/L), ALP (90 ± 33 IU/L), GGT (50 ± 34 IU/L), ALT (59 ± 35 IU/L), cortisol (117.5 ± 46.6 nmol/L), and testosterone (20.2 ± 23.8 nmol/L). Most of the measured variables clearly increased; thus, we found severe hyperglycemia and increases in LDH, AST, GGT, and ALT enzymes, particularly in CK. The increases in all these variables are justified by the mobilization of energy sources, tissue/muscle damage, and dehydration due to continued stress and intense exercise.

Effects of statin therapy and exercise on postprandial triglycerides in overweight individuals with hypercholesterolaemia

AIMS

To determine the effects of statins on postprandial lipaemia (PPL) and to study if exercise could enhance statin actions.

METHODS

Ten hypercholesteraemic (blood cholesterol 204 ± 36 mg dL^-1 ; low-density lipoprotein-cholesterol 129 ± 32 36 mg dL^-1 ) overweight (body mass index 30 ± 4 kg m^-2 ), metabolic syndrome individuals chronically medicated with statins (>6 months) underwent 5-hour PPL tests in 4 occasions in a randomized order: (i) substituting their habitual statin medication by placebo for 96 hours (PLAC trial); (ii) taking their habitual statin medicine (STA trial); (iii) placebo combined with a bout of intense aerobic exercise (EXER+PLAC trial); and (iv) combining exercise and statin medicine (EXER+STA trial).

RESULTS

Before the fat meal, statin withdrawal (i.e. PLAC and EXER+PLAC) increased blood triglycerides (TG; 24%), low-density lipoprotein-cholesterol (31%) and total cholesterol (19%; all P < .05) evidencing treatment compliance. After the meal, statin withdrawal increased 5-hour postprandial TG (PPTG) compared to its matched trials (94% higher PLAC vs STA and 45% higher EXER+PLAC vs EXER+STA; P < .05). EXER+PLAC trial did not lower PPTG below PLAC (i.e. incremental AUC of 609 ± 152 vs 826 ± 190 mg dL^-1 5 h; P = .09). Adding exercise to statin did not result in larger reductions in PPTG (i.e. EXER+STA vs STA incremental area under the curve of 421 ± 87 vs 421 ± 84 mg dL^-1 5 h; P = .99).

CONCLUSION

In hypercholesteraemic metabolic syndrome individuals, chronic statin therapy blunts the elevations in TG after a fat meal (i.e. incremental area under the curve of PPTG) reducing the cardiovascular risk associated to their atherogenic dyslipidaemia. However, a single bout of intense aerobic exercise before the high fat meal, does not reduce PPTG but also does not interfere with the effects of statin treatment.

The Importance of Fatty Acids as Nutrients during Post-Exercise Recovery

It is well recognized that whole-body fatty acid (FA) oxidation remains increased for several hours following aerobic endurance exercise, even despite carbohydrate intake. However, the mechanisms involved herein have hitherto not been subject to a thorough evaluation. In immediate and early recovery (0–4 h), plasma FA availability is high, which seems mainly to be a result of hormonal factors and increased adipose tissue blood flow. The increased circulating availability of adipose-derived FA, coupled with FA from lipoprotein lipase (LPL)-derived very-low density lipoprotein (VLDL)-triacylglycerol (TG) hydrolysis in skeletal muscle capillaries and hydrolysis of TG within the muscle together act as substrates for the increased mitochondrial FA oxidation post-exercise. Within the skeletal muscle cells, increased reliance on FA oxidation likely results from enhanced FA uptake into the mitochondria through the carnitine palmitoyltransferase (CPT) 1 reaction, and concomitant AMP-activated protein kinase (AMPK)-mediated pyruvate dehydrogenase (PDH) inhibition of glucose oxidation. Together this allows glucose taken up by the skeletal muscles to be directed towards the resynthesis of glycogen. Besides being oxidized, FAs also seem to be crucial signaling molecules for peroxisome proliferator-activated receptor (PPAR) signaling post-exercise, and thus for induction of the exercise-induced FA oxidative gene adaptation program in skeletal muscle following exercise. Collectively, a high FA turnover in recovery seems essential to regain whole-body substrate homeostasis.

Effects of exercise training on intrahepatic lipid content in humans

Non-alcoholic fatty liver (NAFL) is the most common liver disorder in western society. Various factors may play a role in determining hepatic fat content, such as delivery of lipids to the liver, de novo lipogenesis, hepatic lipid oxidation, secretion of intrahepatic lipids to the circulation or a combination of these. If delivery of lipids to the liver outweighs the sum of hepatic lipid oxidation and secretion, the intrahepatic lipid (IHL) content starts to increase and NAFL may develop. NAFL is closely related to obesity and insulin resistance and a fatty liver increases the vulnerability to type 2 diabetes development. Exercise training is a cornerstone in the treatment and prevention of type 2 diabetes. There is a large body of literature describing the beneficial metabolic consequences of exercise training on skeletal muscle metabolism. Recent studies have started to investigate the effects of exercise training on liver metabolism but data is still limited. Here, first, we briefly discuss the routes by which IHL content is modulated. Second, we review whether and how these contributing routes might be modulated by long-term exercise training. Third, we focus on the effects of acute exercise on IHL metabolism, since exercise also might affect hepatic metabolism in the physically active state. This will give insight into whether the effect of exercise training on IHL could be explained by the accumulated effect of acute bouts of exercise, or whether adaptations might occur only after long-term exercise training. The primary focus of this review will be on observations made in humans. Where human data is missing, data obtained from well-accepted animal models will be used.

The effects of exercise on the lipoprotein subclass profile: A meta-analysis of 10 interventions

OBJECTIVE

The goal was to examine lipoprotein subclass responses to regular exercise as measured in 10 exercise interventions derived from six cohorts.

