Physical exercise and the prevention of atherosclerosis and cholesterol gall stones.

There is accumulating evidence in man and experimental animals that even mild exercise, if regularly repeated, may alter the metabolism of lipids. Exercise has been reported as decreasing peripheral tissue cholesterol in red blood cells, working muscle, lungs and the liver. During physical activity, the output of cholesterol and bile acids into the bile increases. This probably leads to higher faecal losses of sterols which may lead to lower cholesterol levels in the peripheral tissues and in the bile, when exercise is repeated regularly. Preferential release of unsaturated fatty acids from the adipose tissue during exercise and the linoleic acid-dependent LCAT enzyme (transporting plasma cholesterol) may be partly responsible for this effect of exercise. The experimental data reviewed provide supportive basis for epidemiological studies reporting on the beneficial effect of regular exercise. Physical activity is an important factor in the phylogeny of all animal species, secondary only to food intake and reproduction. Exercise is readily available to all population groups. There is good evidence that the amount of exercise required for a protective effect is easily accessible for time-pressured and older individuals. Short bursts of activity repeated several times a day may be equally or more beneficial than prolonged exhaustive exercise. Modified exercise is also beneficial for patients with coronary heart disease and for elderly patients, provided this is done under strict medical supervision. To be effective, physical exercise should be regular and continuous throughout life.