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Jumat, 25 Januari 2008

[Supertraining] Re: HDL and Training

--- In, Ed White <kitesurfer257@...>
> Without diet changes, how much improvement can a person achieve in
lipid profile (LDL reduction, HDL increase, Trig reduction):
> - from 3x per week x 1 hr strength training sessions?
> - from 3x per week x 1 hr aerobic sessions (treadmill, eliptical,
> - both?
> Can anyone explain the mechanism that allows lipid profile to
improve from exercise alone?

The exact mechanisms involved in exercise-induced alterations in
cholesterol metabolism are not understood fully. Durstine and
Haskell (1994) believe potential mechanisms for exercise-induced
alterations in blood lipids include loss of body weight, decreased
adiposity, and changes in the enzymes that regulate lipoprotein

Durstine, J.L. and W.L. Haskell. (1994). Effects of exercise training on plasma lipids and lipoproteins. In:. Exercise and Sport Sciences Reviews. J.O. Hollozy, ed. Baltimore: Williams {&} Wilkins, 477–521.


Physical activity and high density lipoprotein cholesterol levels:
what is the relationship?

Sports Med. 1999 Nov;28(5):307-14. Links

Kokkinos PF, Fernhall B.

High density lipoprotein cholesterol (HDL-C) levels are strongly,
inversely and independently associated with coronary heart disease
(CHD). Increased physical activity is associated with reduced CHD
mortality. This protection against CHD may partially be explained by
the increase in HDL-C levels observed following aerobic exercise
training. Many also agree that an exercise threshold needs to be met
before such favourable changes in HDL-C metabolism can occur.

likely, the exercise-induced changes in HDL-C are the result of the
interaction amongst exercise intensity, frequency, duration of each
exercise session and length of the exercise training period. Although
a relative contribution of each exercise component (intensity,
duration and frequency) is also likely, it has not been established.
There is also substantial support for a dose-response relationship.
Favourable changes in HDL-C appear to occur incrementally and reach
statistical significance at approximately 7-10 miles per week or 1200
to 1600kcal. Exercise-induced changes in HDL-C may also be gender
dependent. The volume of exercise required to increase HDL-C levels
appears to be substantially more for women than men. This perhaps is
due to higher HDL-C levels in women at baseline compared with men.
However, the many other health benefits derived from increased
physical activity should encourage women to participate in regular
exercise regardless of the exercise effects on HDL-C levels. A
practical approach in prescribing exercise for patients is to use
moderate intensity exercises (70 to 80% of predicted maximal heart
rate), 3 to 5 times per week, for a total of 7 to 14 miles per week.

This is equivalent to approximately 1200 to 1600kcal per week.
Moderate to low intensity exercise should be preferred because such
exercise carries a lower risk for cardiac complications. In addition,
patients are more likely to participate and sustain a lower than
higher intensity exercise programme. It is also important to
recognise that other modes of physical activity can also be
encouraged for patients. Such activities should be associated with
similar increases in HDL-C levels as long as they meet or exceed the
caloric expenditure of 1200 to 1600kcal (7 to 14 miles per week of

Blood lipid and lipoprotein adaptations to exercise: a quantitative
Sports Med. 2001;31(15):1033-62. Links

Durstine JL, Grandjean PW, Davis PG, Ferguson MA, Alderson NL, DuBose

Dose-response relationships between exercise training volume and
blood lipid changes suggest that exercise can favourably alter blood
lipids at low training volumes, although the effects may not be
observable until certain exercise thresholds are met. The thresholds
established from cross-sectional literature occur at training volumes
of 24 to 32 km (15 to 20 miles) per week of brisk walking or jogging
and elicit between 1200 to 2200 kcal/wk. This range of weekly energy
expenditure is associated with 2 to 3 mg/dl increases in high-density
lipoprotein-cholesterol (HDL-C) and triglyceride (TG) reductions of 8
to 20 mg/dl. Evidence from cross-sectional studies indicates that
greater changes in HDL-C levels can be expected with additional
increases in exercise training volume.

