Effect of exercise and medium-chain fatty acids on postprandial lipemia

Short-Term Standard Diet Consumption Prior to the Oral Fat Tolerance Test Modulates the Postprandial Triglyceride Response

We hypothesized that the consumption of a 3-day standard diet (SD) prior to the oral fat tolerance test (OFTT), used to evaluate postprandial lipemia, may counteract the undesirable effects of individual dietary habits on the test results. The OFTT was applied to 22 healthy adults (11 females and 11 males), after their habitual diets (HDs) and following the consumption of a 3-day SD (45-60% energy from carbohydrate, 20-35% from fat, and 10-20% from protein). Plasma triglyceride (TG) concentrations were measured during fasting and at the fourth hour of the OFTT. A 3-day SD significantly reduced fasting and fourth-hour TG concentrations and delta TG values by 10%, 12.8%, and 22.7%, respectively. Decreases were observed in fasting and fourth-hour TG and delta TG values following the 3-day SD compared to the HD in subjects with fasting TG concentrations between 89 and 180 mg/dL (p = 0.062, p = 0.018, and 0.047, respectively). As a result, the consumption of a 3-day standardized diet prior to the OFTT may be useful to eliminate the false positive or negative effects of individual dietary habits on test results and to correctly identify individuals who should be administered the OFTT.

Effect of Prior Exercise on Postprandial Lipemia: An Updated Meta-Analysis and Systematic Review

The purpose of this systematic review was to synthesize the results from current literature examining the effects of prior exercise on the postprandial triglyceride (TG) response to evaluate current literature and provide future direction. A quantitative review was performed using meta-analytic methods to quantify individual effect sizes. A moderator analysis was performed to investigate potential variables that could influence the effect of prior exercise on postprandial TG response. Two hundred and seventy-nine effects were retrieved from 165 studies for the total TG response and 142 effects from 87 studies for the incremental area under the curve TG response. There was a moderate effect of exercise on the total TG response (Cohen's d = -0.47; p < .0001). Moderator analysis revealed exercise energy expenditure significantly moderated the effect of prior exercise on the total TG response (p < .0001). Exercise modality (e.g., cardiovascular, resistance, combination of both cardiovascular and resistance, or standing), cardiovascular exercise type (e.g., continuous, interval, concurrent, or combined), and timing of exercise prior to meal administration significantly affected the total TG response (p < .001). Additionally, exercise had a moderate effect on the incremental area under the curve TG response (Cohen's d = -0.40; p < .0001). The current analysis reveals a more homogeneous data set than previously reported. The attenuation of postprandial TG appears largely dependent on exercise energy expenditure (∼2 MJ) and the timing of exercise. The effect of prior exercise on the postprandial TG response appears to be transient; therefore, exercise should be frequent to elicit an adaptation.

Effects of thirty and sixty minutes of moderate-intensity aerobic exercise on postprandial lipemia and inflammation in overweight men: a randomized cross-over study

BACKGROUND

The transient rise in blood lipids following a high-fat meal (HFM), known as postprandial lipemia, is linked to systemic inflammation and cardiovascular disease, but can be blunted by exercise. However, minimal research has investigated the effects of realistic exercise bouts on postprandial lipemia and inflammation in at-risk individuals. The purpose of this study was to assess the effects of moderate-intensity aerobic exercise lasting 30 or 60 min performed the evening before a HFM, on postprandial lipemia and inflammation in overweight, insufficiently active men.

METHODS

In this randomized-crossover study, twelve participants remained sedentary (CON), or performed a brisk walk on a treadmill at 60 % VO2peak for either 30 min (EX-30) or 60 min (EX-60), after which they consumed a small snack (270 kcal) to partially replace exercise energy expenditure. Following a 12-h overnight fast, participants consumed a standard HFM (1 g fat/kg; 1 g CHO/kg; 1117.8 ± 117.0 kcal). Blood draws were performed at baseline (pre-HFM) and 1, 2, 4, 6, and 8 h post-HFM to assess glucose, insulin, lipids, and systemic inflammation.

