Clinical Investigation
Prevention and Rehabilitation
Exercise effects on lipids in persons with varying dietary patterns—does diet matter if they exercise? Responses in Studies of a Targeted Risk Reduction Intervention through Defined Exercise I

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Background

The standard clinical approach for reducing cardiovascular disease risk due to dyslipidemia is to prescribe changes in diet and physical activity. The purpose of the current study was to determine if, across a range of dietary patterns, there were variable lipoprotein responses to an aerobic exercise training intervention.

Methods

Subjects were participants in the STRRIDE I, a supervised exercise program in sedentary, overweight subjects randomized to 6 months of inactivity or 1 of 3 aerobic exercise programs. To characterize diet patterns observed during the study, we calculated a modified z-score that included intakes of total fat, saturated fat, trans fatty acids, cholesterol, omega-3 fatty acids, and fiber as compared with the 2006 American Heart Association diet recommendations. Linear models were used to evaluate relationships between diet patterns and exercise effects on lipoproteins/lipids.

Results

Independent of diet, exercise had beneficial effects on low-density lipoprotein cholesterol particle number, low-density lipoprotein cholesterol size, high-density lipoprotein cholesterol, high-density lipoprotein cholesterol size, and triglycerides (P < .05 for all). However, having a diet pattern that closely adhered to American Heart Association recommendations was not related to changes in these or any other serum lipids or lipoproteins in any of the exercise groups.

Conclusions

We found that even in sedentary individuals whose habitual diets vary in the extent of adherence to AHA dietary recommendations, a rigorous, supervised exercise intervention can achieve significant beneficial lipid effects.

Section snippets

Subjects and experimental design

The STRRIDE I study design, hypotheses, recruitment strategies, methods, preliminary results, and the initial findings for exercise effects on serum lipids are published elsewhere.3, 4 Written informed consent was obtained from all subjects. In this analysis, we report on the 204 subjects for whom full nutrition and lipid information was available. There were no significant differences (P < .05 for all) in age, gender, race, or body mass index (BMI) between the subjects not included (n = 23)

Results

Median intakes of the target nutrients were similar to those reported in representative national studies (Table II). Intakes of fat and saturated fat tended to exceed, and intakes of omega-3 fatty acids and fiber fall to short of recommended standards. Diet patterns (diet z-scores) and reported calorie intakes (2009 [± 433], 2029 [± 481]), 2012 [± 497]), and 2119 [± 519] kcal for the control, L/M, L/V, and H/V groups, respectively) did not vary significantly between treatment groups (P = .61 and P

Discussion

As previously published from STRRIDE I findings, we observed that an aerobic exercise intervention, in the absence of clinically significant weight loss, improves lipoprotein profiles.4 Here, we extend these findings by reporting that exercise-mediated improvements in lipoprotein profiles are independent of the extent to which participants adhered to an AHA-recommended diet pattern. Our findings suggest that when an exercise regimen is instituted to improve lipoprotein profiles, at least within

Disclosures

None.

Acknowledgements

We would like to acknowledge the STRRIDE I participants and the rest of the STRRIDE research team at Duke University Medical Center and East Carolina University.

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