HDL-C and TG changes are often
observed after training regimens requiring energy expenditures
similar to those characterised from cross-sectional data. Training
programmes that elicit 1200 to 2200 kcal/wk in exercise are often
effective at elevating HDL-C levels from 2 to 8 mg/dl, and lowering
TG levels by 5 to 38 mg/dl. Exercise training seldom alters total
cholesterol (TC) and low-density lipoprotein-cholesterol (LDL-C).
However, this range of weekly exercise energy expenditure is also
associated with TC and LDL-C reductions when they are reported. The
frequency and extent to which most of these lipid changes are
reported are similar in both genders, with the exception of TG. Thus,
for most individuals, the positive effects of regular exercise are
exerted on blood lipids at low training volumes and accrue so that
noticeable differences frequently occur with weekly energy
expenditures of 1200 to 2200 kcal/wk.

It appears that weekly exercise
caloric expenditures that meet or exceed the higher end of this range
are more likely to produce the desired lipid changes. This amount of
physical activity, performed at moderate intensities, is reasonable
and attainable for most individuals and is within the American
College of Sports Medicine's currently recommended range for healthy

Exercise, lipids, and lipoproteins in older adults: a meta-analysis.
Kelley GA, Kelley KS, Tran ZV.
Prev Cardiol. 2005 Fall;8(4):206-14. Links

The authors used the meta-analytic approach to examine the effects of
aerobic exercise on lipids and lipoproteins in adults 50 years of age
and older. Twenty-eight outcomes representing 1427 subjects (806
exercise, 621 control) were available for pooling. Random-effects
modeling yielded statistically significant improvements of 1.1%,
5.6%, 2.5%, and 7.1%, respectively, for total cholesterol (mean +/-
SEM in mg/dL, -3.3+/-1.7; 95% confidence interval [CI], -6.5 to -
0.02; p=0.05), high-density lipoprotein cholesterol (2.5+/-1.0; 95%
CI, 0.7-4.4; p=0.01), low-density lipoprotein cholesterol (-3.9+/-
1.9; 95% CI, -7.7 to -0.08; p=0.05), ratio of total cholesterol to
high-density lipoprotein cholesterol (-0.8+/-0.2; 95% CI, -1.2 to -
0.4; p<0.001), but not triglycerides (-7.0+/-3.6; 95% CI, -14.0 to
0.1; p=0.06). After conducting sensitivity analyses, only the
improvements in high-density lipoprotein cholesterol and the ratio of
total cholesterol to high-density lipoprotein cholesterol remained
statistically significant (p<0.05 for both).

It was concluded that
aerobic exercise increases high-density lipoprotein cholesterol and
decreases the ratio of total cholesterol to high-density lipoprotein
cholesterol in older adults.

Aerobic exercise and lipids and lipoproteins in women: a meta-
analysis of randomized controlled trials.

Kelley GA, Kelley KS, Tran ZV.

BACKGROUND: Cardiovascular disease (CVD) in women is the leading
cause of mortality in the United States, and less than optimal lipid
and lipoprotein levels are major risk factors for CVD. The purpose of
this study was to use the meta-analytic approach to examine the
effects of aerobic exercise on lipids and lipoproteins in women.
METHODS: Studies were retrieved via computerized literature searches,
review of reference lists, hand searching selected journals, and
expert review of our reference list. The inclusion of studies was
limited to randomized controlled trials published in the English
language literature between January 1955 and January 2003 in which
aerobic exercise was used as the primary intervention in adult women
aged > or =18 years. One or more of the following lipids and
lipoproteins were assessed: total cholesterol (TC), high-density
lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol
(LDL-C), and triglycerides (TG).

RESULTS: Using a random effects
model, statistically significant improvements were observed for all
lipids and lipoproteins (TC, +/- SEM, -4.3 +/- 1.3 mg/dl, 95% CI -6.9
to -1.7 mg/dl; HDL-C, +/- SEM, 1.8 +/- 0.9 mg/dl, 95% CI 0.1 to 3.5
mg/dl; LDL-C, +/- SEM, -4.4 +/- 1.1 mg/dl, 95% CI -6.5 to -2.2 mg/dl;
TG, +/- SEM, -4.2 +/- 2.1 mg/dl, 95% CI -8.4 to -0.1 mg/dl).
Reductions of approximately 2%, 3%, and 5%, respectively, were
observed for TC, LDL-C, and TG, whereas an increase of 3% was
observed for HDL-C.

CONCLUSIONS: Aerobic exercise is efficacious for
increasing HDL-C and decreasing TC, LDL-C, and TG in women.

Aerobic exercise, lipids and lipoproteins in overweight and obese
adults: a meta-analysis of randomized controlled trials.

Int J Obes (Lond). 2005 Aug;29(8):881-93. Links

Kelley GA, Kelley KS, Vu Tran Z.