METHODS

Nuclear magnetic resonance spectroscopy was used to quantify average particle size, total and subclass concentrations of very low-density lipoprotein, low-density lipoprotein, and high-density lipoprotein particles (VLDL-P, LDL-P, and HDL-P, respectively) before and after an exercise intervention in 1555 adults from six studies, encompassing 10 distinct exercise programs: APOE (N = 106), DREW (N = 385), GERS (N = 79), HERITAGE (N = 715), STRRIDE I (N = 168) and II (N = 102). Random-effects meta-analyses were performed to evaluate the overall estimate of mean change across the unadjusted and adjusted mean change values from each exercise group.

RESULTS

Meta-analysis of unadjusted data showed that regular exercise induced significant decreases in the concentration of large VLDL-P, small LDL-P, and medium HDL-P and mean VLDL-P size, with significant increases in the concentration of large LDL-P and large HDL-P and mean LDL-P size. These changes remained significant in meta-analysis with adjustment for age, sex, race, baseline body mass index, and baseline trait value.

CONCLUSIONS

Despite differences in exercise programs and study populations, regular exercise produced putatively beneficial changes in the lipoprotein subclass profile across 10 exercise interventions. Further research is needed to examine how exercise-induced changes in lipoprotein subclasses may be associated with (concomitant changes in) cardiovascular disease risk.

Ten weeks of aerobic training does not result in persistent changes in VLDL triglyceride turnover or oxidation in healthy men

OBJECTIVE

Very low density lipoprotein triglyceride (VLDL-TG) and free fatty acids (FFA) constitute a substantial proportion of human energy supply both at rest and during exercise. Exercise acutely decreases VLDL-TG concentration, and VLDL-TG clearance is increased after an exercise bout. However, the effects of long-term training are not clear.

DESIGN

The aim was to investigate long-term effects of training by direct assessments of VLDL-TG and palmitate kinetics and oxidation in healthy lean men (n=9) at rest, before and after a 10-week training program, compared with a non-training control group (n=9).

METHODS

VLDL-TG kinetics were assessed by a primed constant infusion of [1-14C]VLDL-TG, and VLDL-TG oxidation by specific activity (14CO2) in expired air. The metabolic study days were placed 60-72 h after the last exercise bout.

RESULTS

Palmitate kinetics and oxidation were assessed by a 2 h constant infusion of [9,10-(3)H]palmitate. In the training group (n=9), maximal oxygen uptake increased significantly by ≈20% (P<0.05), and the insulin sensitivity (assessed by the hyperinsulinemic-euglycemic clamp) improved significantly (P<0.05). Despite these metabolic improvements, no changes were observed in VLDL-TG secretion, clearance, or oxidation or in palmitate kinetics.

CONCLUSION

We conclude that 10 weeks of exercise training did not induce changes in VLDL-TG and palmitate kinetics in healthy lean men.

Exercise and dietary-mediated reductions in postprandial lipemia

Postprandial hyperlipemia produces long-term derangements in lipid/lipoprotein metabolism, vascular endothelial dysfunction, hypercoagulability, and sympathetic hyperactivity which are strongly linked to atherogenesis. The purpose of this review is to (1) provide a qualitative analysis of the available literature examining the dysregulation of postprandial lipid metabolism in the presence of obesity, (2) inspect the role of adiposity distribution and sex on postprandial lipid metabolism, and (3) examine the role of energy deficit (exercise- and/or energy restriction-mediated), isoenergetic low-carbohydrate diets, and omega-3 (n-3) fatty acid supplementation on postprandial lipid metabolism. We conclude from the literature that central adiposity primarily accounts for sex-related differences in postprandial lipemia and that aerobic exercise attenuates this response in obese or lean men and women to a similar extent through potentially unique mechanisms. In contrast, energy restriction produces only mild reductions in postprandial lipemia suggesting that exercise may be superior to energy restriction alone as a strategy for lowering postprandial lipemia. However, isoenergetic very low-carbohydrate diets and n-3 fatty acid supplementation reduce postprandial lipemia indicating that macronutrient manipulations reduce postprandial lipemia in the absence of energy restriction. Therefore, interactions between exercise/energy restriction and alterations in macronutrient content remain top priorities for the field to identify optimal behavioral treatments to reduce postprandial lipemia.

The latest on the effect of prior exercise on postprandial lipaemia

This review examines the effect of prior exercise on postprandial triacylglycerol (pTAG) concentrations, an independent risk factor for cardiovascular diseases. Numerous studies have shown that a single bout of exercise reduces pTAG concentrations; however, several modulators such as exercise energy expenditure/deficit, mode of exercise (aerobic/resistance/high intensity/intermittent exercise or combinations), type of meal (moderate or high fat), time frame between exercise and meal and target group may individually or in conjunction influence this effect. On the other hand, at least for aerobic exercise, training reduces pTAG concentrations transiently (~2 days); therefore, exercise sessions should be frequent enough to maintain this clinically significant improvement. For the healthy population, it seems that a subject's preference and ability determine which type of exercise to undertake to attenuate pTAG concentrations; an energy expenditure of ~30 kJ/kg of body mass (or ~2-2.5 MJ) not combined with a corresponding increase in energy intake is required; for resistance or intermittent exercise, for those following a moderate rather than a high-fat diet, and for those with obesity (expressed as kJ/kg of body mass), a smaller energy expenditure is probably sufficient. More studies are needed to investigate dose-response/plateau effects, as well as the threshold of energy expenditure in those with diabetes mellitus and other high-risk populations. Finally, investigation of the underlying mechanisms may be clinically helpful in individualizing the appropriate intervention.

