Weight loss is superior to exercise in improving the atherogenic lipid profile in a sedentary, overweight population with stable coronary artery disease: A randomized trial

TY - JOUR

T1 - Weight loss is superior to exercise in improving the atherogenic lipid profile in a sedentary, overweight population with stable coronary artery disease

T2 - A randomized trial

AU - Pedersen, Lene Rørholm

AU - Olsen, Rasmus Huan

AU - Anholm, Christian

AU - Walzem, Rosemary L

AU - Fenger, Mogens

AU - Eugen-Olsen, Jesper

AU - Haugaard, Steen Bendix

AU - Prescott, Eva

N1 - Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

PY - 2016/3/1

Y1 - 2016/3/1

N2 - Background: Dyslipidemia and low-grade inflammation are integral in the pathogenesis of atherosclerosis. We aim to compare the effects of a considerable weight loss and intensive exercise training on lipid atherogenicity and low-grade inflammation in a high-risk population with coronary artery disease (CAD). Methods: Seventy non-diabetic participants with CAD, BMI 28-40 kg/m2, age 45-75 years were randomized to 12 weeks' aerobic interval training (AIT) at 85-90% of peak heart rate three times/week or a low energy diet (LED, 800-1000 kcal/day) for 8-10 weeks followed by 2-4 weeks' weight maintenance diet. Lipid profile atherogenicity was described using lipoprotein particle size and density profiling. Low-grade inflammation was evaluated by tumor necrosis factor alpha (TNFα), C-reactive protein, interleukin 6 and soluble urokinase plasminogen activator receptor. Results: Twenty-six (74%) AIT and 29 (83%) LED participants completed intervention per protocol. AIT and LED decreased total (AIT: -518 (906;-129),P = 0.011, LED: -767 (-1128:-406),P < 0.001) and low-density lipoprotein (LDL, AIT: -186 (-306;-65),P = 0.004, LED: -277 (-433;-122),P < 0.001) assessed as the area under the density profile curve. LED was superior to AIT in decreasing atherogenicity reflected by increased LDL (between-group: 1.0 Å (0.4; 1.7),P = 0.003) and high-density lipoprotein (between-group: 1.2 Å (0.2; 2.4),P = 0.026) particle size and a decreased proportion of total lipoprotein constituted by the small, dense LDL5 subfraction (between-group: -5.0% (-8.4;-1.7),P = 0.004). LED decreased TNFα (9.5% (-15.8;-2.6),P = 0.009). No changes were seen following AIT. Conclusion: LED and AIT decreased total and LDL lipoprotein. LED was superior in decreasing atherogenicity assessed by a shift in density profile and increased particle size. Effect on low-grade inflammation was limited.

AB - Background: Dyslipidemia and low-grade inflammation are integral in the pathogenesis of atherosclerosis. We aim to compare the effects of a considerable weight loss and intensive exercise training on lipid atherogenicity and low-grade inflammation in a high-risk population with coronary artery disease (CAD). Methods: Seventy non-diabetic participants with CAD, BMI 28-40 kg/m2, age 45-75 years were randomized to 12 weeks' aerobic interval training (AIT) at 85-90% of peak heart rate three times/week or a low energy diet (LED, 800-1000 kcal/day) for 8-10 weeks followed by 2-4 weeks' weight maintenance diet. Lipid profile atherogenicity was described using lipoprotein particle size and density profiling. Low-grade inflammation was evaluated by tumor necrosis factor alpha (TNFα), C-reactive protein, interleukin 6 and soluble urokinase plasminogen activator receptor. Results: Twenty-six (74%) AIT and 29 (83%) LED participants completed intervention per protocol. AIT and LED decreased total (AIT: -518 (906;-129),P = 0.011, LED: -767 (-1128:-406),P < 0.001) and low-density lipoprotein (LDL, AIT: -186 (-306;-65),P = 0.004, LED: -277 (-433;-122),P < 0.001) assessed as the area under the density profile curve. LED was superior to AIT in decreasing atherogenicity reflected by increased LDL (between-group: 1.0 Å (0.4; 1.7),P = 0.003) and high-density lipoprotein (between-group: 1.2 Å (0.2; 2.4),P = 0.026) particle size and a decreased proportion of total lipoprotein constituted by the small, dense LDL5 subfraction (between-group: -5.0% (-8.4;-1.7),P = 0.004). LED decreased TNFα (9.5% (-15.8;-2.6),P = 0.009). No changes were seen following AIT. Conclusion: LED and AIT decreased total and LDL lipoprotein. LED was superior in decreasing atherogenicity assessed by a shift in density profile and increased particle size. Effect on low-grade inflammation was limited.

KW - Journal Article

KW - Research Support, Non-U.S. Gov't

U2 - 10.1016/j.atherosclerosis.2016.01.001

DO - 10.1016/j.atherosclerosis.2016.01.001

M3 - Journal article

C2 - 26803431

SN - 0021-9150

VL - 246

SP - 221

EP - 228

JO - Atherosclerosis

JF - Atherosclerosis

ER -