Division of Rheumatology, Duke University Medical Center, Durham, NC, USA.
Am Heart J. 2012 Jul;164(1):117-24. doi: 10.1016/j.ahj.2012.04.014.
The standard clinical approach for reducing cardiovascular disease risk due to dyslipidemia is to prescribe changes in diet and physical activity. The purpose of the current study was to determine if, across a range of dietary patterns, there were variable lipoprotein responses to an aerobic exercise training intervention.
Subjects were participants in the STRRIDE I, a supervised exercise program in sedentary, overweight subjects randomized to 6 months of inactivity or 1 of 3 aerobic exercise programs. To characterize diet patterns observed during the study, we calculated a modified z-score that included intakes of total fat, saturated fat, trans fatty acids, cholesterol, omega-3 fatty acids, and fiber as compared with the 2006 American Heart Association diet recommendations. Linear models were used to evaluate relationships between diet patterns and exercise effects on lipoproteins/lipids.
Independent of diet, exercise had beneficial effects on low-density lipoprotein cholesterol particle number, low-density lipoprotein cholesterol size, high-density lipoprotein cholesterol, high-density lipoprotein cholesterol size, and triglycerides (P < .05 for all). However, having a diet pattern that closely adhered to American Heart Association recommendations was not related to changes in these or any other serum lipids or lipoproteins in any of the exercise groups.
We found that even in sedentary individuals whose habitual diets vary in the extent of adherence to AHA dietary recommendations, a rigorous, supervised exercise intervention can achieve significant beneficial lipid effects.
降低血脂异常导致的心血管疾病风险的标准临床方法是改变饮食和进行身体活动。本研究的目的是确定在一系列饮食模式下,有氧运动训练干预对脂蛋白的反应是否存在差异。
研究对象为 STRIDE I 的参与者,这是一项针对久坐、超重者的监督性运动计划,参与者被随机分配到 6 个月的不活动或 3 种有氧运动方案中的 1 种。为了描述研究期间观察到的饮食模式,我们计算了一个改良的 z 分数,该分数包括与 2006 年美国心脏协会饮食建议相比的总脂肪、饱和脂肪、反式脂肪酸、胆固醇、ω-3 脂肪酸和纤维的摄入量。线性模型用于评估饮食模式与运动对脂蛋白/脂质的影响之间的关系。
无论饮食如何,运动对低密度脂蛋白胆固醇颗粒数、低密度脂蛋白胆固醇大小、高密度脂蛋白胆固醇、高密度脂蛋白胆固醇大小和甘油三酯都有有益的影响(所有 P 值均<.05)。然而,饮食模式与美国心脏协会建议的密切一致与运动组中这些或任何其他血清脂质或脂蛋白的变化无关。
我们发现,即使在习惯饮食与 AHA 饮食建议的遵守程度不同的久坐个体中,严格的监督性运动干预也可以实现显著的有益的脂质效应。