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Evidence-based Clinical Medicine: Rade N. Pejic and Daniel T. Lee Hypertriglyceridemia J Am Board Fam Med 2006; 19: 310-316 [Abstract] [Full text] [PDF]

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Treatment of hypertriglyceridemia w/ exercise

Brian V. Reamy, Uniformed Services University, Bethesda MD   (26 May 2006)

Treatment of hypertriglyceridemia w/ exercise 26 May 2006
Brian V. Reamy, Chair Dept. of Family Medicine, Uniformed Services University, Bethesda MD Send response to journal: Re: Treatment of hypertriglyceridemia w/ exercise breamy{at}usuhs.mil Brian V. Reamy, et al.	I appreciate the thorough review of hypertriglyceridemia by Pejic & Lee in the JABFM. However, I think it is important to expand on the use, limitations and importance of exercise for the treatment of hypertriglyceridemia. The primary long-term effects of exercise on the lipoprotein profile are a significant and persisitent reduction in triglycerides and an increase in cardioprotective HDL cholesterol. (1) Endurance athletes have TG levels 20-40% lower than sedentary counterparts. (2) The benefical effects of exercise on TG extend across genders and persist with aging. (3,4) Yet, the "dose" of exercise required to get these benefits may be higher than that mentioned by the authors. A recent prospective, randomized trial from the New England Journal of Medicine showed that the salutary changes in lipid levels were directly related to the amount of exercise and not to the intensity of exercise or improvements in weight or fitness.(5) The authors showed that exercise equivalent to jogging 17-18 miles/week at a moderate pace was required to achieve plasma lipoprotein effects.(5) The good news is that extensive exercise can reduce TG up to 40% and it can be of moderate intensity; the bad news is that it probably takes more than 30 minutes 3 to 5 days per week. (1)Haskell WL. The influence of Exercise on the Concentrations of Triglycerides and Cholesterol in Human Plasma. EXERC SPORT SCI REV 1984;12:205-244. (2)Reamy B, Thompson P. Lipid Disorders in Athletes. CURR SPORTS MED REP 2004;3:2:70-76. (3)Lemura LM et al. Lipid and Lipoprotein Profiles, Cardiovascular Fitness, Body Composition, and Diet During and After resisitance, aerobic and combination training in young women. EUR J APPL PHYSIOL 2000; 82:451- 458. (4)Kumar DS et al. Coronary artery disease risk factors & their association with physical activity in older adults. J CARDIOVASCULAR RISK 2002; 9:383-392. (5)Kraus WE, et al. Effects of the Amount and Intensity of Exercise on Plasma Lipoproteins. N ENGL J MED 2002;347: 1483-1489.