RESULTS

There were no significant differences (p > 0.05) in fasting triglycerides between EX-60 (118.7 ± 68.3 mg/dL), CON (134.8 ± 66.2 mg/dL) or EX-30 (135.5 ± 85.4 mg/dL). There were no differences in peak, time-to-peak, total or incremental area-under-the-curve between trials for triglyceride response (p > 0.05). There was no significant main effect of time (p > 0.05) in IL-1ra, IL-4, IL-5, IL-6, IL-10 or TNF-α from baseline to 8 h post-HFM in any trial.

CONCLUSIONS

In summary, we found that in overweight, insufficiently active men, neither 30 nor 60 min of moderate-intensity exercise performed 12 h prior to a HFM attenuated postprandial lipemia or inflammation, which could potentially be explained by the partial caloric replacement of exercise energy expenditure.

Dietary medium chain fatty acid supplementation leads to reduced VLDL lipolysis and uptake rates in comparison to linoleic acid supplementation

Dietary medium chain fatty acids (MCFA) and linoleic acid follow different metabolic routes, and linoleic acid activates PPAR receptors. Both these mechanisms may modify lipoprotein and fatty acid metabolism after dietary intervention. Our objective was to investigate how dietary MCFA and linoleic acid supplementation and body fat distribution affect the fasting lipoprotein subclass profile, lipoprotein kinetics, and postprandial fatty acid kinetics. In a randomized double blind cross-over trial, 12 male subjects (age 51±7 years; BMI 28.5±0.8 kg/m²), were divided into 2 groups according to waist-hip ratio. They were supplemented with 60 grams/day MCFA (mainly C8:0, C10:0) or linoleic acid for three weeks, with a wash-out period of six weeks in between. Lipoprotein subclasses were measured using HPLC. Lipoprotein and fatty acid metabolism were studied using a combination of several stable isotope tracers. Lipoprotein and tracer data were analyzed using computational modeling. Lipoprotein subclass concentrations in the VLDL and LDL range were significantly higher after MCFA than after linoleic acid intervention. In addition, LDL subclass concentrations were higher in lower body obese individuals. Differences in VLDL metabolism were found to occur in lipoprotein lipolysis and uptake, not production; MCFAs were elongated intensively, in contrast to linoleic acid. Dietary MCFA supplementation led to a less favorable lipoprotein profile than linoleic acid supplementation. These differences were not due to elevated VLDL production, but rather to lower lipolysis and uptake rates.

Effect of prior exercise on postprandial lipemia: an updated quantitative review

Reducing postprandial triglycerides (TG) can lower the risk for cardiovascular disease. The purpose of this study was to perform a meta-analytic review of the literature to estimate the effect of prior exercise on postprandial lipemia. A total of 121 effects were found from 76 studies for the total TG response and 70 effects from 44 studies for the incremental area under the curve (iAUC) TG response. The weighted mean effect was moderate for the total TG response, Cohen's d = −0.60 ( P < 0.0001), and for the iAUC response, Cohen's d = −0.59 ( P < 0.0001). Moderator analysis revealed women exhibited a larger reduction ( P < .01) in the total TG response following exercise ( d = −0.96) than men ( d = −0.57); high-intensity interval training induced a larger reduction ( P < .05) in the iAUC response ( d = −1.49) than aerobic ( d = −0.58) or resistance ( d = −0.13) exercise, and participants maintaining an energy deficit following exercise exhibited a greater reduction in the iAUC response ( d = −0.67) compared with participants in energy balance ( d = −0.28). We conclude that prior acute exercise reduces postprandial lipemia, with the magnitude of effect influenced by sex, type of exercise, and energy deficit following exercise.

