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Cardiorespiratory fitness may predict lipid, lipoprotein levels in men
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Men with high cardiorespiratory fitness were less likely to have abnormal lipid and lipoprotein levels at a younger age compared with those with low cardiorespiratory fitness, longitudinal study results found.
The researchers wrote that the findings may indicate that promoting increased cardiorespiratory fitness levels could help delay the development of dyslipidemia.
They evaluated 11,418 men aged 20 to 90 years from the Aerobics Center Longitudinal Study without known high cholesterol, high triglycerides, CVD and cancer at baseline and during follow-up. Participants underwent between two and 25 health examinations (mean, 3.5) between 1970 and 2006.
The researchers assessed the longitudinal aging trajectory of lipids and lipoproteins for the life course in adults and aimed to determine whether the level of cardiorespiratory fitness alters the age-associated trajectory of lipids and lipoproteins. Cardiorespiratory fitness was quantified by a maximal treadmill exercise test and participants were stratified into low, middle and high groups standardized by age. Outcomes of interest included total cholesterol, LDL, triglycerides and non-HDL.
At baseline, higher levels of cardiorespiratory fitness were associated with lower total cholesterol, LDL, triglycerides, non-HDL, triglycerides/HDL ratio, total cholesterol/HDL ratio and LDL/HDL ratio, and with higher HDL, Yong-Moon Mark Park, MD, PhD, MS, and colleagues wrote.
Compared with those at high levels, those with low levels of cardiorespiratory fitness had higher BMI, waist circumference, body fat percentage, fasting plasma glucose, systolic and diastolic BP, and had increased prevalence of diabetes, hypertension, smoking, physical activity (P < .0001 for all) and parental history of CVD (P = .0175), according to the researchers.
Abnormal values at younger age
When researchers modeled the age-related trajectories of total cholesterol, LDL, triglycerides and non-HDL, they found that all had inverted U-shaped quadratic trends, increasing up to a certain age and then subsequently decreasing (P < .0001 for all).
Park, from the department of epidemiology and biostatistics, Arnold School of Public Health, University of South Carolina, and colleagues found that compared with men with high cardiorespiratory fitness, those with low cardiorespiratory fitness developed abnormal values of total cholesterol (≥ 200 mg/dL), LDL (≥ 130 mg/dL), non-HDL (≥ 160 mg/dL) and triglycerides/HDL ratio (≥ 3) earlier in life. They observed that abnormal values for total cholesterol and LDL in men with low cardiorespiratory fitness were found approximately 15 years earlier in life than in men with high cardiorespiratory fitness.
Cardiorespiratory fitness was more strongly associated with the aging trajectories of lipids and lipoproteins in younger and middle-aged men than in older men, they found.
“A higher [cardiorespiratory fitness level] has a significant contribution to maintaining favorable lipid and lipoprotein profiles, especially in young to middle-age men,” they wrote. “Therefore, promoting [cardiorespiratory fitness] may contribute to a possible delay of dyslipidemia and its related atherosclerosis and CVD.”
Effect could be even greater
Usman Baber
In a related editorial, Usman Baber, MD, MS, and Paolo Boffetta, MD, MPH, wrote that study participants had a lower rate of diabetes, a lower mean BMI and a higher level of exercise capacity than in the typical patients for whom an exercise prescription is usually considered, so “the favorable benefits of [cardiorespiratory fitness] on changes in lipoprotein levels observed by Park et al in this low-risk cohort might plausibly translate to even larger effects in high-risk patients.”
Baber and Boffetta, both from Icahn School of Medicine at Mount Sinai, wrote that “realizing the health benefits of greater [cardiorespiratory fitness] requires clinicians, policymakers and others to improve public awareness of the health benefits of exercise, increase the amount of time clinicians spend counseling and prescribing fitness regimens to patients, recalibrate individual perceptions of fitness with objective measurements and reprioritize the importance of physical education in schools.” – by Erik Swain
Disclosure: One researcher reports serving on advisory boards for Clarity, Santech and Technogym, receiving unrestricted research grants from BodyMedia, Coca-Cola and Technogym and receiving book royalties from Human Kinetics. Baber and Boffetta report no relevant financial disclosures.
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