Effects of an 8-week aerobic exercise program on plasma markers for cholesterol absorption and synthesis in older overweight and obese men

S Mashnafi, J Plat, R P Mensink, P J Joris, J P D Kleinloog, S Baumgartner, S Mashnafi, J Plat, R P Mensink, P J Joris, J P D Kleinloog, S Baumgartner

Abstract

Background: Increased physical activity is inversely related to the risk to develop cardiovascular disease (CVD). In a recent systematic review, it was reported that CVD patients had an increased cholesterol absorption and a decreased synthesis as compared with control participants. As increased physical activity levels reduce CVD risk, we hypothesized that exercise training will reduce cholesterol absorption and increase endogenous cholesterol synthesis in older overweight and obese men.

Methods: A randomized, controlled, crossover trial was performed. Seventeen apparently healthy older overweight and obese men were randomized to start with an aerobic exercise or no-exercise control period for 8 weeks, separated by 12 weeks washout. Fasting serum total cholesterol (TC) and non-cholesterol sterol concentrations were measured at baseline, and after 4 and 8 weeks.

Results: The aerobic exercise program did not affect serum TC concentrations. In addition, exercise did not affect TC-standardized serum concentrations of sitosterol and cholestanol that are markers for cholesterol absorption. However, a trend for reduced TC-standardized campesterol concentrations, which is another validated marker for cholesterol absorption, was observed as compared with control. Lathosterol concentrations, reflecting cholesterol synthesis, did not differ between both periods.

Conclusions: Aerobic exercise training for 8 weeks did not lower serum TC concentrations in older overweight and obese men, but a trend towards a decrease in the cholesterol absorption marker campesterol was found. The cholesterol synthesis marker lathosterol did not change.

Trial registration: posted on www.clinicaltrials.gov as NCT03272061 on 7 September 2017.

Keywords: Aerobic exercise; Cholesterol absorption; Cholesterol metabolism; Cholesterol precursors; Cholesterol synthesis; Non-cholesterol sterols; Plant sterols.

Conflict of interest statement

The authors declare that they have no competing interests.

© 2021. The Author(s).

Figures

Fig. 1
Fig. 1
Changes in cholesterol standardized levels of cholesterol absorption markers (A, B, C) and cholesterol synthesis marker (D) during an 8-week intervention period. Data are presented as mean ± SEM
Fig. 2
Fig. 2
Changes in TC concentrations during intervention periods for cholesterol absorbers (n = 9) and cholesterol synthesizers (n = 8) subgroups. AP values for factor effects in cholesterol absorbers. SP values for factor effects in cholesterol synthesizers

