BACKGROUND. The National Cholesterol Education Program (NCEP) recommends a low-saturated-fat, low-cholesterol diet, with weight loss if indicated, to correct elevated plasma cholesterol levels. Weight loss accomplished by simple caloric restriction or increased exercise typically increases the level of high-density lipoprotein (HDL) cholesterol. Little is known about the effects on plasma lipoproteins of a hypocaloric NCEP diet with or without exercise in overweight people. METHODS. We tested the hypothesis that exercise (walking or jogging) will increase HDL cholesterol levels in moderately overweight, sedentary people who adopt a hypocaloric NCEP diet. We randomly assigned 132 men and 132 women 25 to 49 years old to one of three groups: control, hypocaloric NCEP diet, or hypocaloric NCEP diet with exercise. One hundred nineteen of the men and 112 of the women returned for testing after one year. RESULTS. After one year, the subjects in both intervention groups had reached or closely approached NCEP Step 1 dietary goals and reduced their mean body fat significantly (range of reduction in mean fat weight, 4.0 to 7.8 kg). Weight loss on the NCEP diet alone did not significantly change HDL cholesterol levels in either the men or the women as compared with the subjects in the control group. Plasma levels of HDL cholesterol increased significantly more in the men who exercised and dieted (mean [+/- SE] change, +13 +/- 3 percent) than in the men who only dieted (+2 +/- 3 percent, P less than 0.01) or the men who acted as controls (-4 +/- 2 percent, P less than 0.001). HDL cholesterol levels remained about the same in the women who exercised and dieted (+1 +/- 2 percent); they were higher than in the women who only dieted (-10 +/- 3 percent, P less than 0.01), but not higher than in the controls (-3 +/- 3 percent). CONCLUSIONS. Regular exercise in overweight men and women enhances the improvement in plasma lipoprotein levels that results from the adoption of a low-saturated-fat, low-cholesterol diet.
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Stanford Center for Research in Disease Prevention, Stanford University School of Medicine, Calif 94304-1583.
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[Abstract][Full Text]
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Rimal, R. N.
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[Abstract]
Hardman, A. E
(2000). High-carbohydrate diets, physical activity, and plasma lipoprotein lipids. Am. J. Clin. Nutr.
72: 1061-1061
[Full Text]
Willett, W. C
(2000). Reply to AE Hardman. Am. J. Clin. Nutr.
72
: 1061-1062
[Full Text]
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(2000). Physical Activity and Coronary Heart Disease in Men : The Harvard Alumni Health Study. Circulation
102: 975-980
[Abstract][Full Text]
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[Abstract][Full Text]
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(2000). Cost-Effectiveness of Cholesterol-Lowering Therapies according to Selected Patient Characteristics. ANN INTERN MED
132: 769-779
[Abstract][Full Text]
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15: 2-2
Apovian, C. M.
(2000). Invited Review: The Medical Management of Obesity and the Role of Pharmacotherapy: An Update. Nutr Clin Pract
15: 5-12
[Abstract]
Gill, J. M., Hardman, A. E
(2000). Postprandial lipemia: effects of exercise and restriction of energy intake compared1. Am. J. Clin. Nutr.
71: 465-471
[Abstract][Full Text]
Rywik, T. M., Blackman, M. R., Yataco, A. R., Vaitkevicius, P. V., Zink, R. C., Cottrell, E. H., Wright, J. G., Katzel, L. I., Fleg, J. L.
(1999). Enhanced endothelial vasoreactivity in endurance-trained older men. J. Appl. Physiol.
87: 2136-2142
[Abstract][Full Text]
Williams, P. T., Winett, R. A., Carpinelli, R. N., Smith, G. D., Ebrahim, S., Dunn, A. L., Blair, S. N., Kampert, J. B., Marcus, B. H., Garcia, M. E., Kohl III, H. W., Andersen, R., Pratt, M.
