The Long-term Effect of Different Exercise Intensities on High-Density Lipoprotein Cholesterol in Older Men and Women Using the Per Protocol Approach: The Generation 100 Study

Ida Berglund, Elisabeth Kleivhaug Vesterbekkmo, Kjetil Retterstøl, Sigmund A Anderssen, Maria A Fiatarone Singh, Jørn W Helge, Stian Lydersen, Ulrik Wisløff, Dorthe Stensvold, Ida Berglund, Elisabeth Kleivhaug Vesterbekkmo, Kjetil Retterstøl, Sigmund A Anderssen, Maria A Fiatarone Singh, Jørn W Helge, Stian Lydersen, Ulrik Wisløff, Dorthe Stensvold

Abstract

Objective: To examine whether 5 years of high-intensity interval training (HIIT) increases high-density lipoprotein cholesterol (HDL-C) concentration more than moderate-intensity continuous training (MICT) and control (CON) in older men and women.

Methods: A total of 1567 older adults (790 [50.4%] women) were randomized (2:1:1) to either CON (n=780; asked to follow the national recommendations for physical activity) or 2 weekly sessions of HIIT (10-minute warm-up followed by 4×4-minute intervals at ∼90% of peak heart rate) or MICT (50 minutes of continuous work at ∼70% of peak heart rate). Serum HDL-C concentration was measured by standard procedures at baseline and at 1 year, 3 years, and 5 years. The study took place between August 21, 2012, and June 31, 2018. Linear mixed models were used to determine between-group differences during 5 years using the per protocol approach.

Results: Men in HIIT had a smaller reduction in HDL-C (-1.2%) than men in CON (-6.9%) and MICT (-7.8%) after 5 years (P=.01 and P=.03 for CON vs HIIT and MICT vs HIIT, respectively). No effect of exercise intensity on HDL-C was seen in women. Changes in peak oxygen uptake were associated with changes in HDL-C in both men and women, whereas changes in body weight and fat mass were not.

Conclusion: In men, HIIT seems to be the best strategy to prevent a decline in HDL-C during a 5-year period. No effect of exercise intensity was seen for older women.

Trial registration: ClinicalTrials.gov identifier: NCT01666340.

Keywords: CON, control; CVD, cardiovascular disease; HDL-C, high-density lipoprotein cholesterol; HIIT, high-intensity interval training; HRpeak, peak heart rate; LDL-C, low-density lipoprotein cholesterol; LMA, lipid-modifying agent; MICT, moderate-intensity continuous training; Vo2peak, peak oxygen uptake.

© 2021 THE AUTHORS.

Figures

Figure 1
Figure 1
Flowchart. Adherence to control (CON), moderate-intensity continuous training (MICT), and high-intensity interval training (HIIT) represents the proportion of men and women who adhered to the prescribed exercise program during 5 years and the proportion of men and women who were analyzed for the primary outcome at each follow-up time. HDL-C, high-density lipoprotein cholesterol.
Figure 2
Figure 2
The levels of high-density lipoprotein cholesterol (HDL-C) in men (A) and women (B) from baseline to 5-year follow-up. A, P<.05 compared with control group (CON). B, P>.05 compared with moderate-intensity continuous training (MICT). BL, baseline; HIIT, high-intensity interval training.

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