References

    1. Mora S, Cook N, Buring JE, Ridker PM, Lee IM. Physical activity and reduced risk of cardiovascular events: potential mediating mechanisms. Circulation. 2007;116(19):2110–2118. doi: 10.1161/CIRCULATIONAHA.107.729939.
    1. Diez-Fernandez A, Martinez-Vizcaino V, Torres-Costoso A, Canete Garcia-Prieto J, Franquelo-Morales P, Sanchez-Lopez M. Strength and cardiometabolic risk in young adults: the mediator role of aerobic fitness and waist circumference. Scand J Med Sci Sports. 2018;28(7):1801–1807. doi: 10.1111/sms.13077.
    1. Fiuza-Luces C, Santos-Lozano A, Joyner M, Carrera-Bastos P, Picazo O, Zugaza JL, Izquierdo M, Ruilope LM, Lucia A. Exercise benefits in cardiovascular disease: beyond attenuation of traditional risk factors. Nat Rev Cardiol. 2018;15(12):731–743. doi: 10.1038/s41569-018-0065-1.
    1. Ostman C, Smart NA, Morcos D, Duller A, Ridley W, Jewiss D. The effect of exercise training on clinical outcomes in patients with the metabolic syndrome: a systematic review and meta-analysis. Cardiovasc Diabetol. 2017;16(1):110. doi: 10.1186/s12933-017-0590-y.
    1. Whelton SP, Chin A, Xin X, He J. Effect of aerobic exercise on blood pressure: a meta-analysis of randomized, controlled trials. Ann Intern Med. 2002;136(7):493–503. doi: 10.7326/0003-4819-136-7-200204020-00006.
    1. Halverstadt A, Phares DA, Wilund KR, Goldberg AP, Hagberg JM. Endurance exercise training raises high-density lipoprotein cholesterol and lowers small low-density lipoprotein and very low-density lipoprotein independent of body fat phenotypes in older men and women. Metabolism. 2007;56(4):444–450. doi: 10.1016/j.metabol.2006.10.019.
    1. Durstine JL, Grandjean PW, Cox CA, Thompson PD. Lipids, lipoproteins, and exercise. J Cardpulm Rehabil. 2002;22(6):385–398. doi: 10.1097/00008483-200211000-00002.
    1. Kelley GA, Kelley KS, Roberts S, Haskell W. Comparison of aerobic exercise, diet or both on lipids and lipoproteins in adults: a meta-analysis of randomized controlled trials. Clin Nutr. 2012;31(2):156–167. doi: 10.1016/j.clnu.2011.11.011.
    1. Miettinen TA, Tilvis RS, Kesaniemi YA. Serum plant sterols and cholesterol precursors reflect cholesterol absorption and synthesis in volunteers of a randomly selected male population. Am J Epidemiol. 1990;131(1):20–31. doi: 10.1093/oxfordjournals.aje.a115479.
    1. Miettinen TA, Gylling H, Nissinen MJ. The role of serum non-cholesterol sterols as surrogate markers of absolute cholesterol synthesis and absorption. Nutr Metab Cardiovasc Dis. 2011;21(10):765–769. doi: 10.1016/j.numecd.2011.05.005.
    1. De Smet E, Mensink RP, Plat J. Effects of plant sterols and stanols on intestinal cholesterol metabolism: suggested mechanisms from past to present. Mol Nutr Food Res. 2012;56(7):1058–1072. doi: 10.1002/mnfr.201100722.
    1. Garcia-Calvo M, Lisnock J, Bull HG, Hawes BE, Burnett DA, Braun MP, Crona JH, Davis HR, Jr, Dean DC, Detmers PA, et al. The target of ezetimibe is Niemann-pick C1-like 1 (NPC1L1) Proc Natl Acad Sci U S A. 2005;102(23):8132–8137. doi: 10.1073/pnas.0500269102.
    1. Hoenig MR, Rolfe BE, Campbell JH. Cholestanol: a serum marker to guide LDL cholesterol-lowering therapy. Atherosclerosis. 2006;184(2):247–254. doi: 10.1016/j.atherosclerosis.2005.09.007.
    1. Matthan NR, Resteghini N, Robertson M, Ford I, Shepherd J, Packard C, Buckley BM, Jukema JW, Lichtenstein AH, Schaefer EJ, Group P Cholesterol absorption and synthesis markers in individuals with and without a CHD event during pravastatin therapy: insights from the PROSPER trial. J Lipid Res. 2010;51(1):202–209. doi: 10.1194/jlr.M900032-JLR200.
    1. Fukushima M, Miura S, Mitsutake R, Fukushima T, Fukushima K, Saku K. Cholesterol metabolism in patients with hemodialysis in the presence or absence of coronary artery disease. Circ J. 2012;76(8):1980–1986. doi: 10.1253/circj.CJ-11-1302.