Effect of high-intensity interval exercise on basal triglyceride metabolism in non-obese men

A single bout of high-intensity interval aerobic exercise has been shown to produce the same or greater metabolic benefits as continuous endurance exercise with considerably less energy expenditure, but whether this applies to very low density lipoprotein (VLDL) metabolism is not known. We sought to examine the effect of a single bout of high-intensity interval aerobic exercise on basal VLDL-triglyceride (TG) kinetics 14 and 48 h after exercise cessation to determine the acute and time-dependent effects of this type of exercise on VLDL-TG metabolism. Eight healthy sedentary men (age, 23.6 ± 6.1 years; body mass index, 23.1 ± 2.2 kg·m(-2), peak oxygen consumption (V̇O2peak), 36.3 ± 5.5 mL·kg(-1)·min(-1)) participated in three stable isotopically labeled tracer infusion studies: (i) 14 h and (ii) 48 h after a single bout of high-intensity aerobic interval exercise (60% and 90% of V̇O2peak in 4 min intervals for a total of 32 min; gross energy expenditure ∼500 kcal) and (iii) after an equivalent period of rest, in random order. Fasting plasma VLDL-TG concentration was 20% lower at 14 h (P = 0.046) but not at 48 h (P = 1.000) after exercise compared with the resting trial. VLDL-TG plasma clearance rate increased by 21% at 14 h (P < 0.001) but not at 48 h (P = 0.299) after exercise compared with rest, whereas hepatic VLDL-TG secretion rate was not different from rest at any time point after exercise. We conclude that high-intensity interval exercise reduces fasting plasma VLDL-TG concentrations in non-obese men the next day by augmenting VLDL-TG clearance, just like a single bout of continuous endurance exercise. This effect is short-lived and abolished by 48 h after exercise.

Acute effects of exercise and calorie restriction on triglyceride metabolism in women

PURPOSE

The mechanisms by which exercise reduces fasting plasma triglyceride (TG) concentrations in women and the effect of negative energy balance independent of muscular contraction are not known.The aim of this study was to evaluate the effects of equivalent energy deficits induced by exercise or calorie restriction on basal VLDL-TG metabolism in women.

METHODS

Eleven healthy women (age = 23.5 ± 2.7 yr, body mass index = 21.6 ± 1.4 kg·m-2; mean ± SD) underwent a stable isotopically labeled tracer infusion study to determine basal VLDL-TG kinetics after performing, in random order, three experimental trials on the previous day: (i) a single exercise bout (brisk walking at 60% of peak oxygen consumption for 123 ± 18 min, with a net energy expenditure of 2.06 ± 0.39 MJ, ∼500 kcal), (ii) dietary energy restriction of 2.10 ± 0.41 MJ, and (iii) a control day of isocaloric feeding and rest (zero energy balance).

RESULTS

Fasting plasma VLDL-TG concentration was approximately 30% lower after the exercise trial compared with the control trial (P < 0.001), whereas no significant change was detected after the calorie restriction trial (P = 0.297 vs control). Relative to the control condition, exercise increased the plasma clearance rate of VLDL-TG by 22% (P = 0.001) and reduced hepatic VLDL-TG secretion rate by approximately 17% (P = 0.042), whereas hypocaloric diet had no effect on VLDL-TG kinetics (P > 0.2).

CONCLUSION

(i) Exercise-induced hypotriglyceridemia in women manifests through a different mechanism (increased clearance and decreased secretion of VLDL-TG) than that previously described in men (increased clearance of VLDL-TG only), and (ii) exercise affects TG homeostasis by eliciting changes in VLDL-TG kinetics that cannot be reproduced by an equivalent diet-induced energy deficit, indicating that these changes are independent of the exercise-induced negative energy balance but instead are specific to muscular contraction.

Effects of high-intensity intermittent training on carnitine palmitoyl transferase activity in the gastrocnemius muscle of rats

We examined the capacity of high-intensity intermittent training (HI-IT) to facilitate the delivery of lipids to enzymes responsible for oxidation, a task performed by the carnitine palmitoyl transferase (CPT) system in the rat gastrocnemius muscle. Male adult Wistar rats (160-250 g) were randomly distributed into 3 groups: sedentary (Sed, N = 5), HI-IT (N = 10), and moderate-intensity continuous training (MI-CT, N = 10). The trained groups were exercised for 8 weeks with a 10% (HI-IT) and a 5% (MI-CT) overload. The HI-IT group presented 11.8% decreased weight gain compared to the Sed group. The maximal activities of CPT-I, CPT-II, and citrate synthase were all increased in the HI-IT group compared to the Sed group (P < 0.01), as also was gene expression, measured by RT-PCR, of fatty acid binding protein (FABP; P < 0.01) and lipoprotein lipase (LPL; P < 0.05). Lactate dehydrogenase also presented a higher maximal activity (nmol·min(-1)·mg protein(-1)) in HI-IT (around 83%). We suggest that 8 weeks of HI-IT enhance mitochondrial lipid transport capacity thus facilitating the oxidation process in the gastrocnemius muscle. This adaptation may also be associated with the decrease in weight gain observed in the animals and was concomitant to a higher gene expression of both FABP and LPL in HI-IT, suggesting that intermittent exercise is a "time-efficient" strategy inducing metabolic adaptation.

High-intensity exercise attenuates postprandial lipaemia and markers of oxidative stress

Regular exercise can reduce the risk of CVD (cardiovascular disease). Although moderate-intensity exercise can attenuate postprandial TAG (triacylglycerol), high-intensity intermittent exercise might be a more effective method to improve health. We compared the effects of high-intensity intermittent exercise and 30 min of brisk walking on postprandial TAG, soluble adhesion molecules and markers of oxidative stress. Nine men each completed three 2-day trials. On day 1, subjects rested (control), walked briskly for 30 min (walking) or performed 5×30 s maximal sprints (high-intensity). On day 2, subjects consumed a high-fat meal for breakfast and 3 h later for lunch. Blood samples were taken at various times and analysed for TAG, glucose, insulin, ICAM-1 (intracellular adhesion molecule-1), VCAM-1 (vascular adhesion molecule-1), TBARS (thiobarbituric acid- reactive substances), protein carbonyls and β-hydroxybutyrate. On day 2 of the high-intensity trial, there was a lower (P<0.05) incremental TAG AUC (area under the curve; 6.42±2.24 mmol/l per 7 h) compared with the control trial (9.68±4.77 mmol/l per 7 h) with no differences during day 2 of the walking trial (8.98±2.84 mmol/l per 7 h). A trend (P=0.056) for a reduced total TAG AUC was also seen during the high-intensity trial (14.13±2.83 mmol/l per 7 h) compared with control (17.18±3.92 mmol/l per 7 h), walking showed no difference (16.33±3.51 mmol/l per 7 h). On day 2 of the high-intensity trial plasma TBARS and protein carbonyls were also reduced (P<0.05) when compared with the control and walking trials. In conclusion, high-intensity intermittent exercise attenuates postprandial TAG and markers of oxidative stress after the consumption of a high-fat meal.