OBJECTIVE: Use the meta-analytic approach to examine the effects of
aerobic exercise on lipids and lipoproteins in overweight and obese
adults. DATA SOURCES: (1) Computerized literature searches, (2) cross-
referencing from review and original articles, (3) hand searching,
and (4) expert review of reference list.

randomized controlled trials, (2) aerobic exercise > or =8 weeks, (3)
adult humans > or =18 y of age, (4) all subjects overweight or obese
(BMI > or =25 kg/m(2)), (5) studies published in journal,
dissertation, or master's thesis format, (6) studies published in the
English-language, (7) studies published between 1 January 1955 and 1
January 2003, (8) assessment of one or more of the following lipid
and/or lipoprotein variables: total cholesterol (TC), high-density
lipoprotein cholesterol (HDL), low-density lipoprotein cholesterol
(LDL), and triglycerides (TG). DATA ABSTRACTION: Dual-coding by the
first two authors (inter-rater agreement=0.96). RESULTS: In total, 13
studies representing 31 groups (17 exercise, 14 control), 613
subjects (348 exercise, 265 control), and up to 17 outcomes were
available for pooling. Across all categories, random-effects modeling
resulted in statistically significant improvements for TC (X +/-
s.e.m., - 3.4+/-1.7 mg/dl, 95% CI, - 6.7 to - 0.2 mg/dl) and TG (X +/-
s.e.m., - 16.1+/-7.3 mg/dl, 95% CI, - 30.2 to - 2.1 mg/dl) but not
HDL (X +/- s.e.m., 1.6+/-0.8 mg/dl, 95% CI, - 0.02 to 3.2 mg/dl) or
LDL (X +/-s.e.m., - 0.5+/-1.3 mg/dl, 95% CI, - 3.0 to 2.0 mg/dl).
Changes were equivalent to improvements of 2% (TC), 11% (TG), 3%
(HDL), and 0.3% (LDL). After conducting sensitivity analyses (each
study deleted from the model once), only decreases in TG remained
statistically significant. Increases in HDL were associated with
increases in maximum oxygen consumption (VO(2 max) in ml/kg/min,
r=0.75, P=0.002) and decreases in body weight (r=0.77, P<0.001),
while decreases in LDL were associated with decreases in body weight
(r=0.75, P=0.009).

CONCLUSIONS: Aerobic exercise decreases TG in
overweight and obese adults. However, a need exists for additional
randomized controlled trials in various overweight and/or obese
populations above and beyond those included in our analysis.

The effects of exercise on blood lipids and lipoproteins: a meta-
analysis of studies.

Med Sci Sports Exerc. 1983;15(5):393-402. Links

Tran ZV, Weltman A, Glass GV, Mood DP.

The results of 66 training studies involving the measurement of human
blood lipid and lipoprotein changes over time, conducted over the
last 26 yr, and representing 2925 subjects (2086 experimental and 839
control) were collected and statistically aggregated using the meta-
analysis technique. Across all types of subjects, treatments,
sources, and research designs, the average exercising subject was
found to have a reduction in total cholesterol of 10 mg X dl-1 (P les
than 0.01), total triglyceride decreased by 15.8 mg X dl-1 (P less
than 0.01), DHL-C increased by 1.2 mg X dl-1 (NS), LDL-C decreased by
5.1 mg X dl-1 (P less than 0.05), and total/HDL-C ratio showed a
large decrease of 0.48 (P less than 0.01).

None of the changes for
the control groups were significant. Initial levels of total
cholesterol, total triglyceride, HDL-C, and total/HDL-C ratio were
strongly correlated with their respective changes as a result of
training, regardless of the data partitioning. Higher initial levels
of total cholesterol, total triglyceride, and total/HDL-C ratio
resulted in greater decreases post-exercise (r = 0.48, 0.76, and
0.75, respectively; P less than 0.01), and lower initial levels of
HDL-C resulted in greater post-exercise increases (r = 0.50; P less
than 0.01). Overall, physical training seemed to produce beneficial
changes in blood lipids and lipoproteins. However, researchers must
be careful when examining the relationship between physical training
and serum lipids and lipoproteins because initial levels, age, length
of training, intensity, VO2max, body weight, and percent body fat
have been shown in this meta-analysis to interact with exercise and
serum lipid and lipoprotein changes.

Jamie Carruthers
Wakefield, UK

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