Dyslipidemia in obesity: mechanisms and potential targets

Obesity has become a major worldwide health problem. In every single country in the world, the incidence of obesity is rising continuously and therefore, the associated morbidity, mortality and both medical and economical costs are expected to increase as well. The majority of these complications are related to co-morbid conditions that include coronary artery disease, hypertension, type 2 diabetes mellitus, respiratory disorders and dyslipidemia. Obesity increases cardiovascular risk through risk factors such as increased fasting plasma triglycerides, high LDL cholesterol, low HDL cholesterol, elevated blood glucose and insulin levels and high blood pressure. Novel lipid dependent, metabolic risk factors associated to obesity are the presence of the small dense LDL phenotype, postprandial hyperlipidemia with accumulation of atherogenic remnants and hepatic overproduction of apoB containing lipoproteins. All these lipid abnormalities are typical features of the metabolic syndrome and may be associated to a pro-inflammatory gradient which in part may originate in the adipose tissue itself and directly affect the endothelium. An important link between obesity, the metabolic syndrome and dyslipidemia, seems to be the development of insulin resistance in peripheral tissues leading to an enhanced hepatic flux of fatty acids from dietary sources, intravascular lipolysis and from adipose tissue resistant to the antilipolytic effects of insulin. The current review will focus on these aspects of lipid metabolism in obesity and potential interventions to treat the obesity related dyslipidemia.

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

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

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

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

Predicting postprandial lipemia in healthy adults and in at-risk individuals with components of the cardiometabolic syndrome

To determine whether a single-point triglyceride (TG) concentration could estimate the 8-hour postprandial lipemic (PPL) response, men and women performed baseline PPL (n=188) and postexercise PPL (n=92) trials. Correlations were generated between TG concentrations at baseline and at various time points after a high-fat meal vs 8-hour area under the TG curve (TG-AUC) and peak TG level. Stepwise multiple regression and bootstrap simulations using TG level and additional predictor variables of sex, age, percentage of body fat, training status, and maximal oxygen consumption indicated that the 4-hour TG concentrations accounted for >90% of the variance in TG-AUC and peak TG responses during the PPL trials. Equations were confirmed by cross-validation in healthy as well as at-risk individuals with components of the cardiometabolic syndrome. Our data suggest that the 4-hour TG value is highly related to the total 8-hour PPL response and can be used for accurate estimation of PPL in a clinical or research setting.

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.

Dietary, physiological, genetic and pathological influences on postprandial lipid metabolism

Most of diurnal time is spent in a postprandial state due to successive meal intakes during the day. As long as the meals contain enough fat, a transient increase in triacylglycerolaemia and a change in lipoprotein pattern occurs. The extent and kinetics of such postprandial changes are highly variable and are modulated by numerous factors. This review focuses on factors affecting postprandial lipoprotein metabolism and genes, their variability and their relationship with intermediate phenotypes and risk of CHD. Postprandial lipoprotein metabolism is modulated by background dietary pattern as well as meal composition (fat amount and type, carbohydrate, protein, fibre, alcohol) and several lifestyle conditions (physical activity, tobacco use), physiological factors (age, gender, menopausal status) and pathological conditions (obesity, insulin resistance, diabetes mellitus). The roles of many genes have been explored in order to establish the possible implications of their variability in lipid metabolism and CHD risk. The postprandial lipid response has been shown to be modified by polymorphisms within the genes for apo A-I, A-IV, A-V, E, B, C-I and C-III, lipoprotein lipase, hepatic lipase, fatty acid binding and transport proteins, microsomal triglyceride transfer protein and scavenger receptor class B type I. Overall, the variability in postprandial response is important and complex, and the interactions between nutrients or dietary or meal compositions and gene variants need further investigation. The extent of present knowledge and needs for future studies are discussed in light of ongoing developments in nutrigenetics.

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.

