Key result
Lifestyle modification with exercise and dietary instruction significantly increased the LDL/ApoB ratio and decreased apolipoprotein B levels, indicating a reduction in atherogenic small dense LDL particles.
Why the study?
Does exercise training and dietary instruction improve lipid parameters and cardio-respiratory fitness in individuals with mildly abnormal cardiovascular risk factors?
RCT (n=217)
Open-label
Randomly allocated by drawing lots
No
Does exercise training and dietary instruction improve lipid parameters and cardio-respiratory fitness in individuals with mildly abnormal cardiovascular risk factors?
Lifestyle modifications including exercise and dietary instruction improve cardio-respiratory fitness, which correlates with favorable qualitative and quantitative changes in LDL particles.
Answers are grounded in this paper and cite their sources.
Supports prescribing exercise and diet to lower atherogenic LDL in mild-risk patients; extends RCT evidence on qualitative lipid improvements.
OBJECTIVE: To investigate the correlation between lifestyle improvements, in particular increased cardio-respiratory fitness and changes in the blood lipid profile. METHODS: The participants were 217 residents of Fuji and Yamato Towns, Saga City, with mildly abnormal blood pressure, serum lipids or blood glucose detected at health check-ups in 2003. Participants were randomly allocated to an Intervention (108 subjects) or Control group (109 subjects), matched for age and various conditions. The Intervention group was given exercise advice and prescription and dietary instructions. Cardio-respiratory fitness was evaluated using the work rate at double product breaking point. Changes of lipid parameters were compared before and after intervention, and examined the relationship with cardio-respiratory fitness. RESULTS: Seventy nine subjects in each group could be followed up for 17 months without requiring pharmacotherapy. Body mass index, waist circumference, systolic blood pressure, homeostasis model assessment insulin resistance, and triglycerides were decreased in the Intervention group. Furthermore, apolipoprotein B levels were lower (p<0.05), and the ratio of LDL cholesterol to apolipoprotein B (LDL/ApoB) was higher (p<0.001). When all subjects were divided into 3 subgroups according to the degree of improvement in cardio-respiratory fitness, LDL/ApoB increased and apolipoprotein B decreased as the degree of improvement increased (p<0.05). CONCLUSION: Improvement was seen in atherosclerotic risk factors through lifestyle modification. In particular, improved cardiorespiratory fitness was associated with qualitative and quantitative changes in LDLs.
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Kawano et al. (2009) conducted an RCT in Mildly abnormal blood pressure, serum lipids, or blood glucose (n=217). Lifestyle modification (exercise training and dietary instruction) vs. Control group (lifestyle disease seminars and health-related information only) was evaluated on Ratio of LDL cholesterol to apolipoprotein B (LDL/ApoB) at 17 months (p=<0.001). Lifestyle modification with exercise and dietary instruction significantly increased the LDL/ApoB ratio and decreased apolipoprotein B levels, indicating a reduction in atherogenic small dense LDL particles.
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