The effects on plasma lipoproteins of a prudent weight-reducing diet, with or without exercise, in overweight men and women.

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.

[1]  C. Caspersen,et al.  Physical activity and the incidence of coronary heart disease. , 1987, Annual review of public health.

[2]  W. Haskell,et al.  Cardiorespiratory Responses of Cardiac Transplant Patients to Graded, Symptom‐limited Exercise , 1980, Circulation.

[3]  R. Levy,et al.  Estimation of the concentration of low-density lipoprotein cholesterol in plasma, without use of the preparative ultracentrifuge. , 1972, Clinical chemistry.

[4]  K. Anderson,et al.  An updated coronary risk profile. A statement for health professionals. , 1991, Circulation.

[5]  Manning Feinleib,et al.  Obesity as an Independent Risk Factor for Cardiovascular Disease: A 26‐year Follow‐up of Participants in the Framingham Heart Study , 1983, Circulation.

[6]  P. Fu,et al.  Enzymatic determination of total serum cholesterol. , 1974, Clinical chemistry.

[7]  W. Siri.  Body composition from fluid spaces and density: analysis of methods. 1961. , 1993, Nutrition.

[8]  W. Haskell,et al.  Effects of weight loss on clinic and ambulatory blood pressure in normotensive men. , 1988, The American journal of cardiology.

[9]  K. Vranizan,et al.  Changes in plasma lipids and lipoproteins in overweight men during weight loss through dieting as compared with exercise. , 1988, The New England journal of medicine.

[10]  K. Pennert,et al.  Distribution of adipose tissue and risk of cardiovascular disease and death: a 12 year follow up of participants in the population study of women in Gothenburg, Sweden. , 1984, British medical journal.

[11]  R. Krauss,et al.  Regulation of high density lipoprotein levels. , 1982, The Medical clinics of North America.

[12]  B Rosner,et al.  A prospective study of obesity and risk of coronary heart disease in women. , 1990, The New England journal of medicine.

[13]  R. Blevins,et al.  New assay of apolipoproteins A-I and B by rate nephelometry evaluated. , 1987, Clinical chemistry.

[14]  Arthur F. Krieg,et al.  Faster enzymatic procedure for serum triglycerides. , 1975, Clinical chemistry.

[15]  K. Cureton,et al.  Exercise and obesity: etiology, physiology, and intervention. , 1982, Psychological bulletin.

[16]  J. Albers,et al.  Dextran sulfate-Mg2+ precipitation procedure for quantitation of high-density-lipoprotein cholesterol. , 1982, Clinical chemistry.

[17]  P. Björntorp,et al.  Abdominal adipose tissue distribution, obesity, and risk of cardiovascular disease and death: 13 year follow up of participants in the study of men born in 1913. , 1984, British medical journal.

[18]  H. Naito.  The Association of Serum Lipids, Lipoproteins, and Apolipoproteins with Coronary Artery Disease Assessed by Coronary Arteriography , 1985, Annals of the New York Academy of Sciences.