Interaction of exercise training andn-3 fatty acid supplementation on postprandial lipemia

The effect of combining omega-3 fatty acid (n-3 FA) supplementation and exercise training treatment on postprandial lipemia (PPL) has not been studied. The purpose of this study was to examine the interaction of n-3 FA and exercise training in attenuating PPL after a high-fat meal. Previously sedentary, overweight, subjects (n = 22; 12 women, 10 men, BMI 26.6 ±0.7 kg/m2) were randomly assigned to one of two treatment groups: n-3 FA supplementation alone (FO, n = 10) or n-3 FA supplementation plus exercise training (FO+ExTr, n = 12). Both groups consumed 4 g/d n-3 FA, and one group also exercise trained for 45 min/d, 5d/week of brisk walking and (or) jogging at 60% VO2 max. Before and after 4 weeks of treatment, subjects performed a baseline PPL and a PPL following a single session of exercise (ExPPL). PPL was assessed by triglyceride (TG) area under the curve (AUC) and peak TG response (TGpeak). A two-way analysis of variance (ANOVA) with repeated measures was used to compare results from treatments for baseline and exercise trials. FO alone reduced PPL and Ex PPL, and FO+ExTr attenuated the ExPPL response measured as total AUC and TGpeak. There was no significant main effect for group or group by time interaction for baseline PPL or ExPPL. Fasting high-density lipoprotein cholesterol (HDL-C) and HDL2-C (i.e., subfraction 2) concentrations were significantly increased in the FO+ExTr group after the treatments. These results suggest that n-3 FA supplementation reduced PPL in sedentary subjects. Exercise training has no interference or additive effects with n-3 FA supplementation in attenuating PPL, but combined treatments may be additive in raising high-density lipoprotein cholesterol.

Weight-bearing, aerobic exercise increases markers of bone formation during short-term weight loss in overweight and obese men and women

We investigated the impact of weight-bearing, aerobic exercise- and diet-induced weight loss on markers of bone turnover during a larger study of changes in metabolic fitness during short-term weight reduction using a repeated-measures, within-subject experimental design. Subjects (N = 19) underwent 6 weeks of energy restriction (reduced by approximately 3140 kJ/d) and aerobic exercise ( approximately 1675 kJ/d, walking or jogging at 60% maximum oxygen consumption) to induce a 5% reduction in body weight. Bone turnover markers and hormones were measured in serum collected at baseline and after 6 weeks of weight loss. Despite a 5% reduction in body weight at week 6, markers of bone formation, osteocalcin, and bone alkaline phosphatase, were significantly increased, and resorption markers, C-terminal cross-links of type I collagen and soluble receptor activator of nuclear factor kappaB ligand, were unchanged after 6 weeks of energy restriction and exercise. The concentration of leptin was significantly reduced after weight loss, but insulin-like growth factor I (IGF-I) and cortisol levels were unaffected. In conclusion, weight-bearing, aerobic exercise training may favorably affect the balance between bone resorption and formation during weight loss.

Short-term lifestyle modification alters circulating biomarkers of endothelial health in sedentary, overweight adults

Obesity and inactivity are associated with endothelial dysfunction that may contribute to the development of atherosclerosis. We examined the effects of a short-term lifestyle intervention on circulating biomarkers of endothelial health. Nineteen overweight or obese (mean body mass index (BMI): 28.9 ± 0.7 kg/m2) men and women underwent 6 weeks of body mass reduction induced by moderate energy restriction (~750 kcal/d; 1 kcal = 4.184 kJ) and aerobic training (~400 kcal/d). Fasting serum samples were collected at baseline and after reduction in body mass (week 6) to assess concentrations of nitrotyrosine (NT), secretory phospholipase A2 (sPLA2), and soluble intracellular adhesion molecule-1 (sICAM-1). Body mass was significantly reduced from 81.3 ± 2.8 to 77.3 ± 2.6 kg (p < 0.05). Circulating concentrations of NT and sICAM-1 were significantly reduced with treatment (~25% and ~10%, respectively), whereas sPLA2 levels were significantly elevated (~45%). Elevations in sPLA2 were negatively correlated with changes in NT (r = –0.58, p = 0.047); reductions in NT did not correlate significantly with reductions in sICAM-1. It appears that circulating markers of endothelial health are susceptible to short-term exercise interventions with modest reduction in body mass, and such a lifestyle modification may improve endothelial health by reducing protein nitration products and cellular adhesion.

