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Physical activity for preventing and treating obesity-related dyslipoproteinemias

STEFANICK, MARCIA L.

Medicine & Science in Sports & Exercise: November 1999 - Volume 31 - Issue 11 - p S609
Roundtable Consensus Statement

STEFANICK, M. L. Physical activity for preventing and treating obesity-related dyslipoproteinemias. Med. Sci. Sports Exerc., Vol. 31, No. 11, Suppl., pp. S609–S618, 1999.

Purpose The clinical trial data were reviewed on effects of physical activity on obesity-related dyslipoproteinemias (specifically low HDL-cholesterol (HDL-C), elevated triglycerides (TG), and high total and LDL-cholesterol (TC and LDL-C)) in adult men and women.

Methods Effort was made to identify all randomized clinical trials (RCT), with exercise intervention programs of at least 4 months’ duration, which had lipoprotein outcomes. Those that had both an exercise only intervention and control groups or both a diet plus exercise and identical diet only intervention groups were reviewed. Tables were developed of baseline characteristics and weight and lipoprotein changes for aerobic exercise trials by body mass index: 1) < 25.0 kg·m−2, 2) 25.0–29.9 kg·m−2, and 3) ≥ 30.0 kg·m−2 and for studies involving resistance exercise or increased energy expenditure from daily activities versus structured exercise programs.

Results Very few RCT were found that specifically addressed the role of physical activity in preventing or treating obesity-related adverse lipoprotein levels. There was essentially no evidence found in lean or overweight men or women to support a specific role for exercise in improving undesirable lipoprotein levels; however, trial data strongly suggest that the addition of exercise to a hypocaloric, reduced-fat diet improves HDL-C and TG in men and women with generally desirable initial levels and reduces LDL-C in men and women with initially elevated LDL-C levels. The evidence is also reasonably strong that weight loss, including that achieved solely by exercise, improves HDL-C and TG in obese men, without reducing LDL-C, whereas it remains weak for women. There are also virtually no trial data to support a role for resistance exercise or an increase in daily living activities for improving obesity-related lipoproteins.

Conclusions Current evidence from RCT is too limited to determine whether physical activity can raise low HDL-C or lower high TG or LDL-C levels in overweight and obese individuals.

Stanford Center for Research in Disease Prevention, Department of Medicine, Stanford University, Stanford, CA 94304–1583

Address for correspondence: Marcia L. Stefanick, Ph.D., Stanford Center for Research in Disease Prevention, 730 Welch Rd., Suite B, Palo Alto, CA. 94304-1583; E-mail: stefanick@scrdp.stanford.edu.

Roundtable held February 4–7, 1999, Indianapolis, IN.

© 1999 Lippincott Williams & Wilkins, Inc.