Fasted Exercise and LDL-C

The Effect of Fasted Exercise on LDL-cholesterol in Men and Women

Cardiovascular disease (CVD) is the leading cause of death in the UK and worldwide with low density lipoprotein cholesterol (LDL-C) being one of the most important modifiable risk factors. Physical activity is inexpensive and research shows that it consistently improves high density lipoprotein and triglyceride concentrations. However, fails to improve LDL-C concentrations. Preliminary research suggests fasted exercise could potentially improve LDL-C concentrations. The majority of research in these areas have also mostly been done in males with the results generalised to females. As it is known that lipid metabolism and CVD risk is different between sexes it is possible that the response to fasted exercise may also be different between sexes. This aim of this study is to assess the effect of physical activity performed before or after a meal on plasma LDL-C concentrations in men and women and explore sex differences. The study will also assess the effect of fasted exercise on other CVD risk factors.

Study Overview

• Status: Completed
• Conditions: Cardiovascular Diseases
• Intervention / Treatment: Other: Meal timing

• Study Type: Interventional
• Enrollment (Actual): 29
• Phase: Not Applicable

Contacts and Locations

Study Locations

• United Kingdom
  • Bath, United Kingdom, BA2 7AY
    • Department for Health, University of Bath

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 25 years to 60 years (Adult)
• Accepts Healthy Volunteers: Yes

Description

Inclusion Criteria:

• Age 18-65 years
• Body mass index 20-40kg/m2
• Physically inactive (exercise for less than 150 minutes per week)

Exclusion Criteria:

• Weight instability (>5kg change in body mass over last 6 months)
• Diagnosis of diabetes or CVD
• Pregnant or lactating
• Any medical condition or medication that could introduce bias into the study (eg. lipid disorders, lipid or glucose metabolism altering medications eg statins)

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Basic Science
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: None (Open Label)

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Active Comparator: Exercise in a fed-state; 12-weeks of exercise training, 50-minutes, 3 days per week performed 1.5-3 hours after a high-carbohydrate meal (1 g/kg body mass).	Other: Meal timing; A high-carbohydrate (1 g/kg body mass) meal to be consumed either 1.5-3 hours before or immediately after exercise. Those consuming the meal after exercise will have fasted for at least 8 hours before exercise.
Experimental: Exercise in a fasted-state; 12-weeks of exercise training, 50-minutes, 3 days per week performed after at least an 8-hour fast. A high-carbohydrate meal (1 g/kg body mass) will be consumed after exercise.	Other: Meal timing; A high-carbohydrate (1 g/kg body mass) meal to be consumed either 1.5-3 hours before or immediately after exercise. Those consuming the meal after exercise will have fasted for at least 8 hours before exercise.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change in fasting plasma LDL-C concentrations at week 12	Fasting plasma LDL-cholesterol concentrations (mmol/L)	Baseline and week 12

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change in fasting plasma LDL-C concentrations at week 4	Fasting plasma LDL-cholesterol concentrations (mmol/L)	Baseline and week 4
Change in fasting plasma HDL-C concentrations at week 12	Fasting plasma HDL-cholesterol concentrations (mmol/L)	Baseline and week 12
Change in fasting plasma HDL-C concentrations at week 4	Fasting plasma HDL-cholesterol concentrations (mmol/L)	Baseline and week 4
Change in fasting plasma total cholesterol concentrations at week 12	Fasting plasma total cholesterol concentrations (mmol/L)	Baseline and week 12
Change in fasting plasma total cholesterol concentrations at week 4	Fasting plasma total cholesterol concentrations (mmol/L)	Baseline and week 4
Change in fasting plasma apolipoprotein B concentrations at week 12	Fasting plasma apolipoprotein B concentrations (mmol/L)	Baseline and week 12
Change in fasting plasma apolipoprotein B concentrations at week 4	Fasting plasma apolipoprotein B concentrations (mmol/L)	Baseline and week 4
Change in fasting plasma triglyceride concentrations at week 12	Fasting plasma triglyceride concentrations (mmol/L)	Baseline and week 12
Change in fasting plasma triglyceride concentrations at week 4	Fasting plasma triglyceride concentrations (mmol/L)	Baseline and week 4
Change in fasting plasma C-reactive protein concentrations at week 12	Fasting plasma C-reactive protein concentrations (mg/L)	Baseline and week 12
Change in fasting plasma C-reactive protein concentrations at week 4	Fasting plasma C-reactive protein concentrations (mg/L)	Baseline and week 4
Change in fasting plasma glucose concentrations at week 12	Fasting plasma glucose concentrations (mmol/L)	Baseline and week 12
Change in fasting plasma glucose concentrations at week 4	Fasting plasma glucose concentrations (mmol/L)	Baseline and week 4
Change in fasting plasma insulin concentrations at week 12	Fasting plasma insulin concentrations (mmol/L)	Baseline and week 12
Change in fasting plasma insulin concentrations at week 4	Fasting plasma insulin concentrations (mmol/L)	Baseline and week 4
Change in fasting plasma non-esterified fatty acid concentrations at week 12	Fasting plasma non-esterified fatty acid concentrations (mmol/L)	Baseline and week 12
Change in fasting plasma non-esterified fatty acid concentrations at week 4	Fasting plasma non-esterified fatty acid concentrations (mmol/L)	Baseline and week 4
Change in 7-day mean interstitial glucose concentration at week 12	Mean interstitial glucose concentration (mmol/L) measured by continuous glucose monitor over a 7-day period	Baseline and week 12
Change in 7-day standard deviation of interstitial glucose concentration at week 12	Standard deviation of interstitial glucose concentration (mmol/L) measured by continuous glucose monitor over a 7-day period	Baseline and Week 12
Change in 7-day coefficient of variation for interstitial glucose concentration at week 12	Coefficient of variation for interstitial glucose concentration (%) measured by continuous glucose monitor over a 7-day period	Baseline and week 12.
Change in 7-day mean amplitude of glycaemic excursions for interstitial glucose at week 12	Mean amplitude of glycaemic excursions for interstitial glucose (mmol/L) measured by continuous glucose monitor over a 7-day period	Baseline and week 12.