Exercise, postprandial triacylglyceridemia, and cardiovascular disease risk

An elevation of plasma triacylglycerides (TAG) is a well recognized cardiovascular risk factor. Less appreciated is that high and prolonged elevations in TAG in the postprandial (PP) phase is also a risk factor. Given that we spend approximately 18 hrs a day in the PP state, this is particularly critical. The elevation is due to both cylomicron and very low density lipoprotein TAG. It is thought that enhancing the concentrations of these lipoproprotein fractions increases the production of smaller, more dense low density lipoprotein and that this leads to increased cardiovascular disease risk. The PP TAG response is greater in men, in obese individuals, and in type 2 diabetics. It has been reported repeatedly that exercise the day before ingestion of a high fat meal is associated with a marked dampening of the PP TAG rise. The mechanisms for this are not clear and do not appear to be due to changes in the exercised muscle itself. There is some speculation that the production of plasma TAG may be decreased. The exercise benefits are lost within 3 days. The minimum exercise required has not been determined, but even 30 min of intermittent aerobic exercise or mild resistance exercise has a positive effect. This demonstrates a clear benefit from an active lifestyle and one that does not require intense exercise or months of training.

Effect of aerobic exercise on lipaemia and its fatty acid profile after a meal of moderate fat content in eumenorrhoeic women

Exercise prior to eating has repeatedly been shown to reduce postprandial lipaemia. The aim of the present study was to investigate whether this effect was manifest in the presence of two factors that independently mitigate postprandial lipaemia: eumenorrhoea and moderate fat intake. Eight healthy eumenorrhoeic rowers consumed a meal of moderate fat content (35 % total energy, 0.66 g/kg body mass) 14 h after having either rowed at 55 % of maximal aerobic power (81 % of maximal heart rate) for 80 min or rested. Both trials were performed during the luteal phase. Blood samples were drawn before the meal and for 8 h postprandially for the measurement of individual fatty acids in the triacylglycerol and NEFA fractions, as well as of glucose, insulin and oestradiol. Plasma oestradiol concentrations were not significantly different in the two trials. The postprandial lipaemic response, expressed as either plasma triacylglycerol concentration or area under the triacylglycerol-time curve, was 35 % lower (P<0.05) after exercise. The postprandial glycaemic and insulinaemic responses were also lower, indicating increased insulin sensitivity, whereas the NEFA response was higher, suggesting a lower entrapment of dietary fatty acids in adipose tissue after exercise. Finally, exercise increased the proportion of unsaturated:saturated NEFA during the postprandial period. In conclusion, aerobic exercise performed 14 h before a moderate-fat meal reduced postprandial lipaemia in women in the luteal phase. This effect shows the potential of exercise to mitigate even moderate lipaemic responses in eumenorrhoeic women.

Evidence for an exaggerated postprandial lipemia in chronic paraplegia

BACKGROUND/OBJECTIVE

Excessive delay in triglyceride (TG) metabolism after ingestion of dietary fat represents a significant cardiovascular disease (CVD) risk. The objective of this study was to compare the postprandial lipemic responses of individuals with paraplegia with those of healthy nondisabled individuals.

METHODS

The ability of 3 recreationally active individuals with paraplegia having normal fasting TG (mean = 103 mg/dL) to metabolize TG after ingestion of a high-fat test meal was compared with a previously published cohort of 21 recreationally active individuals without paraplegia (TG mean = 86 mg/dL) who underwent identical testing. The subjects with paraplegia had venous blood taken under fasting conditions, and then ingested a milkshake containing premium ice cream blended with heavy whipping cream (approximately 92% of calories from fat). Additional blood samples were obtained at 2, 4, and 6 hours after ingestion. The area under the curve (AUC) for TG clearance for both subject groups was measured with an area planimeter.