Effects of moderate exercise on VLDL₁ and Intralipid kinetics in overweight/obese middle-aged men

Prior moderate exercise reduces plasma triglyceride (TG)-rich lipoprotein concentrations, mainly in the large very low-density lipoprotein (VLDL₁) fraction, but the mechanism responsible is unclear. We investigated the effects of brisk walking on TG-rich lipoprotein kinetics using a novel method. Twelve overweight/obese middle-aged men underwent two kinetic studies, involving infusion of Intralipid to block VLDL₁ catabolism, in random order. On the afternoon prior to infusion, subjects either walked on a treadmill for 2 h at ∼50% maximal oxygen uptake or performed no exercise. Multiple blood samples were taken during and after infusion for separation of Intralipid (S(f) 400) and VLDL₁ (S(f) 60-400). VLDL₁-TG and -apoB production rates were calculated from their linear rises during infusion; fractional catabolic rates (FCR) were calculated by dividing linear rises by fasting concentrations. Intralipid-TG FCR was determined from the postinfusion exponential decay. Exercise reduced fasting VLDL₁-TG concentration by 30% (P = 0.007) and increased TG enrichment of VLDL₁ particles [30% decrease in cholesteryl ester (CE)/TG ratio (P = 0.007); 26% increase in TG/apoB ratio (P = 0.059)]. Exercise also increased VLDL₁-TG, VLDL₁-apoB, and Intralipid-TG FCRs by 82, 146, and 43%, respectively (all P < 0.05), but had no significant effect on VLDL₁-TG or -apoB production rates. The exercise-induced increase in VLDL₁-apoB FCR correlated strongly with the exercise-induced changes in VLDL₁ CE/TG (r = -0.659, r = 0.020) and TG/apoB (r = 0.785, P = 0.002) ratios. Thus, exercise-induced reductions in VLDL₁ concentrations are mediated by increased catabolism, rather than reduced production, which may be facilitated by compositional changes to VLDL₁ particles that increase their affinity for clearance from the circulation.

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.

Effects of exercise on VLDL-triglyceride oxidation and turnover

Lipids are important substrates for oxidation at rest and during exercise. Aerobic exercise mediates a delayed onset decrease in total and VLDL-triglyceride (TG) plasma concentration. However, the acute effects of exercise on VLDL-TG oxidation and turnover remain unclear. Here, we studied the acute effects of 90 min of moderate-intensity exercise in healthy women and men. VLDL-TG kinetics were assessed using a primed constant infusion of ex vivo labeled [1-(14)C]triolein VLDL-TG. Fractional VLDL-TG-derived fatty acid oxidation was measured from (14)CO(2) specific activity in expired air. VLDL-TG concentration was unaltered during exercise and early recovery, whereas non-VLDL-TG concentration decreased significantly.VLDL-TG secretion rate decreased significantly during exercise and remained suppressed during recovery. Total VLDL-TG oxidation rate was unaffected by exercise. However, the contribution of VLDL-TG oxidation to total energy expenditure fell from 14 ± 9% at rest to 3 ± 4% during exercise. We conclude that VLDL-TG fatty acids are quantitatively important oxidative substrates under basal postabsorptive conditions but remain unaffected during 90-min moderate-intensity exercise and, thus, become relatively less important during exercise. Lower VLDL secretion rate during exercise may contribute to the decrease in TG concentrations during and after exercise.

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.

Lipidomics analysis reveals efficient storage of hepatic triacylglycerides enriched in unsaturated fatty acids after one bout of exercise in mice

Background

Endurance exercise induces lipolysis, increases circulating concentrations of free fatty acids (FFA) and the uptake and oxidation of fatty acids in the working muscle. Less is known about the regulation of lipid metabolism in the liver during and post-exercise.

Methodology/Principal Findings

We performed an ultra fast liquid chromatography-mass spectrometry (UFLC-MS) based lipidomics analysis of liver tissue samples obtained from C57Bl/6J mice immediately after a 60 min treadmill run of moderate intensity, and after 3 h of recovery. The PLS-DA scores plot for 115 quantified lipid molecular species revealed a clear separation of the hepatic lipid profile of sedentary from recovering mice, but not from mice immediately after running. 21 lipid species were considered to be most responsible for the difference in the hepatic lipid profiles, including 17 triacylglycerides (TG), one lysophosphatidylcholine (LPC) and three phosphatidylcholines (PC). TG species were found to be more abundant in the recovery phase, while PC species were decreased. The degree of accumulation of individual TG species correlated well with the amount of theoretical energy stored whereas no increase was found for TG species containing only saturated or one monounsaturated fatty acid. Total liver TG content as assayed by an enzymatic method was increased to 163% in the recovery phase, while it was significantly decreased in skeletal muscle by the exercise bout and remained less in the recovery phase. Results from fasted and refed mice indicate that fasting-induced lipolysis was associated with a pronounced accumulation of hepatic TG, which is reversed by refeeding for 5 h. Thus food intake per se did not elevate hepatic TG.

Conclusion

These data indicate that high availability of FFA induced by endurance exercise or fasting resulted in a transient hepatic TG accumulation, while muscle TG content was decreased during exercise presumably due to increased muscle fatty acid oxidation.