Other Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change in fasting plasma VLDL-rich triglyceride concentrations at week 12	Fasting plasma VLDL-rich triglyceride concentrations (mmol/L)	Baseline and week 12
Change in fasting plasma VLDL-rich triglyceride concentrations at week 4	Fasting plasma VLDL-rich triglyceride concentrations (mmol/L)	Baseline and week 4
Change in body mass at week 12	Body mass (kg)	Baseline and week 12
Change in body mass at week 4	Body mass (kg)	Baseline and week 4
Change in waist-to-hit ratio at week 12	Waist-to-hit ratio	Baseline and week 12
Change in waist-to-hit ratio at week 4	Waist-to-hit ratio	Baseline and week 4
Change in fat mass at week 12	Fat mass determined by dual-energy x-ray absorptiometry (kg)	Baseline and week 12
Change in fat mass at week 4	Fat mass determined by dual-energy x-ray absorptiometry (kg)	Baseline and week 4
Change in fat-free mass at week 12	Fat-free mass determined by dual-energy x-ray absorptiometry (kg)	Baseline and week 12
Change in fat-free mass at week 4	Fat-free mass determined by dual-energy x-ray absorptiometry (kg)	Baseline and week 4
Change in sagittal abdominal diameter at week 12	Sagittal abdominal diameter (cm)	Baseline and week 12
Change in sagittal abdominal diameter at week 4	Sagittal abdominal diameter (cm)	Baseline and week 4
Change in gut microbiome species richness at week 12	Species count in fecal sample (as part of ZOE testing program)	Baseline and week 12

Collaborators and Investigators

• Sponsor: University of Bath
• Collaborators: King's College London; Zoe Global Limited

Publications and helpful links

General Publications

• Edinburgh RM, Bradley HE, Abdullah NF, Robinson SL, Chrzanowski-Smith OJ, Walhin JP, Joanisse S, Manolopoulos KN, Philp A, Hengist A, Chabowski A, Brodsky FM, Koumanov F, Betts JA, Thompson D, Wallis GA, Gonzalez JT. Lipid Metabolism Links Nutrient-Exercise Timing to Insulin Sensitivity in Men Classified as Overweight or Obese. J Clin Endocrinol Metab. 2020 Mar 1;105(3):660-76. doi: 10.1210/clinem/dgz104.
• Edinburgh RM, Koumanov F, Gonzalez JT. Impact of pre-exercise feeding status on metabolic adaptations to endurance-type exercise training. J Physiol. 2022 Mar;600(6):1327-1338. doi: 10.1113/JP280748. Epub 2021 Jan 27.

Study record dates

Study Major Dates

• Study Start (Actual): March 30, 2022
• Primary Completion (Actual): August 13, 2024
• Study Completion (Actual): August 30, 2024

Study Registration Dates

• First Submitted: February 16, 2022
• First Submitted That Met QC Criteria: March 3, 2022
• First Posted (Actual): March 15, 2022

Study Record Updates

• Last Update Posted (Actual): March 27, 2025
• Last Update Submitted That Met QC Criteria: March 24, 2025
• Last Verified: March 1, 2025

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Cardiovascular Diseases
• Other Study ID Numbers: EIRA1-7137

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: UNDECIDED

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No
• product manufactured in and exported from the U.S.: No