RESULTS

TG uptake for both groups was almost identical for the first 2 hours after ingestion. At 4 and 6 hours after ingestion, the TG levels were 50 and 35 mg/dL higher, respectively, in subjects with paraplegia than in nondisabled subjects. When corrected for small baseline differences in TG concentrations (16 mg/dL), the AUC was 46.5% greater for the group with paraplegia than in the nondisabled group. A near mirror association across time was observed between postprandial serum high-density lipoprotein cholesterol (HDL-C) and TG levels in subjects with paraplegia.

CONCLUSION

This case series finds an exaggerated postprandial lipemia (PPL) in persons with paraplegia with normal fasting TGs. This finding is the first evidence, in a small population, of an unreported potential CVD risk in persons with paraplegia.

Exercise plus n-3 fatty acids: additive effect on postprandial lipemia

The purpose of this study was to examine changes in postprandial lipemia (PPL) in recreationally active males following aerobic exercise, omega-3 fatty acids (n-3FA) supplementation, and the combination of the two. PPL following a high-fat meal was measured in 10 recreationally active males (25 +/-1.5 years) under each of the following conditions: no exercise and no n-3 FA supplementation (control); exercise and no n-3FA supplementation (exercise); n-3FA supplementation and no exercise (n-3FA); and exercise and n-3 FA supplementation (combined). Blood was collected before the high-fat meal and at 2, 4, 6, and 8 hours after the meal to assess the PPL response. Supplementation consisted of 4.0 g of n-3FA per day for 5 weeks. Triglyceride (TG) peak response, the total area under the TG curve (TG-AUCT), and the incremental area under the TG curve (TG-AUCI) were used to define the PPL response. TG peak response was significantly reduced 38% by n-3FA supplementation and 50% by the combination of exercise and n-3FA supplementation. N-3FAs significantly reduced the TG-AUCT by 27% and by 42% when combined with exercise. When compared with the exercise trial, the TG-AUCT during the combined trial was significantly lower. Exercise, n-3FAs, and the combination significantly reduced the TG-AUCI by 40%, 42%, and 58%, respectively. These results suggest that the combination of exercise and n-3FA supplementation reduce PPL to a greater degree in recreationally active males when compared with the individual treatments.

Effect of Exercise Timing on Postprandial Lipemia in Hypertriglyceridemic Men

We investigated the effect of exercise timing on attenuation of postprandial hyper-triglyceridemia (PHTG) in individuals with hypertriglyceridemia (HTG). Subjects were 10 males (TG = 290.1 ± 28.5 mg/dl). Each subject performed a control trial (Ctr), 12-hr premeal exercise trial (12-hr Pre), and 24-hr premeal exercise trial (24-hr Pre). In each trial, subjects had a fat-rich meal. In the exercise trials they jogged on a treadmill at 60% of their [Formula: see text] for 1 hr at a designated time. Blood samples were taken at 0 (immediately before the fat meal), and at 2, 4, 6, 8, and 24 hrs after the meal. The results indicated that plasma TG concentrations in 12-hr Pre were lower than in Ctr and 24-hr Pre (p <  0.03). The area score under the TG concentration curve (TG AUC score) in 12-hr Pre was 37% and 33% lower than in 24-hr Pre and Ctr (p <  0.02), respectively. Insulin concentrations in 12-hr Pre were lower than Ctr and 24-hr Pre (p <  0.001). The plasma nonesterified fatty acid (NEFA) concentration was higher in 12-hr Pre than in both 24-hr Pre and Ctr (p <  0.003). There were no trial differences in both HDLtot-Ch and HDL2-Ch. These results suggest that exercising 12 hrs prior to a fat-meal intake significantly reduces PHTG response whereas exercising 24 hrs prior to the meal does not attenuate PHTG in hypertriglyceridemic men. The effect of an acute exercise bout on PHTG lowering may be short-lived and diminished by 24 hrs. Key words: high-density lipoprotein cholesterol, triglyceride, lipoprotein lipase, insulin

Effect of exercise on postprandial lipemia following a higher calorie meal in Yucatan miniature swine