    1. Rogacev KS, Pinsdorf T, Weingartner O, Gerhart MK, Welzel E, van Bentum K, Popp J, Menzner A, Fliser D, Lutjohann D, Heine GH. Cholesterol synthesis, cholesterol absorption, and mortality in hemodialysis patients. Clin J Am Soc Nephrol. 2012;7(6):943–948. doi: 10.2215/CJN.05170511.
    1. Mashnafi S, Plat J, Mensink RP, Baumgartner S. Non-cholesterol sterol concentrations as biomarkers for cholesterol absorption and synthesis in different metabolic disorders: a systematic review. Nutrients. 2019;11(1). 10.3390/nu11010124.
    1. Varady KA, Houweling AH, Jones PJ. Effect of plant sterols and exercise training on cholesterol absorption and synthesis in previously sedentary hypercholesterolemic subjects. Transl Res. 2007;149(1):22–30. doi: 10.1016/j.trsl.2006.06.002.
    1. Wilund KR, Feeney LA, Tomayko EJ, Weiss EP, Hagberg JM. Effects of endurance exercise training on markers of cholesterol absorption and synthesis. Physiol Res. 2009;58(4):545–552. doi: 10.33549/physiolres.931515.
    1. Cho AR, Moon JY, Kim S, An KY, Oh M, Jeon JY, Jung DH, Choi MH, Lee JW. Effects of alternate day fasting and exercise on cholesterol metabolism in overweight or obese adults: a pilot randomized controlled trial. Metabolism. 2019;93:52–60. doi: 10.1016/j.metabol.2019.01.002.
    1. Dhana K, Berghout MA, Peeters A, Ikram MA, Tiemeier H, Hofman A, Nusselder W, Kavousi M, Franco OH. Obesity in older adults and life expectancy with and without cardiovascular disease. Int J Obes. 2016;40(10):1535–1540. doi: 10.1038/ijo.2016.94.
    1. Hajduk AM, Chaudhry SI. Sedentary behavior and cardiovascular risk in older adults: a scoping review. Curr Cardiovasc Risk Rep. 2016;10(1). 10.1007/s12170-016-0485-6.
    1. Kim K, Choi S, Hwang SE, Son JS, Lee JK, Oh J, Park SM. Changes in exercise frequency and cardiovascular outcomes in older adults. Eur Heart J. 2020;41(15):1490–1499. doi: 10.1093/eurheartj/ehz768.
    1. Wannamethee SG, Shaper AG, Walker M. Changes in physical activity, mortality, and incidence of coronary heart disease in older men. Lancet. 1998;351(9116):1603–1608. doi: 10.1016/S0140-6736(97)12355-8.
    1. Kleinloog JPD, Mensink RP, Ivanov D, Adam JJ, Uludag K, Joris PJ. Aerobic exercise training improves cerebral blood flow and executive function: a randomized, Controlled Cross-Over Trial in Sedentary Older Men. Front Aging Neurosci. 2019;11:333. doi: 10.3389/fnagi.2019.00333.
    1. Mackay DS, Jones PJ, Myrie SB, Plat J, Lutjohann D. Methodological considerations for the harmonization of non-cholesterol sterol bio-analysis. J Chromatogr B Analyt Technol Biomed Life Sci. 2014;957:116–122. doi: 10.1016/j.jchromb.2014.02.052.
    1. Luu W, Hart-Smith G, Sharpe LJ, Brown AJ. The terminal enzymes of cholesterol synthesis, DHCR24 and DHCR7, interact physically and functionally. J Lipid Res. 2015;56(4):888–897. doi: 10.1194/jlr.M056986.
    1. Goran MI, Poehlman ET. Endurance training does not enhance total energy expenditure in healthy elderly persons. Am J Phys. 1992;263(5):E950–E957. doi: 10.1152/ajpendo.1992.263.5.E950.
    1. Gomez-Bruton A, Navarrete-Villanueva D, Perez-Gomez J, Vila-Maldonado S, Gesteiro E, Gusi N, et al. The effects of age, organized physical activity and Sedentarism on fitness in older adults: An 8-year longitudinal study. Int J Environ Res Public Health. 2020;17(12). 10.3390/ijerph17124312.
    1. Thuluva SC, Igel M, Giesa U, Lutjohann D, Sudhop T, von Bergmann K. Ratio of lathosterol to campesterol in serum predicts the cholesterol-lowering effect of sitostanol-supplemented margarine. Int J Clin Pharmacol Ther. 2005;43(07):305–310. doi: 10.5414/CPP43305.
    1. Trautwein EA, Vermeer MA, Hiemstra H, Ras RT. LDL-cholesterol lowering of plant sterols and Stanols-which factors influence their efficacy? Nutrients. 2018;10(9). 10.3390/nu10091262.
    1. Li J, Siegrist J. Physical activity and risk of cardiovascular disease--a meta-analysis of prospective cohort studies. Int J Environ Res Public Health. 2012;9(2):391–407. doi: 10.3390/ijerph9020391.

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