Abstract
BackgroundIncreased physical activity is inversely related to the risk to develop cardiovascular disease (CVD). In a recent systematic review, it was reported that CVD patients had an increased cholesterol absorption and a decreased synthesis as compared with control participants. As increased physical activity levels reduce CVD risk, we hypothesized that exercise training will reduce cholesterol absorption and increase endogenous cholesterol synthesis in older overweight and obese men.MethodsA randomized, controlled, crossover trial was performed. Seventeen apparently healthy older overweight and obese men were randomized to start with an aerobic exercise or no-exercise control period for 8 weeks, separated by 12 weeks washout. Fasting serum total cholesterol (TC) and non-cholesterol sterol concentrations were measured at baseline, and after 4 and 8 weeks.ResultsThe aerobic exercise program did not affect serum TC concentrations. In addition, exercise did not affect TC-standardized serum concentrations of sitosterol and cholestanol that are markers for cholesterol absorption. However, a trend for reduced TC-standardized campesterol concentrations, which is another validated marker for cholesterol absorption, was observed as compared with control. Lathosterol concentrations, reflecting cholesterol synthesis, did not differ between both periods.ConclusionsAerobic exercise training for 8 weeks did not lower serum TC concentrations in older overweight and obese men, but a trend towards a decrease in the cholesterol absorption marker campesterol was found. The cholesterol synthesis marker lathosterol did not change.Trial registrationposted on www.clinicaltrials.gov as NCT03272061 on 7 September 2017.
Highlights
Increased physical activity is inversely related to the risk to develop cardiovascular disease (CVD) [1]
The number of involved study participants in these studies was in general small and a meta-analysis including six randomized controlled trials and data from 192 men and women with intervention periods ranging from 10 to 104 weeks concluded that serum total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C) and high-density lipoprotein cholesterol (HDL-C) concentrations were not improved after aerobic exercise training [8]
Chronic kidney disease (CKD) patients on hemodialysis are characterized by higher cholesterol absorption and lower cholesterol synthesis compared to controls [15, 16]
Summary
Increased physical activity is inversely related to the risk to develop cardiovascular disease (CVD) [1]. Even without affecting serum TC concentrations, aerobic exercise may still affect processes underlying cholesterol homeostasis These processes e.g., intestinal cholesterol absorption and endogenous cholesterol synthesis do determine serum TC concentrations, but may be related to certain metabolic diseases. Circulating levels of campesterol, sitosterol and cholestanol reflect intestinal cholesterol absorption, while lathosterol and desmosterol levels are markers of endogenous cholesterol synthesis [10] Using these markers, patients can be classified as cholesterol absorber or synthesizer [11,12,13,14]. In a recent systematic review, it was reported that CVD patients have an increased cholesterol absorption and decreased cholesterol synthesis as compared with control participants [17]. In a recent systematic review, it was reported that CVD patients had an increased cholesterol absorption and a decreased synthesis as compared with control participants. As increased physical activity levels reduce CVD risk, we hypothesized that exercise training will reduce cholesterol absorption and increase endogenous cholesterol synthesis in older overweight and obese men
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