Exercise has been shown to attenuate the postprandial lipemic (PPL) response to a modest kcal high-fat meal in numerous human studies, but has not been fully examined in swine. In addition, the effects of exercise on a high-fat meal of larger magnitude have not been examined in humans or in swine. Thus, the purpose of this study was to examine the PPL response to a single, high-fat/cholesterol (HFC) meal (approximately 3,000 kcal, 1,300 kcal from fat) and determine if exercise attenuates the PPL response. Sedentary, female Yucatan miniature swine (n = 10) completed 3 PPL trials: (1) pre diet (PRE); (2) post HFC diet (POST); and (3) post HFC diet plus exercise (EX, 45 minutes at 75% heart rate maximum). Blood samples were collected before (0 hour) and at 2, 4, 6, and 8 hours after the single HFC meal for PPL analysis. Postheparin lipoprotein lipase (LPL) activity was assessed at 8 hours. While fasting LPL activity was significantly increased with the HFC diet, the PPL response to the HFC meal did not differ depending on diet. Furthermore, the PPL response was not significantly altered with a single session of exercise, perhaps because of the severity of the HFC meal, the sedentary nature of the swine, or because LPL activity was not elevated after exercise. These findings suggest that administration of a HFC meal of this magnitude (approximately 3,000 kcal, 1,300 kcal from fat) will promote significant elevations in postprandial triglyceride (TG) concentrations, overwhelm the adaptive response to a HFC diet (elevated LPL activity), and attenuate the beneficial effects of a single exercise session on this system.

Single Sessions of Intermittent and Continuous Exercise and Postprandial Lipemia

PURPOSE

This study compared the effects of continuous (CON-EX) and intermittent (INT-EX) exercise on postprandial lipemia (PPL).

METHODS

Subjects were 18 inactive males (N = 7) and females (N = 11), aged 25 +/- 1.8 yr (mean +/- SE), VO2max 38.4 +/- 1.5 (mL x kg(-1)x min(-1)), and BMI 23.2 +/- 0.8 (kg x m(-2)). After 48-h activity and 24-h dietary control periods, subjects consumed a high-fat meal (HFM) containing 1.5 g fat (88% of calories), 0.05 g protein, and 0.4 g carbohydrate per kilogram body weight for three trials: no exercise (NOEX), CON-EX, and INT-EX. Both exercise trials consisted of 30 min of treadmill running at 60% VO2max. INT-EX was conducted in a single session of three bouts, each lasting 10 min and separated by a 20-min rest period. Blood was collected before the HFM (0 h) and at 2, 4, 6, and 8 h post-HFM. Exercise trials were completed 12 h before the HFM. Trials were separated by 7-10 d and were performed in random order.

RESULTS

Plasma analysis indicated TG incremental area under the curve (AUCI) and TG incremental peak (PeakI) were significantly lower in INT-EX compared with NOEX, but CON-EX was not different from INT-EX or NOEX. Compared with females, males had significantly higher AUCI and PeakI in both exercise trials, but genders were not different in the NOEX trial. No difference was discovered among trials in high density lipoprotein (HDL)Total-C, HDL2-C, and HDL3-C, or fasting total cholesterol (TC) or fasting TC:HDL ratio. Females had higher fasting HDLTotal-C, HDL2-C, and HDL3-C compared with males. No gender or trial difference was found for fasting TC or TC:HDL ratio.

CONCLUSIONS

Our data suggest that a single bout of INT-EX is more effective than CON-EX for lowering PPL as compared with NOEX in inactive, normolipidemic individuals.

