Abstract
Background: There is consolidated evidence that physical activity exerts beneficial effects on several chronic conditions and longevity, on the basis of its proposed biological effects, especially on lipid profiles. However, debate continues regarding the intensity of activity required for good health, as vigorous physical activity might overwhelm advantageous changes. In addition, little is known so far on the effect of a vigorous and regular aerobic training regimen on emerging markers of cardiovascular risk, such as lipoprotein(a), total/high-density lipoprotein cholesterol ratio and the atherogenic index of plasma.
Methods: To further investigate this topic, an extensive lipid profile, in accordance with the most recent guidelines issued by the American Heart Association (AHA)/American College of Cardiology (ACC) and the National Cholesterol Education Program (NCEP), was evaluated in 60 healthy male sedentary controls and in a wide population of professional endurance athletes, including 40 male professional cross-country skiers and 102 male professional road cyclists.
Results: Total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), triglycerides, TC low-density lipoprotein cholesterol (LDL-C) ratio and the atherogenic index of plasma were significantly lower in both categories of professional athletes, whereas the mean HDL-C concentration was significantly higher. The concentration of lipoprotein(a) did not differ significantly between the groups. When compared to current NCEP or AHA/ACC goals, the percentage of patients with undesirable values was statistically different for all parameters tested, apart from lipoprotein(a). According to multiple stepwise logistic regression analysis, lower TC/HDL-C ratio in professional skiers and lower TC/HDL-C ratio and TC in professional cyclists were significantly associated with increased aerobic physical activity.
Conclusions: Results of this case-control study confirm that elevated aerobic energy expenditure might be associated with a highly favorable stabilization of most traditional and emerging cardiovascular risk predictors. Therefore, a substantial increase in aerobic physical activity within the population might be recommended to reverse adverse lipid abnormalities, especially in subjects with a higher cardiovascular risk.
References
1. Blair SN, LaMonte MJ, Nichaman MZ. The evolution of physical activity recommendations: how much is enough? Am J Clin Nutr 2004; 79:913S–20S.10.1093/ajcn/79.5.913SSearch in Google Scholar PubMed
2. McKechnie R, Mosca L. Physical activity and coronary heart disease: prevention and effect on risk factors. Cardiol Rev 2003; 11:21–5.10.1097/00045415-200301000-00005Search in Google Scholar PubMed
3. Go VL, Wong DA, Wang Y, Butrum RR, Norman HA, Wilkerson L. Diet and cancer prevention: evidence-based medicine to genomic medicine. J Nutr 2004; 134(Suppl 12):3513S–16S.10.1093/jn/134.12.3513SSearch in Google Scholar PubMed
4. Painter P. Exercise for patients with chronic disease: physician responsibility. Curr Sports Med Rep 2003; 2:173–80.10.1249/00149619-200306000-00011Search in Google Scholar PubMed
5. Manson JE, Hu FB, Rich-Edwards JW, Colditz GA, Stampfer MJ, Willett WC, et al. A prospective study of walking as compared with vigorous exercise in the prevention of coronary heart disease in women. N Engl J Med 1999; 341:650–8.10.1056/NEJM199908263410904Search in Google Scholar PubMed
6. Tanasescu M, Leitzmann MF, Rimm EB, Willett WC, Stampfer MJ, Hu FB. Exercise type and intensity in relation to coronary heart disease in men. J Am Med Assoc 2002; 288:1994–2000.10.1001/jama.288.16.1994Search in Google Scholar PubMed
7. Lee IM, Sesso HD, Oguma Y, Paffenbarger RS Jr. Relative intensity of physical activity and risk of coronary heart disease. Circulation 2003; 107:1110–6.10.1161/01.CIR.0000052626.63602.58Search in Google Scholar
8. Fletcher GF, Blair SN, Blumenthal J, Caspersen C, Chaitman B, Epstein S, et al. 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 1992; 86:340–4.10.1161/01.CIR.86.1.340Search in Google Scholar PubMed
9. NIH Consensus Development Panel on Physical Activity and Cardiovascular Health. Physical activity and cardiovascular health. J Am Med Assoc 1996;276:241–6.10.1001/jama.276.3.241Search in Google Scholar
10. Burtscher M, Pachinger O, Mittleman MA, Ulmer H. Prior myocardial infarction is the major risk factor associated with sudden cardiac death during downhill skiing. Int J Sports Med 2000; 21:613–5.10.1055/s-2000-8481Search in Google Scholar PubMed
11. Hosey RG, Armsey TD. Sudden cardiac death. Clin Sports Med 2003; 22:51–66.10.1016/S0278-5919(02)00071-6Search in Google Scholar
12. Maron BJ, Chaitman BR, Ackerman MJ, Bayes de Luna A, Corrado D, Crosson JE, et al., Working Groups of the American Heart Association Committee on Exercise, Cardiac Rehabilitation, and Prevention; Councils on Clinical Cardiology and Cardiovascular Disease in the Young. Recommendations for physical activity and recreational sports participation for young patients with genetic cardiovascular diseases. Circulation 2004; 109:2807–16.10.1161/01.CIR.0000128363.85581.E1Search in Google Scholar
