Prescribing Aerobic Exercise for the Regulation of Postprandial Lipid Metabolism

Department of Surgery, The University of Texas Medical Branch, Galveston, Texas, USA.
Sports Medicine (Impact Factor: 5.04). 02/2006; 36(7):547-60. DOI: 10.2165/00007256-200636070-00001
Source: PubMed


Prolonged presence of elevated plasma triglycerides (TGs) during the postprandial period has been suggested to increase the risk for coronary artery disease. Aerobic exercise attenuates postprandial lipaemia and this has generally been described as a short-term effect of the exercise. Effects of exercise on postprandial lipaemia have mostly been investigated, and documented, with large exercise-induced energy expenditures (i.e. 1000 kcal). The exact mechanisms involved in the attenuation of postprandial lipaemia with exercise are not completely understood, but it appears that at least two mechanisms are involved: a decrease in TG secretion by the liver and an increase in plasma TG clearance by the muscle. Changes in the metabolism of other lipids, such as those in high-density lipoprotein cholesterol, have been documented only when the exercise is performed some hours before the fat meal. Although factors such as the physical fitness and percentage body fat of an individual are likely to also be involved, the most important factors determining the magnitude of the attenuation in postprandial lipaemia appear to be the magnitude of the exercise-induced energy expenditure and the intensity of exercise. To date, the evidence suggests that healthy individuals can generally induce favourable changes in postprandial lipaemia with aerobic exercise that: (i) is completed during the period extending from 16 hours before a meal through 1.5 hours after a meal; (ii) is of moderate intensity; and (iii) results in an energy expenditure of approximately 500 kcal (or more).

