Abstract
BackgroundVisceral obesity and insulin resistance are associated with a postprandial accumulation of atherogenic chylomicron remnants that is difficult to modulate with lipid-lowering therapies. Dietary fish oil and exercise are cardioprotective interventions that can significantly modify the metabolism of TAG-rich lipoproteins. In this study, we investigated whether chronic exercise and fish oil act in combination to affect chylomicron metabolism in obese men with moderate insulin resistance.MethodsThe single blind study tested the effect of fish oil, exercise and the combined treatments on fasting and postprandial chylomicron metabolism. Twenty nine men with metabolic syndrome were randomly assigned to take fish oil or placebo for four weeks, before undertaking an additional 12 week walking program. At baseline and at the end of each treatment, subjects were tested for concentrations of fasting apo B48, plasma lipids and insulin. Postprandial apo B48 and TAG kinetics were also determined following ingestion of a fat enriched meal.ResultsCombining fish oil and exercise resulted in a significant reduction in the fasting apo B48 concentration, concomitant with attenuation of fasting TAG concentrations and the postprandial TAGIAUC response (p < 0.05). Fish oil by itself reduced the postprandial TAG response (p < 0.05) but not postprandial apo B48 kinetics. Individual treatments of fish oil and exercise did not correspond with improvements in fasting plasma TAG and apo B48.ConclusionFish oil was shown to independently improve plasma TAG homeostasis but did not resolve hyper-chylomicronaemia. Instead, combining fish oil with chronic exercise reduced the plasma concentration of pro-atherogenic chylomicron remnants; in addition it reduced the fasting and postprandial TAG response in viscerally obese insulin resistant subjects.
Highlights
Introduction of exercise concomitant withfish oil (FO) supplementation had a substantial lowering effect on fasting plasma TAG concentration (p = 0.026) and TAGIAUC (p = 0.004) that was not apparent with the provision of exercise without FO supplementation
To begin with 16 subjects participated in the fish oil group and after week four, two subjects withdrew for personal reasons
Data for fish oil group at baseline (BF) and FO are reported for 16 subjects and 14 subjects for the fish oil + exercise (FOX) intervention
Summary
We investigated whether chronic exercise and fish oil act in combination to affect chylomicron metabolism in obese men with moderate insulin resistance. In dyslipidaemic diabetic subjects, others have found that the fasting apo B48 concentration was not significantly lowered by fluvastatin alone, but when fish oil was concurrently administered, the change was significant [13]. Based on these findings, we suggest that interventions designed to regulate lipoprotein kinetics may need to be more aggressive to modulate the chylomicron fraction, compared to interventions that reduce hepatically derived apo B
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