Free fatty acid kinetics in the late phase of postexercise recovery: importance of resting fatty acid metabolism and exercise-induced energy deficit

Free fatty acid (FFA) availability increases several-fold during exercise and remains significantly elevated for at least 3 to 6 hours after exercise cessation. Little, however, is known regarding the duration of the postexercise rise in FFA flux. In the present study, we used stable isotope-labeled palmitate infusion to examine fatty acid metabolism in 27 healthy untrained men and women (age, 29 +/- 7 years; body mass index, 25 +/- 4 kg/m2) between 13 to 16 hours and 21 to 24 hours after a single bout of moderate-intensity endurance exercise (1-2 hours at 60% of peak oxygen consumption), performed in the evening, and after a time-matched resting trial. Postabsorptive FFA rate of appearance (Ra) and FFA concentration in plasma were significantly greater after exercise than rest throughout the recovery period (P < .015), but the exercise-induced increases declined from approximately 40% at 13 to 16 hours to approximately 10% at 21 to 24 hours postexercise (P = .001). The magnitude of the exercise-induced increase in plasma FFA concentration was proportional to the increase in FFA Ra. Correlation analysis demonstrated that exercise-induced changes in plasma FFA Ra at 13 to 16 hours are (1) negatively associated with resting plasma FFA Ra and (2) positively associated with the net energy expenditure of exercise and the exercise-induced changes in whole-body fat oxidation rate (all P values < .05). In multivariate stepwise linear regression analysis, baseline plasma FFA Ra (P < or = .008) and net energy expenditure of exercise (P < or = .005) independently predicted the exercise-induced change in plasma FFA Ra at 13 to 16 hours. We conclude that the exercise-induced increase in FFA mobilization is (1) long-lived, persisting for 12 to 24 hours after exercise, with a progressive decline with time; (2) greater in subjects with low than high resting plasma FFA availability; and (3) greater after exercise with high than low energy demand.

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.

A single bout of whole-body resistance exercise augments basal VLDL-triacylglycerol removal from plasma in healthy untrained men

A single bout of prolonged aerobic exercise lowers plasma TAG (triacylglycerol) concentrations the next day by increasing the efficiency of VLDL (very-low-density lipoprotein)-TAG removal from the circulation. The effect of resistance exercise on VLDL-TAG metabolism is not known. Therefore we evaluated VLDL-TAG kinetics by using stable isotope-labelled tracers in eight healthy untrained men (age, 25.3+/-0.8 years; body mass index, 24.5+/-0.6 kg/m(2)) in the post-absorptive state in the morning on two separate occasions: once after performing a single 90-min bout of strenuous isokinetic resistance exercise (three sets x ten repetitions, 12 exercises at 80% of maximum peak torque production, with a 2-min rest interval between exercises) on the preceding afternoon and once after an equivalent period of rest. Fasting plasma VLDL-TAG concentrations in the morning after exercise were significantly lower than in the morning after rest (0.23+/-0.04 compared with 0.33+/-0.06 mmol/l respectively; P=0.001). Hepatic VLDL-TAG secretion rate was not different (P=0.31), but plasma clearance rate of VLDL-TAG was significantly higher (by 26+/-8%) after exercise than rest (31+/-3 compared with 25+/-3 ml/min respectively; P=0.004), and the mean residence time of VLDL-TAG in the circulation was significantly shorter (113+/-10 compared with 144+/-18 min respectively; P=0.02). Fasting plasma NEFA (non-esterified fatty acid; 'free' fatty acid) and serum beta-hydroxybutyrate concentrations were both significantly higher after exercise than rest (P<0.05), whereas plasma glucose and serum insulin concentrations were not different (P>0.30). We conclude that, in healthy untrained men, a single bout of whole-body resistance exercise lowers fasting plasma VLDL-TAG concentrations by augmenting VLDL-TAG removal from plasma. The effect appears to be qualitatively and quantitatively similar to that reported previously for aerobic exercise.

Basal adipose tissue and hepatic lipid kinetics are not affected by a single exercise bout of moderate duration and intensity in sedentary women

Hypertriacylglycerolaemia is an important risk factor for cardiovascular disease. In men, we have shown that the effects of evening exercise on basal VLDL (very-low-density lipoprotein) metabolism are dose-dependent: a single prolonged bout of aerobic exercise [2 h at 60% of VO(2 peak) (peak oxygen consumption)] reduces fasting plasma TAG [triacylglycerol (triglyceride)] concentrations, via enhanced clearance of VLDL-TAG from the circulation, whereas the same exercise performed for 1 h has no effect on VLDL-TAG metabolism and concentration. We hypothesized that women are more sensitive to the TAG-lowering effect of exercise because they reportedly use more intramuscular TAG as an energy source during exercise, and depletion of muscle TAG stores has been linked to reciprocal changes in skeletal muscle LPL (lipoprotein lipase) activity. To test our hypothesis, we measured basal VLDL-TAG and VLDL-apoB-100 (apolipoprotein B-100), and plasma NEFA [non-esterified fatty acid ('free fatty acid')] kinetics, by using stable isotope-labelled tracer techniques, on the morning after a single session of evening exercise of moderate duration and intensity (1 h at 60% of VO(2 peak)) in eight sedentary pre-menopausal women (age, 28+/-3 years; body mass index, 27+/-2 kg/m(2); body fat, 34+/-3%; values are means+/-S.E.M.). Compared with an equivalent period of evening rest, exercise had no effect on post-absorptive NEFA concentrations and the rate of appearance in plasma, VLDL-TAG and VLDL-apoB-100 concentrations, hepatic VLDL-TAG and VLDL-apoB-100 secretion and plasma clearance rates (all P>0.05). We conclude that, in women, as in men, a single session of exercise of moderate intensity and duration is not sufficient to bring about the alterations in VLDL metabolism that have been linked to post-exercise hypotriacylglycerolaemia.

