Endurance exercise training raises high-density lipoprotein cholesterol and lowers small low-density lipoprotein and very low-density lipoprotein independent of body fat phenotypes in older men and women
Introduction
Cardiovascular disease (CVD) is a critical, worldwide public health threat [1]. Current evidence suggests that in addition to conventional plasma lipoprotein lipid measures, novel measures of plasma lipoprotein subfraction concentration, size, and composition should be considered when evaluating CVD risk, as they may provide a better risk assessment because of their distinct composition and functions [2], [3], [4]. For example, concentrations of total and small low-density lipoprotein (LDL) particles, large high-density lipoprotein (HDL) particles, and large very low-density lipoprotein (VLDL) particles better reflect CVD risk than absolute measures of cholesterol concentrations, thus improving the early detection of CVD risk [3], [4], [5], [6], [7], [8]. In addition, the Adult Treatment Panel (ATP) III report lists small LDL particle concentration as an emerging risk factor and recommends small VLDL particle concentration as a potential target of cholesterol-lowering therapy [7], [9], [10], [11]. Although lipoprotein subclass concentrations and particle size can be measured by nuclear magnetic resonance (NMR) spectroscopy, relatively few studies have used this methodology in a specific population to assess changes in lipid/lipoprotein profiles after endurance exercise training.
Endurance exercise training improves plasma lipoprotein and lipid profiles and thus reduces CVD risk [7], [9], [10], [11]. In a meta-analysis of 52 exercise training studies, Leon and Sanchez found an average increase of 4.6% in HDL cholesterol (HDL-C), a reduction of 3.7% in triglycerides (TGs), and a reduction of 5.0% in LDL cholesterol (LDL-C) [9], [10]. In another review, Durstine et al [11] concluded that 15 to 20 miles of brisk walking or jogging (expenditure of 5021-9205 kJ/wk) was associated with HDL-C increases of 2 to 8 mg/dL. Kraus et al [7] recently found that a relatively high amount of regular exercise improved overall lipoprotein profiles, including an increase in total HDL concentration, large HDL particle concentration, and HDL particle size, even without clinically significant weight loss. However, there is still debate relative to whether these training-induced changes in plasma lipoprotein and lipid profiles are independent of initial levels of body fat and their changes with training [7], [12], [13], [14], [15], [16], [17].
Thus, we sought to investigate the independent effects of 24 weeks of standardized endurance exercise training on conventional and novel NMR measures of plasma lipoprotein subfractions. We hypothesized that exercise training, independent of diet, baseline body fat, and change in body fat with training, would beneficially affect plasma lipoprotein and lipoprotein lipid levels assessed by both conventional and NMR subfraction measures.
Section snippets
Methods
One hundred sedentary men and women volunteered for this study. Subjects were screened by telephone to determine their initial eligibility. The University of Maryland College Park Institutional Review Board approved the study and written informed consent was obtained from all subjects. To be eligible, subjects had to meet the following criteria: healthy, sedentary (physical activity performed for less than 20 minutes on no more than 2 occasions per week), 50 to 75 years old, normotensive or
Results
The study population consisted of 58 women and 42 men with a mean age of 58 ± 0.6 years. Of the women, 24 were on HRT. Seventy-five subjects were Caucasian, 19 were African American, and 6 were of other races. Using ethnicity as a covariate did not affect any statistical results; therefore, all subjects were included in the analyses, and ethnicity was not used as a covariate. With exercise training, body weight and body fat decreased significantly, and V˙o2max increased significantly (Table 1).
Discussion
Our study demonstrates the positive effects of endurance exercise training on conventional and NMR measures of plasma lipoproteins and lipids, independent of diet, baseline body composition, and changes in body composition with training. As addressed in the ATP III guidelines and numerous recent studies, such findings are important, as the evaluation of CVD risk due to a poor plasma lipoprotein lipid profile could be enhanced through the analysis of lipoprotein subfractions in addition to the
Acknowledgment
This study was supported by National Institutes of Health grants AG00268 (A.H. and J.M.H.), AG023464 (A.H.), AG17474 (J.M.H.), and AG15389 (J.M.H.), the Geriatric Research, Education, and Clinical Center and Medical Research Service of the Department of Veterans Affairs (A.P.G.), and the University of Maryland Claude D. Pepper Older American Independence Center grant 2P60 AG12583 (A.P.G.).
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