Physical exercise and the prevention of atherosclerosis and cholesterol gall stones

Cholesterol metabolism in distance runners

Faecal steroid excretion, including betasitosterol excretion, whole-body cholesterol synthesis, plasma lipids, and lipoprotein concentrations and habitual diet, were determined in 14 male distance runners and 14 sedentary men. The proportion of cholesterol-derived steroids excreted as bile acids, and the quantity of betasitosterol excreted in the faeces were significantly (P less than 0.05) higher in the runners compared with the sedentary men. Faecal betasitosterol excretion and the proportion of cholesterol-derived steroids excreted as bile acids were correlated significantly in the distance runners and the sedentary men (r = 0.774, n = 28, P less than 0.001). These results suggest that greater dietary intake of plant sterols may contribute to the higher proportion of cholesterol-derived steroids excreted as bile acids in distance runners.

Influence of exercise on the pharmacokinetics of drugs

Since many patients with a wide variety of diseases are nowadays stimulated to adopt a physically active lifestyle, the question of the influence of exercise on the pharmacokinetics of drugs has become more and more relevant. Because exercise influences a large number of physiological factors that also determine the pharmacokinetics of drugs, including haemodynamics, metabolism, pH, temperature and gastrointestinal function, it can be expected to have an effect on the pharmacokinetic parameters (absorption, distribution, elimination) of certain agents. However, only a very limited number of studies has been directed towards this issue, and only a very few drugs have been studied. Nevertheless, it is clear that exercise does influence the pharmacokinetics of certain drugs, although the magnitude and direction of the effects vary. This is not surprising in view of the widely differing physicochemical properties of drugs, the many possible--often opposing--effects of exercise on the parameters affecting drug pharmacokinetics and the different types of exercise performed. The chance of a clinically relevant effect of exercise on the pharmacokinetics of a particular drug is largest in those with a steep dose-response curve, a narrow therapeutic range, a need for continuity of therapeutic effectiveness and a relatively short half-life, in combination with intensive exercise of long duration. If untoward drug effects occur during or after exercise, a change in the pharmacokinetics of the drug related to the exercise should be seriously considered as a possible cause.

Physical training plasma lipoproteins and faecal steroid excretion in sedentary men

Thirty sedentary men aged 25-52 participated in a 4-month randomized and controlled study of the effects of exercise on plasma lipoproteins and faecal steroid excretion. After 4 months the aerobic training group showed a significant (P = 0.047) increase in physical work capacity (+38 watts) and a significant (P = 0.025) decrease in faecal total steroid excretion (-257 mg/day) compared to corresponding changes in the control group. The drop in faecal total steroid excretion in the men who trained was mainly due to a significant (P less than 0.05) fall in faecal neutral sterol excretion (-240 mg/day). Plasma lipoprotein lipid concentrations did not change significantly during the study although plasma levels of very low density lipoprotein (VLDL) cholesterol and low density lipoprotein (LDL) cholesterol tended to fall in the men who trained. In the aerobic training group individual changes in plasma LDL cholesterol levels were significantly correlated with decreases in faecal total steroid excretion (p = 0.615, P less than 0.05) and faecal neutral sterol excretion (p = 0.627, P less than 0.05). The results of this study show that regular exercise is associated with a drop in faecal neutral sterol excretion which, if sufficiently large, may be associated with a decrease in plasma LDL cholesterol concentration.

[Blood lipid and blood glucose changes during single, multiple and repeated stress]

As soon as various stressors exceed specific thresholds they induce marked metabolic changes in the organism. In a number of studies these facts have been verified experimentally. In our investigations we were able to demonstrate that the pattern of stress-induced changes differs after single and multiple stress exposures and that metoblic alterations in repeated stress situations are modified by habituative and adaptative processes respectively. Stress-induced metabolic mechanisms differently develop for blood lipid fractions and blood glucose. The described mechanisms are explained according to the functions of these blood parameters during stress exposures. The differential analysis of these alterations may be important for the prevention of stress-induced metabolic disorders.