High-intensity interval aerobic training reduces hepatic very low-density lipoprotein-triglyceride secretion rate in men

A single bout of strenuous endurance exercise reduces fasting plasma triglyceride (TG) concentrations the next day (12-24 h later) by augmenting the efficiency of very low-density lipoprotein (VLDL)-TG removal from the circulation. Although much of the hypotriglyceridemia associated with training is attributed to the last bout of exercise, the relevant changes in VLDL-TG metabolism have never been investigated. We therefore examined basal VLDL-TG kinetics in a group of sedentary young men (n=7) who underwent 2 mo of supervised high-intensity interval training (3 sessions/wk; running at 60 and 90% of peak oxygen consumption in 4-min intervals for a total of 32 min; gross energy expenditure: 446+/-29 kcal) and a nonexercising control group (n=8). Each subject completed two stable isotope-labeled tracer infusion studies in the postabsorptive state, once before and again after the intervention (approximately 48 h after the last exercise bout in the training group). Peak oxygen consumption increased by approximately 18% after training (P <or= 0.05), whereas body weight and body composition were not altered. Fasting plasma VLDL-TG concentration was reduced after training by approximately 28% (P <or= 0.05), and this was due to reduced hepatic VLDL-TG secretion rate (by approximately 35%, P <or= 0.05) with no changes (<5%, P>0.7) in VLDL-TG plasma clearance rate and the mean residence time of VLDL-TG in the circulation. No significant changes in VLDL-TG concentration and kinetics were observed in the nonexercising control group (all P >or= 0.3). We conclude that a short period of high-intensity interval aerobic training lowers the rate of VLDL-TG secretion by the liver in previously sedentary men. This is different from the mechanism underlying the hypotriglyceridemia of acute exercise; however, it remains to be established whether our finding reflects an effect of the longer time lapse from the last exercise bout, an effect specific to the type of exercise performed, or an effect of aerobic training itself.

Acute exercise-induced changes in basal VLDL-triglyceride kinetics leading to hypotriglyceridemia manifest more readily after resistance than endurance exercise

Resistance training is considered less effective than endurance training in lowering plasma triglyceride (TG) concentrations. Acutely, however, a single bout of strenuous exercise, whether endurance or resistance, increases the efficiency of very low-density lipoprotein (VLDL)-TG removal from the circulation and leads to hypotriglyceridemia. The comparative effects of these two types of exercise on VLDL-TG metabolism are not known. We therefore examined basal VLDL-TG kinetics by using stable isotope-labeled tracers in seven healthy, nonobese, untrained young men in the postabsorptive state, the morning after a single 90-min bout of either low-intensity endurance exercise (approximately 30% of peak oxygen consumption) or high-intensity resistance exercise (3 sets of 10 repetitions for 12 exercises at 80% of peak torque production), matched for total energy expenditure (approximately 400 kcal), or an equivalent period of rest on the preceding afternoon. Compared with rest, resistance exercise lowered fasting plasma VLDL-TG concentration by -28 +/- 10% (P = 0.034), increased VLDL-TG plasma clearance rate by 30 +/- 8% (P = 0.003), and shortened the mean residence time (MRT) of VLDL-TG in the circulation by -36 +/- 11 min (P = 0.016), whereas endurance exercise had no effect (all P > 0.05). Basal VLDL-TG plasma clearance rate was greater (P = 0.003) and VLDL-TG MRT was shorter (P = 0.012) the morning after resistance than endurance exercise. We conclude that, for the same total energy expenditure, resistance exercise is more potent than endurance exercise in eliciting changes in VLDL-TG metabolism that have been linked with hypotriglyceridemia, and it should thus be considered as an alternative to or in addition to endurance exercise for the control of plasma TG concentrations.

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.

A single 1-h bout of evening exercise increases basal FFA flux without affecting VLDL-triglyceride and VLDL-apolipoprotein B-100 kinetics in untrained lean men

Our group (Magkos F, Wright DC, Patterson BW, Mohammed BS, Mittendorfer B, Am J Physiol Endocrinol Metab 290: E355-E362, 2006) has recently demonstrated that a single, prolonged bout of moderate-intensity cycling (2 h at 60% of peak oxygen consumption) in the evening increases basal whole-body free fatty acid (FFA) flux and fat oxidation, decreases hepatic VLDL-apolipoprotein B-100 (apoB-100) secretion, and enhances removal efficiency of VLDL-triglyceride (TG) from the circulation the following day in untrained, healthy, lean men. In the present study, we investigated the effect of a single, shorter-duration bout of the same exercise (1 h cycling at 60% of peak oxygen consumption) on basal FFA, VLDL-TG, and VLDL-apoB-100 kinetics in seven untrained, healthy, lean men by using stable isotope-labeled tracer techniques. Basal FFA rate of appearance in plasma and plasma FFA concentration were approximately 55% greater (P < 0.05) the morning after exercise than rest, whereas resting metabolic rate and whole-body substrate oxidation rates were not different after rest and exercise. Exercise had no effect on plasma VLDL-TG and VLDL-apoB-100 concentrations, hepatic VLDL-TG and VLDL-apoB-100 secretion rates, and VLDL-TG and VLDL-apoB-100 plasma clearance rates (all P > 0.05). We conclude that in untrained, healthy, lean men 1) the exercise-induced changes in basal whole-body fat oxidation, VLDL-TG, and VLDL-apoB-100 metabolism during the late phase of recovery from exercise are related to the duration of the exercise bout; 2) single sessions of typical recreational activities appear to have little effect on basal, fasting plasma TG homeostasis; and 3) there is a dissociation between systemic FFA availability and VLDL-TG and VLDL-apoB-100 secretion by the liver.

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.

Hemostatic response to postprandial lipemia before and after exercise training

Chronic hypertriglyceridemia is thought to be atherogenic and is associated with an elevated thrombotic potential, both of which may be improved with aerobic exercise training. Eight subjects were tested for aerobic capacity, body composition, and postprandial lipemia (PPL), followed by 6 mo of exercise training and final testing. Blood samples were obtained for measurement of free fatty acid (FFA), triglycerides (TG), insulin (Ins), and glucose (Glu). Hemostatic variables including factor VII activity (FVIIa), tissue factor pathway inhibitor-factor Xa complex (TFPI/Xa), and plasminogen activator inhibitor-1 (PAI-1) antigen/activity as well as leukocyte tumor necrosis factor-alpha (TNF-alpha) gene expression were determined among four subjects. We found that the exercise training was of sufficient intensity to increase aerobic capacity (P < 0.0001) and improve body composition (P = 0.04). There were no differences between tests among PPL responses of FFA, TG, Ins, or Glu; however, the mean TG response and fat oxidation rate improved. PAI-1 antigen/activity, FVIIa, TFPI/Xa, and TNF-alpha gene expression were all improved after exercise training after adjusting for confounders. We conclude that aerobic exercise training reduces the potential for coagulation, improves fibrinolytic potential, and reduces leukocyte TNF-alpha gene expression after the ingestion of a high-fat meal.

