Managing CMR

Managing Cardiometabolic Risk in Abdominally Obese Patients

Physical Activity and Exercise

Exercise and Atherogenic Dyslipidemia

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While post-exercise improvements in HDL cholesterol and triglyceride levels are reported fairly consistently (as reviewed above), there is scant evidence to suggest that exercise significantly reduces LDL cholesterol levels (65-67) ](70, 71). However, while many authors have concluded that exercise rarely has any effect on LDL cholesterol levels (66, 71), some have noted a modest (3%) reduction in response to increased physical activity (67). High numbers of small, dense LDL particles have been shown to predict incidence of CVD independent of total LDL cholesterol levels (73). Importantly, exercise has been shown to reduce the concentration of small, dense LDL particles and increase mean LDL particle size without altering total LDL cholesterol levels (72). Exercise may therefore improve morbidity risk without altering LDL cholesterol levels.


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66. Durstine JL, Grandjean PW, Davis PG, et al. Blood lipid and lipoprotein adaptations to exercise: a quantitative analysis. Sports Med 2001; 31: 1033-62.
67. Leon AS and Sanchez OA. Response of blood lipids to exercise training alone or combined with dietary intervention. Med Sci Sports Exerc 2001; 33: S502-15; discussion S28-9.
70. Halbert JA, Silagy CA, Finucane P, et al. Exercise training and blood lipids in hyperlipidemic and normolipidemic adults: a meta-analysis of randomized, controlled trials. Eur J Clin Nutr 1999; 53: 514-22.
71. Carroll S and Dudfield M. What is the relationship between exercise and metabolic abnormalities? A review of the metabolic syndrome. Sports Med 2004; 34: 371-418.
72. Kraus WE, Houmard JA, Duscha BD, et al. Effects of the amount and intensity of exercise on plasma lipoproteins. N Engl J Med 2002; 347: 1483-92.
73. Lamarche B, Tchernof A, Moorjani S, et al. Small, dense low-density lipoprotein particles as a predictor of the risk of ischemic heart disease in men. Prospective results from the Quebec Cardiovascular Study. Circulation 1997; 95: 69-75.