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    • "Skeletal muscle LPL activity peaks at 4 hr and appears to decline 20 hr after exercise (Katsanos, 2006; Seip & Semenkovich, 1998). Consequently, it has been suggested that exercise 12–16 hr before a meal containing saturated fat produces optimal postprandial TG effects (Katsanos, 2006). The current investigation showed attenuated TG levels 13.5–17 hr after the cessation of exercise. "
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    ABSTRACT: High-intensity intermittent exercise (HIIE) such as the 30-s Wingate test attenuates postprandial triacylglycerol (TG), however, the ability of shorter versions of HIIE to reduce postprandial TG is undetermined. Thus, the effect of 8-s sprinting bouts of HIIE on blood TG levels of 12 females after consumption of a high-fat meal (HFM) was examined. Twelve young, sedentary women (BMI 25.1 ± 2.3 kg/m2; age 21.3 ± 2.1 years) completed a maximal oxygen uptake test and then on different days underwent either an exercise or a no-exercise postprandial TG condition. Both conditions involved consuming a HFM after a 12-hr fast. The HFM, in milkshake form provided 4170 kJ (993 Kcal) of energy and 98 g fat. Order was counter-balanced. In the exercise condition participants completed 20-min of HIIE cycling consisting of repeated bouts of 8 s sprint cycling (100-115 rpm) and 12 s of active rest (easy pedaling) 14 hr before consuming the HFM. Blood samples were collected hourly after the HFM for 4 hr. Total postprandial TG was 13% lower, p = .004, in the exercise (5.84 ± 1.08 mmol L-1 4 h-1)compared to the no-exercise condition (6.71 ± 1.63 mmol L-1 4 h-1). In conclusion, HIIE significantly attenuated postprandial TG in sedentary young women.
    Full-text · Article · Oct 2013 · International Journal of Sport Nutrition and Exercise Metabolism
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    • "In addition, hepatic uptake and recycling of circulating lipoproteins in the postprandial period may be related to exercise and the associated attenuation of PPL, as this was not observed in the control trial, indicating that fatty acid oxidation in the liver was elevated, which, in turn, would reduce the availability of TG for incorporation into VLDL cholesterol [15]. Katsanos [33] suggests that when exercise is completed immediately before the ingestion of a HFM, the mechanism involving the reduction of hepatic secretion of triglyceride-rich VLDL cholesterol may play a more important role in attenuating PPL than the increase in LPL activity. However, we cannot overlook the fact that hepatic uptake and recycling of circulating lipoproteins from a previous meal may affect the response to a subsequent meal, as well as the macronutrient content and timing of subsequent meals would affect daylong response to the first meal. "
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    ABSTRACT: Objective: To investigate the effect of aerobic exercise intensity on postprandial lipemia according to allelic variants of the apolipoprotein E gene. Methods: Three groups of 10 healthy men each were formed based genotyping of the APOE gene, rested or performed 500 Kcal tests in a random sequence separated by a minimum 48 h interval, as follows: (a) no exercise (control), (b) intense intermittent exercise, (c) moderate continuous exercise. Each test series was completed 30-min before ingestion of a high-fat meal (1 g fat/kg). Venous blood was collected before and at 1, 2, 3 and 4 h after the high-fat meal. Postprandial lipemia was assessed using the area under the curve approach as well as the kinetic profile of mean lipid variables. Statistical significance was adopted at P ≤ 0.05 level. Results: The main results show that, in the moderate continuous exercise, total postprandial cholesterolemia was higher in ɛ4 than in ɛ2 carriers, whereas under intense intermittent exercise, total and LDL cholesterolemia were higher in ɛ4 than in ɛ2 and ɛ3 carriers. There was no difference in the lipemic profile of the subjects across APOE genotypes at baseline. Conclusion: Moderate and intense exercise were effective in attenuating PPL in both ɛ2 and ɛ3 subjects, with ɛ2 subjects being more susceptible to the lipid lowering effect of moderate training than ɛ3 subjects. Carriers of the ɛ4 allele, however, showed no attenuation of postprandial lipemia.
    Full-text · Article · Apr 2013 · Atherosclerosis
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    • "In this way, the problem (ROS production) is controlled before it presents itself and subsequently needs to be dealt with (via increased antioxidant defense). Interventions (both chronic and acute) aimed at minimizing the TAG response to feeding should be investigated (as has been done successfully with exercise [36]), with a particular focus on understanding the molecular mechanisms relating elevated TAG and increased oxidative stress and disease. "
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    ABSTRACT: We have recently reported that short-term (21-day) dietary modification in accordance with a stringent vegan diet (i.e., a Daniel Fast) lowers blood lipids as well as biomarkers of oxidative stress. However, this work only involved measurements obtained in a fasted state. In the present study, we determined the postprandial response to a high-fat milkshake with regards to blood triglycerides (TAG), biomarkers of oxidative stress, and hemodynamic variables before and following a 21-day Daniel Fast. Twenty-two subjects (10 men and 12 women; aged 35 ± 3 years) completed a 21-day Daniel Fast. To induce oxidative stress, a milkshake (fat = 0.8 g·kg-1; carbohydrate = 1.0 g·kg-1; protein = 0.25 g·kg-1) was consumed by subjects on day one and day 22 in a rested and 12-hour fasted state. Before and at 2 and 4 h after consumption of the milkshake, heart rate (HR) and blood pressure were measured. Blood samples were also collected at these times and analyzed for TAG, malondialdehyde (MDA), hydrogen peroxide (H2O2), advanced oxidation protein products (AOPP), nitrate/nitrite (NOx), and Trolox Equivalent Antioxidant Capacity (TEAC). A time effect was noted for HR (p = 0.006), with values higher at 2 hr post intake of the milkshake as compared to pre intake (p < 0.05). Diastolic blood pressure was lower post fast as compared to pre fast (p = 0.02), and a trend for lower systolic blood pressure was noted (p = 0.07). Time effects were noted for TAG (p = 0.001), MDA (p < 0.0001), H2O2 (p < 0.0001), AOPP (p < 0.0001), and TEAC (p < 0.0001); all concentrations were higher at 2 h and 4 h post intake compared to pre intake, except for TEAC, which was lower at these times (p < 0.05). A condition effect was noted for NOx (p = 0.02), which was higher post fast as compared to pre fast. No pre/post fast × time interactions were noted (p > 0.05), with the area under the curve from pre to post fast reduced only slightly for TAG (11%), MDA (11%), H2O2 (8%), and AOPP (12%), with a 37% increase noted for NOx. Partaking in a 21-day Daniel Fast does not result in a statistically significant reduction in postprandial oxidative stress. It is possible that a longer time course of adherence to the Daniel Fast eating plan may be needed to observe significant findings.
    Full-text · Article · Mar 2012 · Nutrition Journal
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