Managing Cardiometabolic Risk

Exercise and Atherogenic Dyslipidemia

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The evidence for exercise-related improvements in lipid status appears to be strongest for HDL cholesterol and triglycerides (65-67, 70, 71). For example, a meta-analysis of 15 randomized, controlled studies revealed that 30 to 60 minutes of moderate-intensity aerobic exercise three to five times per week produced a mean increase in HDL cholesterol levels of ~4% (0.05 mmol/l) and a decrease in triglyceride levels of ~12% (0.21 mmol/l) (71). These results generally agree with those of a prior review that concluded that aerobic exercise inducing an energy expenditure of 1,200 to 2,200 kcal/wk can increase HDL cholesterol levels by 4 to 22% (0.05-0.21 mmol/l) and decrease triglyceride levels 4 to 37% (0.01-0.43 mmol/l) (66). Other analyses (67, 70) have echoed these findings, suggesting that only a modest amount of exercise is required to produce significant improvements. However, a dose-response relationship has yet to be established (67). While some studies have suggested that exercise-induced weight loss is necessary to see lipid improvements (65), others have shown that while HDL cholesterol and triglyceride improvements are generally greater in those who lose weight, these improvements can occur even when weight remains virtually unchanged (66, 71, 72). However, these changes may depend on changes to body composition, such as increased skeletal muscle mass or reduced intra-abdominal fat (25, 26).

Reference

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25. Ross R, Dagnone D, Jones PJ, et al. Reduction in obesity and related comorbid conditions after diet-induced weight loss or exercise-induced weight loss in men. A randomized, controlled trial. Ann Intern Med 2000; 133: 92-103.

26. Ross R, Janssen I, Dawson J, et al. Exercise-induced reduction in obesity and insulin resistance in women: a randomized controlled trial. Obes Res 2004; 12: 789-98.

65. Stefanick ML. Physical activity for preventing and treating obesity-related dyslipoproteinemias. Med Sci Sports Exerc 1999; 31: S609-18.

66. Durstine JL, Grandjean PW, Davis PG, et al. Blood lipid and lipoprotein adaptations to exercise: a quantitative analysis. Sports Med 2001; 31: 1033-62.

67. Leon AS and Sanchez OA. Response of blood lipids to exercise training alone or combined with dietary intervention. Med Sci Sports Exerc 2001; 33: S502-15; discussion S28-9.

70. Halbert JA, Silagy CA, Finucane P, et al. Exercise training and blood lipids in hyperlipidemic and normolipidemic adults: a meta-analysis of randomized, controlled trials. Eur J Clin Nutr 1999; 53: 514-22.

71. Carroll S and Dudfield M. What is the relationship between exercise and metabolic abnormalities? A review of the metabolic syndrome. Sports Med 2004; 34: 371-418.

72. Kraus WE, Houmard JA, Duscha BD, et al. Effects of the amount and intensity of exercise on plasma lipoproteins. N Engl J Med 2002; 347: 1483-92.

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