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Previous Volume 347:1483-1492 November 7, 2002 Number 19 Next

	Full Text PDF PDA Full Text PowerPoint Slide Set Editorial by Tall, A. R. Letters Add to Personal Archive Add to Citation Manager Notify a Friend E-mail When Cited PubMed Citation

ABSTRACT

Background Increased physical activity is related to reduced risk of cardiovascular disease, possibly because it leads to improvement in the lipoprotein profile. However, the amount of exercise training required for optimal benefit is unknown. In a prospective, randomized study, we investigated the effects of the amount and intensity of exercise on lipoproteins.

Methods A total of 111 sedentary, overweight men and women with mild-to-moderate dyslipidemia were randomly assigned to participate for six months in a control group or for approximately eight months in one of three exercise groups: high-amount–high-intensity exercise, the caloric equivalent of jogging 20 mi (32.0 km) per week at 65 to 80 percent of peak oxygen consumption; low-amount–high-intensity exercise, the equivalent of jogging 12 mi (19.2 km) per week at 65 to 80 percent of peak oxygen consumption; or low-amount–moderate-intensity exercise, the equivalent of walking 12 mi per week at 40 to 55 percent of peak oxygen consumption. Subjects were encouraged to maintain their base-line body weight. The 84 subjects who complied with these guidelines served as the basis for the main analysis. Detailed lipoprotein profiling was performed by nuclear magnetic resonance spectroscopy with verification by measurement of cholesterol in lipoprotein subfractions.

Results There was a beneficial effect of exercise on a variety of lipid and lipoprotein variables, seen most clearly with the high amount of high-intensity exercise. The high amount of exercise resulted in greater improvements than did the lower amounts of exercise (in 10 of 11 lipoprotein variables) and was always superior to the control condition (11 of 11 variables). Both lower-amount exercise groups always had better responses than the control group (22 of 22 comparisons).

Conclusions The highest amount of weekly exercise, with minimal weight change, had widespread beneficial effects on the lipoprotein profile. The improvements were related to the amount of activity and not to the intensity of exercise or improvement in fitness.

Source Information

From the Divisions of Cardiology (W.E.K., B.D.D., K.J.K., C.A.S.), Geriatrics (C.W.B., S.H.), and General Internal Medicine (G.P.S.), Department of Medicine, the Duke Center for Living (W.E.K.), the Center for Health Policy Research (G.P.S.), and the Department of Community and Family Medicine (G.P.S.), Duke University Medical Center; and the Geriatric Research, Education, and Clinical Center, Durham Veterans Affairs Medical Center (C.W.B.) — both in Durham, N.C.; the Department of Exercise and Sport Science and the Human Performance Laboratory, East Carolina University, Greenville, N.C. (J.A.H., M.B.W., J.S.M.); LipoScience, Cary, N.C. (J.D.O.); and Atherotech, Birmingham, Ala. (K.R.K.).

Address reprint requests to Dr. Kraus at the Division of Cardiology, Department of Medicine, P.O. Box 3327, Duke University Medical Center, Durham, NC 27710, or at william.kraus{at}duke.edu.

Full Text of this Article

Related Letters:

Effects of Exercise on Plasma Lipoproteins
Sharma A. M., Schmidt-Trucksäss A., Mascitelli L., Pezzetta F., Slentz C. A., Kraus W. E., Tall A. R.
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N Engl J Med 2003; 348:1494-1496, Apr 10, 2003. Correspondence

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