Lipid metabolism response to a single, prolonged bout of endurance exercise in healthy young men

To discover the alterations in lipid metabolism linked to postexercise hypotriglyceridemia, we measured lipid kinetics, lipoprotein subclass distribution and lipid transfer enzymes in seven healthy, lean, young men the day after 2 h of cycling and rest. Compared with rest, exercise increased fatty acid rate of appearance and whole body fatty acid oxidation by approximately 65 and 40%, respectively (P < 0.05); exercise had no effect on VLDL-triglyceride (TG) secretion rate, increased VLDL-TG plasma clearance rate by 40 +/- 8%, and reduced VLDL-TG mean residence time by approximately 40 min and VLDL-apolipoprotein B-100 (apoB-100) secretion rate by 24 +/- 8% (all P < 0.05). Exercise also reduced the number of VLDL but almost doubled the number of IDL particles in plasma (P < 0.05). Muscle lipoprotein lipase content was not different after exercise and rest, but plasma lipoprotein lipase concentration increased by approximately 20% after exercise (P < 0.05). Plasma hepatic lipase and lecithin:cholesterol acyltransferase concentrations were not affected by exercise, whereas cholesterol ester transfer protein concentration was approximately 10% lower after exercise than after rest (P = 0.052). We conclude that 1) greater fatty acid availability after exercise does not stimulate VLDL-TG secretion, probably because of the increase in fatty acid oxidation and possibly also fatty acid use for restoration of tissue TG stores; 2) reduced secretion of VLDL-apoB-100 lowers plasma VLDL particle concentration; and 3) increased VLDL-TG plasma clearance maintains low plasma TG concentration but is not accompanied by similar increases in subsequent steps of the delipidation cascade. Acutely, therefore, the cardioprotective lowering of plasma TG and VLDL concentrations by exercise is counteracted by a proatherogenic increase in IDL concentration.

Effects of a moderate exercise session on postprandial lipoproteins, apolipoproteins and lipoprotein remnants in middle-aged men

Prior moderate exercise reduces postprandial triglyceride concentrations. Its effects on the concentrations, compositions and potential atherogenicity of lipoprotein subfractions were investigated in the present study. Twenty normoglycaemic middle-aged men each underwent two fat tolerance tests (blood taken fasting and for 8 h after a meal containing 80 g fat and 70 g carbohydrate). On the afternoon before one test, subjects performed a 90-min treadmill walk (exercise); no exercise was performed before the control test. Prior exercise significantly reduced postprandial concentrations of chylomicrons (Sf >400) by 28.6% (absolute reduction 14.6 mg dl(-1)), of large VLDL1 (Sf 60-400) by 34.4% (39.7 mg dl(-1)) and of small VLDL2 (Sf 20-60) by 23.0% (9.6 mg dl(-1)). Over 95% of VLDL1 and VLDL2 comprised apolipoprotein (apo) B100-containing particles. Exercise also reduced postprandial remnant-like lipoprotein cholesterol (by 35%) and triglyceride concentrations (by 29%). Postprandial apo CIII/apo B and apo E/apo B ratios in VLDL1 were lower following exercise. Postprandial cholesteryl ester/triglyceride ratios were lower in VLDL1 and VLDL2 and higher in HDL2 following exercise. These data suggest that the effect of prior moderate exercise on VLDL1 is quantitatively greater than its effect on chylomicrons and that, in addition to reducing lipoprotein concentrations, exercise induces compositional changes to lipoprotein species which are likely to influence their metabolism and atherogenicity.

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.

Exercise considerations in hypertension, obesity, and dyslipidemia

Sports medicine practitioners who care for a wide array of athletes and active individuals will consistently face issues regarding chronic cardiovascular diseases and their associated risk factors. Among these, hypertension, obesity, and dyslipidemia are common clinical conditions that may be encountered even amongst elite caliber athletes. Consequently, those entrusted with the care of this active population must recognize the presence of these disorders and feel comfortable with their management in the face of continued sports or exercise participation. This article reviews the pathophysiology of these conditions as they relate to athletes and outlines the value of continued exercise in the management of each of these entities while addressing the specific and unique treatment needs of active individuals.

Postprandial leg uptake of triglyceride is greater in women than in men

The postprandial excursion of plasma triglyceride (TG) concentration is greater in men than in women. In this study, the disposition of dietary fat was examined in lean healthy men and women (n = 8/group) in either the overnight-fasted or fed (4.5 h after breakfast) states. A [14C]oleate tracer was incorporated into a test meal, providing 30% of total daily energy requirements. After ingestion of the test meal, measures of arteriovenous differences in TG and 14C across the leg were combined with needle biopsies of skeletal muscle and adipose tissue and respiratory gas collections to define the role of skeletal muscle in the clearance of dietary fat. The postprandial plasma TG and 14C tracer excursions were lower (P = 0.04) in women than in men in the overnight-fasted and fed states. Women, however, had significantly greater limb uptake of total TG compared with men on both the fasted (3,849 +/- 846 vs. 528 +/- 221 total micro mol over 6 h) and fed (4,847 +/- 979 vs. 1,571 +/- 334 total micromol over 6 h) days. This was also true for meal-derived 14C lipid uptake. 14C content of skeletal muscle tissue (micro Ci/g tissue) was significantly greater in women than in men 6 h after ingestion of the test meal. In contrast, 14C content of adipose tissue was not significantly different between men and women at 6 h. The main effect of nutritional state, fed vs. fasted, was to increase the postmeal glucose (P = 0.01) excursion (increase from baseline) and decrease the postmeal TG excursion (P = 0.02). These results support the notion that enhanced skeletal muscle clearance of lipoprotein TG in women contributes to their reduced postprandial TG excursion. Questions remain as to the mechanisms causing these sex-based differences in skeletal muscle TG uptake and metabolism. Furthermore, nutritional state can significantly impact postprandial metabolism in both men and women.