(1999). Lifestyle and Structured Interventions to Increase Physical Activity. JAMA
282: 1515-1517
[Full Text]
Di Buono, M., Hannah, J. S., Katzel, L. I., Jones, P. J. H.
(1999). Weight Loss Due to Energy Restriction Suppresses Cholesterol Biosynthesis in Overweight, Mildly Hypercholesterolemic Men. J. Nutr.
129: 1545-1548
[Abstract][Full Text]
Wilson, P. W. F., Kannel, W. B., Silbershatz, H., D'Agostino, R. B.
(1999). Clustering of Metabolic Factors and Coronary Heart Disease. Arch Intern Med
159: 1104-1109
[Abstract][Full Text]
James, K.
(1999). Exercise plus diet improved cholesterol concentrations in high risk adults. Evid. Based Nurs.
2: 45-45
[Full Text]
Clarkson, P., Montgomery, H. E., Mullen, M. J., Donald, A. E., Powe, A. J., Bull, T., Jubb, M., World, M., Deanfield, J. E.
(1999). Exercise training enhances endothelial function in young men. J Am Coll Cardiol
33: 1379-1385
[Abstract][Full Text]
Niebauer, J., Maxwell, A. J., Lin, P. S., Tsao, P. S., Kosek, J., Bernstein, D., Cooke, J. P.
(1999). Impaired aerobic capacity in hypercholesterolemic mice: partial reversal by exercise training. Am. J. Physiol. Heart Circ. Physiol.
276: H1346-H1354
[Abstract][Full Text]
Anderson, D. A., Wadden, T. A.
(1999). Treating the Obese Patient: Suggestions for Primary Care Practice. Arch Fam Med
8: 156-167
[Abstract][Full Text]
Shephard, R. J., Balady, G. J.
(1999). Exercise as Cardiovascular Therapy. Circulation
99: 963-972
[Full Text]
Dunn, A. L., Marcus, B. H., Kampert, J. B., Garcia, M. E., Kohl III, H. W., Blair, S. N.
(1999). Comparison of Lifestyle and Structured Interventions to Increase Physical Activity and Cardiorespiratory Fitness: A Randomized Trial. JAMA
281: 327-334
[Abstract][Full Text]
Weinstock, R. S., Dai, H., Wadden, T. A.
(1998). Diet and Exercise in the Treatment of Obesity: Effects of 3 Interventions on Insulin Resistance. Arch Intern Med
158: 2477-2483
[Abstract][Full Text]
Thune, I., Njolstad, I., Lochen, M.-L., Forde, O. H.
(1998). Physical Activity Improves the Metabolic Risk Profiles in Men and Women: The Tromso Study. Arch Intern Med
158: 1633-1640
[Abstract][Full Text]
Stefanick, M. L., Mackey, S., Sheehan, M., Ellsworth, N., Haskell, W. L., Wood, P. D.
(1998). Effects of Diet and Exercise in Men and Postmenopausal Women with Low Levels of HDL Cholesterol and High Levels of LDL Cholesterol. NEJM
339: 12-20
[Abstract][Full Text]
Mantha, L., Deshaies, Y.
(1998). beta -Adrenergic modulation of triglyceridemia under increased energy expenditure. Am. J. Physiol. Regul. Integr. Comp. Physiol.
274: R1769-R1776
[Abstract][Full Text]
Williams, P. T.
(1998). Relationships of Heart Disease Risk Factors to Exercise Quantity and Intensity. Arch Intern Med
158: 237-245
[Abstract][Full Text]
Crouse, S. F., O'Brien, B. C., Grandjean, P. W., Lowe, R. C., Rohack, J. J., Green, J. S.
(1997). Effects of training and a single session of exercise on lipids and apolipoproteins in hypercholesterolemic men. J. Appl. Physiol.
83: 2019-2028
[Abstract][Full Text]
Dwyer, T., Iwane, H., Dean, K., Odagiri, Y., Shimomitsu, T., Blizzard, L., Srinivasan, S., Nicklas, T., Wattigney, W., Riley, M., Berenson, G.