13. Grundy SM, Pasternak R, Greenland P, Smith S Jr, Fuster V. Assessment of cardiovascular risk by use of multiple-risk-factor assessment equations: a statement for healthcare professionals from the American Heart Association and the American College of Cardiology. Circulation 1999; 100:1481–92.10.1161/01.CIR.100.13.1481Search in Google Scholar
14. Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults. Executive Summary of the Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). J Am Med Assoc 2001;285:2486–97.10.1001/jama.285.19.2486Search in Google Scholar
15. Sih BL, Stuhmiller JH. The metabolic cost of force generation. Med Sci Sports Exerc 2003; 35:623–9.10.1249/01.MSS.0000058435.67376.49Search in Google Scholar
16. Friedewald WT, Levy RI, Fredrickson DS. Estimation of the concentration of low-density lipoprotein cholesterol in plasma without use of the preparative ultracentrifuge. Clin Chem 1972; 18:499–502.10.1093/clinchem/18.6.499Search in Google Scholar
17. Dobiasova M. Atherogenic index of plasma [log(tri-glycerides/HDL–cholesterol)]: theoretical and practical implications. Clin Chem 2004; 50:1113–5.10.1373/clinchem.2004.033175Search in Google Scholar
18. Brukner PD, Brown WJ. Is exercise good for you? Med J Aust 2005; 183:538–41.10.5694/j.1326-5377.2005.tb07159.xSearch in Google Scholar
19. Durstine JL, Thompson PD. Exercise in the treatment of lipid disorders. Cardiol Clin 2001; 19:471–88.10.1016/S0733-8651(05)70230-7Search in Google Scholar
20. Drygas W, Kostka T, Jegier A, Kunski H. Long-term effects of different physical activity levels on coronary heart disease risk factors in middle-aged men. Int J Sports Med 2000; 21:235–41.10.1055/s-2000-309Search in Google Scholar PubMed
21. Sgouraki E, Tsopanakis A, Kioussis A, Tsopanakis C. Acute effects of short duration maximal endurance exercise on lipid, phospholipid and lipoprotein levels. J Sports Med Phys Fitness 2004; 44:444–50.Search in Google Scholar
22. Mackinnon LT, Hubinger LM. Effects of exercise on lipoprotein(a). Sports Med 1999; 28:11–24.10.2165/00007256-199928010-00002Search in Google Scholar
23. Lippi G, Guidi G. Lipoprotein(a): an emerging cardiovascular risk factor. Crit Rev Clin Lab Sci 2003; 40:1–42.10.1080/713609328Search in Google Scholar
24. Lippi G, Braga V, Adami S, Guidi G. Modification of serum apolipoprotein A-I, apolipoprotein B and lipoprotein(a) levels after bisphosphonates-induced acute phase response. Clin Chim Acta 1998; 271:79–87.10.1016/S0009-8981(97)00212-XSearch in Google Scholar
25. Ramharack R, Barkalow D, Spahr MA. Dominant negative effect of TGF-β1 and TNF-α on basal and IL-6-induced lipoprotein(a) and apolipoprotein(a) mRNA expression in primary monkey hepatocyte cultures. Arterioscler Thromb Vasc Biol 1998; 18:984–90.10.1161/01.ATV.18.6.984Search in Google Scholar PubMed
26. Byrne DJ, Jagroop IA, Montgomery HE, Thomas M, Mikhailidis DP, Milton NG, et al. Lipoprotein(a) does not participate in the early acute phase response to training or extreme physical activity and is unlikely to enhance any associated immediate cardiovascular risk. J Clin Pathol 2002; 55:280–5.10.1136/jcp.55.4.280Search in Google Scholar PubMed PubMed Central
27. Kinosian B, Glick H, Garland G. Cholesterol and coronary heart disease: predicting risks by levels and ratios. Ann Intern Med 1994; 121:641–7.10.7326/0003-4819-121-9-199411010-00002Search in Google Scholar PubMed
28. Kelley GA, Kelley KS, Tran ZV. Walking, lipids, and lipo-proteins: a meta-analysis of randomized controlled trials. Prev Med 2004; 38:651–61.10.1016/j.ypmed.2003.12.012Search in Google Scholar PubMed
29. Twisk JW, Kemper HC, van Mechelen W. Prediction of cardiovascular disease risk factors later in life by physical activity and physical fitness in youth: introduction. Int J Sports Med 2002; 23(Suppl 1):S5–7.10.1055/s-2002-28454Search in Google Scholar PubMed
30. Boreham C, Twisk J, Neville C, Savage M, Murray L, Gallagher A. Associations between physical fitness and activity patterns during adolescence and cardiovascular risk factors in young adulthood: the Northern Ireland Young Hearts Project. Int J Sports Med 2002; 23(Suppl 1):S22–6.10.1055/s-2002-28457Search in Google Scholar PubMed
31. Janz KF, Dawson JD, Mahoney LT. Increases in physical fitness during childhood improve cardiovascular health during adolescence: the Muscatine Study. Int J Sports Med 2002; 23(Suppl 1):S15–21.10.1055/s-2002-28456Search in Google Scholar PubMed
32. Twisk JW, Kemper HC, van Mechelen W. The relationship between physical fitness and physical activity during adolescence and cardiovascular disease risk factors at adult age. The Amsterdam Growth and Health Longitudinal Study. Int J Sports Med 2002; 23(Suppl 1):S8–14.10.1055/s-2002-28455Search in Google Scholar PubMed
33. Duscha BD, Slentz CA, Johnson JL, Houmard JA, Bensimhon DR, Knetzger KJ, et al. Effects of exercise training amount and intensity on peak oxygen consumption in middle-age men and women at risk for cardiovascular disease. Chest 2005; 128:2788–93.10.1378/chest.128.4.2788Search in Google Scholar PubMed
©2006 by Walter de Gruyter Berlin New York