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

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

Exercise in the treatment of lipid disorders

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

Moderate exercise, postprandial lipaemia and triacylglycerol clearance

Moderate intensity exercise reduces postprandial triacylglycerol (TG) concentrations. We tested whether this reflects increased TG clearance. Eight normotriglyceridaemic men, aged 48.3 +/- 7.3 years (mean +/- SD), performed two oral fat tolerance tests (blood samples taken in the fasted state and for six hours after a high-fat meal containing 1.00 g fat, 0.97 g carbohydrate, 58 kJ energy kg-1 fat-free body mass) and two intravenous fat tolerance tests (blood samples in the fasted state and after a bolus injection of Intralipid, 0.1 g fat kg-1 body mass). The afternoon before one oral and one intravenous test, subjects walked briskly for 90 min; no exercise was performed before the control tests. Prior exercise reduced fasting TG concentration similarly in the oral (16 +/- 7 %) (mean +/- SEM) and intravenous (18 +/- 7 %) tests, and reduced postprandial TG concentrations in the oral test by 18 +/- 6 % (all P < 0.05). However, prior exercise did not increase Intralipid clearance (disappearance curve slopes: control, 4.69 +/- 0.49 % min-1; exercise, 4.85 +/- 0.40 % min-1). These data suggest that mechanisms other than increased TG clearance mediate the lower postprandial TG concentrations seen after moderate exercise.

Postprandial lipemia in young men and women of contrasting training status

This study compared the postprandial triacylglycerol (TAG) response to a high-fat meal in trained and untrained normolipidemic young adults after 2 days' abstinence from exercise. Fifty-three subjects (11 endurance-trained men, 9 endurance-trained women, 10 sprint/strength-trained men, 11 untrained men, 11 untrained women) consumed a meal (1.2 g fat, 1.1 g carbohydrate, 66 kJ per kg body mass) after a 12-h fast. Venous blood samples were obtained in the fasted state and at intervals until 6 h. Postprandial responses were the areas under the plasma or serum concentration-vs.-time curves. Neither fasting TAG concentrations nor the postprandial TAG response differed between trained and untrained subjects. The insulinemic response was 29% lower in endurance-trained men than in untrained men [mean difference -37.4 (95% confidence interval -62.9 to -22.9) microIU/ml x h, P = 0.01]. Responses of plasma glucose, serum insulin, and plasma nonesterified fatty acids were all lower for endurance-trained men than for untrained men. These findings suggest that, in young adults, no effect of training on postprandial lipemia can be detected after 60 h without exercise. The effect on postprandial insulinemia may persist for longer.

Acute changes in serum lipids and lipoprotein subclasses in triathletes as assessed by proton nuclear magnetic resonance spectroscopy

Exercise is associated with changes in lipids that may protect against coronary heart disease (CHD). In this study of 28 triathletes, we analyzed acute changes in serum lipid and lipoprotein concentrations after completion of the 1995 World Championship Hawaii Ironman Triathlon. With standard laboratory assays, we demonstrate significant decreases in total cholesterol, VLDL cholesterol, ApoB100, and Lp(a). Total HDL cholesterol increased significantly immediately after the race. With a novel proton NMR spectroscopy assay, we demonstrate that smaller diameter LDL particles, corresponding to small, dense LDL, declined by 62%. Moreover, larger HDL subclasses, whose levels are inversely associated with CHD, increased significantly by 11%. Smaller HDL subclasses, which have been directly associated with CHD in some studies, acutely decreased by 16%. Therefore, exercise not only acutely induces changes in lipoprotein concentrations among the standard species in a manner that favorably affects CHD risk, but also induces favorable changes in specific lipoprotein subclass size distribution that also may alter CHD risk independently of the total lipoprotein serum concentration.

The reduction in postprandial lipemia after exercise is independent of the relative contributions of fat and carbohydrate to energy metabolism during exercise

A single session of exercise several hours before a high-fat meal reduces postprandial lipemia. The purpose of the present study was to test the hypothesis that this effect is independent of substrate metabolism during exercise. Twelve men aged 21 to 36 years underwent three oral fat tolerance tests with intervals of at least 1 week. On one occasion, only activities of daily living were allowed the preceding day (control). On the other two occasions, subjects ran on a treadmill for 90 minutes on the afternoon preceding the fat tolerance test; 90 minutes before running, they ingested either acipimox, an inhibitor of lipolysis in adipose tissue, or placebo. Acipimox abolished the increase in the nonesterified fatty acid (NEFA) concentration observed during the run after placebo and reduced lipid oxidation (placebo, 37 +/- 7 g; acipimox, 21 +/- 3 g; P < .05, mean +/- SEM), but had no effect on gross energy expenditure (placebo, 4.86 +/- 0.20 MJ; acipimox, 4.83 +/- 0.18 MJ). Before each of the three fat tolerance tests, subjects reported to the laboratory after an overnight fast. Blood samples were obtained in the fasted state and for 6 hours after consumption of a high-fat meal (per kilogram of body mass: 1.2 g fat, 1.2 g carbohydrate, and 61 kJ energy). Plasma concentrations of NEFA were higher postprandially with acipimox, compared with control and placebo (P < .05), as were glucose concentrations measured over the first 4 hours. The insulin response to the meal was lower in placebo compared with control and acipimox (P < .05). Despite these counterregulatory responses, postprandial lipemia was reduced to the same degree (compared with control, P < .05) by exercise preceded by acipimox and by exercise preceded by placebo (area under the plasma triacylglycerol concentration v time curve: control, 8.77 +/- 1.17 mmol/L x 6 h; placebo, 6.95 +/- 0.97 mmol/L x 6 h; acipimox, 6.81 +/- 0.81 mmol/L x 6 h). These findings suggest that some factor other than the nature of the metabolic substrate used during exercise determines the attenuating effect of prior exercise on postprandial lipemia.

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.

Effect of exercise timing on postprandial lipemia and HDL cholesterol subfractions

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