(1997). Differences in HDL Cholesterol Concentrations in Japanese, American, and Australian Children. Circulation
96: 2830-2836
[Abstract][Full Text]
Perusse, L., Rice, T., Despres, J. P., Bergeron, J., Province, M. A., Gagnon, J., Leon, A. S., Rao, D. C., Skinner, J. S., Wilmore, J. H., Bouchard, C.
(1997). Familial Resemblance of Plasma Lipids, Lipoproteins and Postheparin Lipoprotein and Hepatic Lipases in the HERITAGE Family Study. Arterioscler. Thromb. Vasc. Bio.
17: 3263-3269
[Abstract][Full Text]
Niebauer, J., Hambrecht, R., Velich, T., Hauer, K., Marburger, C., Kalberer, B., Weiss, C., von Hodenberg, E., Schlierf, G., Schuler, G., Zimmermann, R., Kubler, W.
(1997). Attenuated Progression of Coronary Artery Disease After 6 Years of Multifactorial Risk Intervention : Role of Physical Exercise. Circulation
96: 2534-2541
[Abstract][Full Text]
Williams, P. T.
(1997). Dose of Exercise and Health Benefit. Arch Intern Med
157: 1774-1776
[Abstract]
Williams, P. T., Dreon, D. M., Blanche, P. J., Krauss, R. M.
(1997). Variability of Plasma HDL Subclass Concentrations in Men and Women Over Time. Arterioscler. Thromb. Vasc. Bio.
17: 702-706
[Abstract][Full Text]
McCarron, D. A., Oparil, S., Chait, A., Haynes, R. B., Kris-Etherton, P., Stern, J. S., Resnick, L. M., Clark, S., Morris, C. D., Hatton, D. C., Metz, J. A., McMahon, M., Holcomb, S., Snyder, G. W., Pi-Sunyer, F. X.
(1997). Nutritional Management of Cardiovascular Risk Factors: A Randomized Clinical Trial. Arch Intern Med
157: 169-177
[Abstract]
Williams, P. T.
(1997). Relationship of Distance Run per Week to Coronary Heart Disease Risk Factors in 8283 Male Runners: The National Runners' Health Study. Arch Intern Med
157: 191-198
[Abstract]
Crouse, S. F., O'Brien, B. C., Grandjean, P. W., Lowe, R. C., Rohack, J. J., Green, J. S., Tolson, H.
(1997). Training intensity, blood lipids, and apolipoproteins in men with high cholesterol. J. Appl. Physiol.
82: 270-277
[Abstract][Full Text]
Fletcher, G. F., Balady, G., Blair, S. N., Blumenthal, J., Caspersen, C., Chaitman, B., Epstein, S., Froelicher, E. S. S., Froelicher, V. F., Pina, I. L., Pollock, M. L.
(1996). Statement on Exercise: Benefits and Recommendations for Physical Activity Programs for All Americans: A Statement for Health Professionals by the Committee on Exercise and Cardiac Rehabilitation of the Council on Clinical Cardiology, American Heart Association. Circulation
94: 857-862
[Full Text]
Caggiula, A. W., Watson, J. E., Kuller, L. H., Olson, M. B., Milas, N. C., Berry, M., Germanowski, J.
(1996). Cholesterol-Lowering Intervention Program: Effect of the Step I Diet in Community Office Practices. Arch Intern Med
156: 1205-1213
[Abstract]
Katzel, L. I., Bleecker, E. R., Colman, E. G., Rogus, E. M., Sorkin, J. D., Goldberg, A. P.
(1995). Effects of Weight Loss vs Aerobic Exercise Training on Risk Factors for Coronary Disease in Healthy, Obese, Middle-aged and Older Men: A Randomized Controlled Trial. JAMA
274: 1915-1921
[Abstract]
Denke, M. A., Winker, M. A.