Effect of exercise performed immediately before a meal of moderate fat content on postprandial lipaemia

The majority of the studies that have found a lowering effect of exercise on postprandial lipaemia have employed exercise 12-18 h before a test meal of exaggerated fat content (over 60 % total energy). The aim of the present study was to investigate whether this effect is manifest when exercise is performed immediately before a test meal of moderate fat content. Eleven healthy young men cycled for 45 min at 62 % maximal heart rate or rested, and, immediately afterwards, consumed a meal of moderate fat content (35 % total energy, 0.65 g/kg body mass) in a random counterbalanced design. Blood samples were drawn before exercise, before the meal, and for 8 h postprandially. No significant differences were observed in plasma triacylglycerol concentrations and areas under the triacylglycerol concentration v. time curves between exercise and rest, although exercise reduced the postprandial lipaemic response by 17 %. Non-esterified fatty acids, glucose, and insulin did not differ significantly between the trials. In conclusion, moderate exercise performed immediately before a meal of a fat content typical to the Western diet had only a modest effect on postprandial lipaemia.

Effect of prior exercise on lipemia after a meal of moderate fat content

OBJECTIVE

Prior exercise has been repeatedly shown to reduce lipemia after meals of exaggerated fat content (over 60% of total energy). The aim of the present study was to investigate whether the same applies to meals closer to the composition of the typical Western diet and explore whether exercise affects the release of dietary fat into the bloodstream.

DESIGN

Randomized counterbalanced.

SETTING

Laboratory.

SUBJECTS

Nine healthy young male volunteers.

INTERVENTION

Subjects consumed a meal of moderate fat content (35% of total energy, 0.66 g/kg body mass) 14 h after having either cycled for 1 h at 70-75% of maximal heart rate or rested. Macadamia nuts were used as the main source of dietary fat to trace its entry into the circulation because of their unusual fatty acid composition. Blood samples were drawn before the meal and for 8 h postprandially.

RESULTS

Plasma triacylglycerol concentrations and total area under the triacylglycerol concentration vs time curve (AUC) were significantly lower after exercise (P = 0.001 and 0.003, respectively; effect size for the latter, 0.84). However, incremental (above baseline) AUC was not affected by exercise significantly. When controlling for differences in baseline plasma concentrations, only the fatty acids that were more abundant in the meal than in plasma triacylglycerols were decreased in the early postprandial period following exercise, implying either a suppressive effect of exercise on the rate of triacylglycerol release from the intestine or a more rapid chylomicron clearance after meal consumption.

CONCLUSIONS

Exercise performed between 15 and 14 h before a meal of moderate fat content reduced postprandial lipemia, mainly by lowering fasting triacylglycerols. The effect of exercise on postprandial triacylglycerol metabolism may be mediated, at least in part, by attenuated release of dietary fat from the intestine.

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.

Changes in LPLa and reverse cholesterol transport variables during 24-h postexercise period

We investigated the time course of exercise-induced lipoprotein lipase activity (LPLa) and reverse cholesterol transport (RCT) during the 24-h postexercise period. Subjects were 10 sedentary normolipidemic males [NTG; fasting triglyceride (TG) = 89.1 +/- 8.6 mg/dl] and 6 hyperlipidemic males (HTG; fasting TG = 296.8 +/- 64.0 mg/dl). Each subject performed a control trial (no exercise) and 4 exercise trials. In the exercise trials, a subject jogged on a treadmill at 60% of his maximal O(2) consumption for 1 h. Pre- and postheparin blood samples were taken before exercise (baseline) and at 4, 8, 12, and 24 h after exercise. There was no group difference in LPLa (P > 0.05) over the time points. When the LPLa data from the two groups were combined, LPLa at 24 h after exercise was higher than baseline or at 4, 8, 12 h after exercise (P < 0.05). Plasma TG and lecithin-cholesterol acyltransferase activity (LCATa) were higher in HTG than in NTG, and the total high-density lipoprotein-cholesterol (HDL(tot)-Chol) was lower in HTG than in NTG (P < 0.05). HDL(2)-Chol, LCATa, and cholesterol ester transfer protein activity did not differ during the 24-h postexercise period (P > 0.05). These results suggest that LPLa is still increasing 24 h after an acute aerobic exercise and that the magnitude of the increase in exercise-induced LPLa in HTG was similar to that in NTG. Furthermore, in the sedentary population with or without HTG, the variables related to RCT do not change during the 24-h period after exercise.