(1995). Cholesterol and Coronary Heart Disease in Older Adults: No Easy Answers. JAMA
274: 575-577
[Abstract]
Schaefer, E. J., Lichtenstein, A. H., Lamon-Fava, S., Contois, J. H., Li, Z., Rasmussen, H., McNamara, J. R., Ordovas, J. M.
(1995). Efficacy of a National Cholesterol Education Program Step 2 Diet in Normolipidemic and Hypercholesterolemic Middle-Aged and Elderly Men and Women. Arterioscler. Thromb. Vasc. Bio.
15: 1079-1085
[Abstract][Full Text]
Rich-Edwards, J. W., Manson, J. E., Hennekens, C. H., Buring, J. E.
(1995). The Primary Prevention of Coronary Heart Disease in Women. NEJM
332: 1758-1766
[Full Text]
Eaton, C. B., Medalie, J. H., Flocke, S. A., Zyzanski, S. J., Yaari, S., Goldbourt, U.
(1995). Self-reported Physical Activity Predicts Long-term Coronary Heart Disease and All-Cause Mortalities: Twenty-one-Year Follow-up of The Israeli Ischemic Heart Disease Study. Arch Fam Med
4: 323-329
[Abstract]
Kokkinos, P. F., Holland, J. C., Narayan, P., Colleran, J. A., Dotson, C. O., Papademetriou, V.
(1995). Miles Run per Week and High-Density Lipoprotein Cholesterol Levels in Healthy, Middle-aged Men: A Dose-Response Relationship. Arch Intern Med
155: 415-420
[Abstract]
Pate, R. R., Pratt, M., Blair, S. N., Haskell, W. L., Macera, C. A., Bouchard, C., Buchner, D., Ettinger, W., Heath, G. W., King, A. C., Kriska, A., Leon, A. S., Marcus, B. H., Morris, J., Paffenbarger, R. S. Jr, Patrick, K., Pollock, M. L., Rippe, J. M., Sallis, J., Wilmore, J. H.
(1995). Physical Activity and Public Health: A Recommendation From the Centers for Disease Control and Prevention and the American College of Sports Medicine. JAMA
273: 402-407
[Abstract]
Barnard, N. D., Akhtar, A., Nicholson, A.
(1995). Factors That Facilitate Compliance to Lower Fat Intake. Arch Fam Med
4: 153-158
[Abstract]
Rosenson, R. S.
(1993). Low Levels of High-Density Lipoprotein Cholesterol (Hypoalphalipoproteinemia) An Approach to Management. Arch Intern Med
153: 1528-1538
[Abstract]
Taylor, P. A., Ward, A.
(1993). Women, High-Density Lipoprotein Cholesterol, and Exercise. Arch Intern Med
153: 1178-1184
[Abstract]
Hunninghake, D. B., Stein, E. A., Dujovne, C. A., Harris, W. S., Feldman, E. B., Miller, V. T., Tobert, J. A., Laskarzewski, P. M., Quiter, E., Held, J., Taylor, A. M., Hopper, S., Leonard, S. B., Brewer, B. K.
(1993). The Efficacy of Intensive Dietary Therapy Alone or Combined with Lovastatin in Outpatients with Hypercholesterolemia. NEJM
328: 1213-1219
[Abstract][Full Text]
Lavie, C. J., Milani, R. V.
(1993). Factors Predicting Improvements in Lipid Values Following Cardiac Rehabilitation and Exercise Training. Arch Intern Med
153: 982-988
[Abstract]
Curfman, G. D.
(1993). The Health Benefits of Exercise -- A Critical Reappraisal. NEJM
328: 574-576
[Full Text]
Cooper, G. R., Myers, G. L., Smith, S. J., Schlant, R. C.
(1992). Blood Lipid Measurements: Variations and Practical Utility. JAMA
267: 1652-1660
[Abstract]
(1991). EXERCISE PLUS WEIGHT LOSS RAISES HDL CHOLESTEROL IN OVERWEIGHT MEN. JWatch General
1991: 5-5
[Full Text]
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