Abstract
There is accumulating evidence in man and experimental animals that even mild exercise, if regularly repeated, may alter the metabolism of lipids. Exercise has been reported as decreasing peripheral tissue cholesterol in red blood cells, working muscle, lungs and the liver. During physical activity, the output of cholesterol and bile acids into the bile increases. This probably leads to higher faecal losses of sterols which may lead to lower cholesterol levels in the peripheral tissues and in the bile, when exercise is repeated regularly. Preferential release of unsaturated fatty acids from the adipose tissue during exercise and the linoleic acid-dependent LCAT enzyme (transporting plasma cholesterol) may be partly responsible for this effect of exercise. The experimental data reviewed provide supportive basis for epidemiological studies reporting on the beneficial effect of regular exercise.
Physical activity is an important factor in the phylogeny of all animal species, secondary only to food intake and reproduction. Exercise is readily available to all population groups. There is good evidence that the amount of exercise required for a protective effect is easily accessible for time-pressured and older individuals. Short bursts of activity repeated several times a day may be equally or more beneficial than prolonged exhaustive exercise. Modified exercise is also beneficial for patients with coronary heart disease and for elderly patients, provided this is done under strict medical supervision. To be effective, physical exercise should be regular and continuous throughout life.
Full text
PDF







Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Allard C., Alteresco M., Ferguson R. J., Chaniotis L., Choquette G., Skinner J. Changes in adipose tissue and increased serum cholesterol of coronary patients following training. Can Med Assoc J. 1973 Aug 4;109(3):194–197. [PMC free article] [PubMed] [Google Scholar]
- Askeq E. W., Dohm G. L., Doub W. H., Jr, Husotn R. L., Van Natta P. A. Lipogenesis and glyceride synthesis in the rat: response to diet and exercise. J Nutr. 1975 Feb;105(2):190–199. doi: 10.1093/jn/105.2.190. [DOI] [PubMed] [Google Scholar]
- Askew E. W., Dohm G. L., Huston R. L. Fatty acid and ketone body metabolism in the rat: response to diet and exercise. J Nutr. 1975 Nov;105(11):1422–1432. doi: 10.1093/jn/105.11.1422. [DOI] [PubMed] [Google Scholar]
- BARR D. P. Some chemical factors in the pathogenesis of atherosclerosis. Circulation. 1953 Nov;8(5):641–654. doi: 10.1161/01.cir.8.5.641. [DOI] [PubMed] [Google Scholar]
- BISHOP J. M., DONALD K. W., TAYLOR S. H., WORMALD P. N. Changes in arterial-hepatic venous oxygen content difference during and after supine leg exercise. J Physiol. 1957 Jul 11;137(2):309–317. doi: 10.1113/jphysiol.1957.sp005814. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Bock A. V., Vancaulaert C., Dill D. B., Fölling A., Hurxthal L. M. Studies in muscular activity: III. Dynamical changes occurring in man at work. J Physiol. 1928 Oct 10;66(2):136–161. doi: 10.1113/jphysiol.1928.sp002514. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Brunner D., Manelis G., Modan M., Levin S. Physical activity at work and the incidence of myocardial infarction, angina pectoris and death due to ischemic heart disease. An epidemiological study in Israeli collective settlements (Kibbutzim). J Chronic Dis. 1974 Jul;27(4):217–233. doi: 10.1016/0021-9681(74)90047-2. [DOI] [PubMed] [Google Scholar]
- Cassel J., Heyden S., Bartel A. G., Kaplan B. H., Tyroler H. A., Cornoni J. C., Hames C. G. Occupation and physical activity and coronary heart disease. Arch Intern Med. 1971 Dec;128(6):920–928. [PubMed] [Google Scholar]
- Cooper K. H. Guidelines in the management of the exercising patient. JAMA. 1970 Mar 9;211(10):1663–1667. [PubMed] [Google Scholar]
- Cooper K. H., Zechner A. Physical fitness in United States and Austrian military personnel. A comparative study. JAMA. 1971 Feb 8;215(6):931–934. [PubMed] [Google Scholar]
- Costill D. L. Physiology of marathon running. JAMA. 1972 Aug 28;221(9):1024–1029. [PubMed] [Google Scholar]
- DeVries H. A., Adams G. M. Comparison of exercise responses in old and young men. I. The cardiac effort-total body effort relationship. J Gerontol. 1972 Jul;27(3):344–348. doi: 10.1093/geronj/27.3.344. [DOI] [PubMed] [Google Scholar]
- DeVries H. A., Adams G. M. Comparison of exercise responses in old and young men. II. Ventilatory mechanics. J Gerontol. 1972 Jul;27(3):349–352. doi: 10.1093/geronj/27.3.349. [DOI] [PubMed] [Google Scholar]
- Edington D. W., Cosmas A. C., McCafferty W. B. Exercise and longevity: evidence for a threshold age. J Gerontol. 1972 Jul;27(3):341–343. doi: 10.1093/geronj/27.3.341. [DOI] [PubMed] [Google Scholar]
- Felig P., Wahren J. Fuel homeostasis in exercise. N Engl J Med. 1975 Nov 20;293(21):1078–1084. doi: 10.1056/NEJM197511202932107. [DOI] [PubMed] [Google Scholar]
- Fordtran J. S., Saltin B. Gastric emptying and intestinal absorption during prolonged severe exercise. J Appl Physiol. 1967 Sep;23(3):331–335. doi: 10.1152/jappl.1967.23.3.331. [DOI] [PubMed] [Google Scholar]
- Fox S. M., 3rd, Naughton J. P., Gorman P. A. Physical activity and cardiovascular health. I. Potential for prevention of coronary heart disease and possible mechanisms. Mod Concepts Cardiovasc Dis. 1972 Apr;41(4):17–20. [PubMed] [Google Scholar]
- Frank C. W., Weinblatt E., Shapiro S., Sager R. V. Physical inactivity as a lethal factor in myocardial infarction among men. Circulation. 1966 Dec;34(6):1022–1033. doi: 10.1161/01.cir.34.6.1022. [DOI] [PubMed] [Google Scholar]
- Fröberg S. O. Effects of training and of acute exercise in trained rats. Metabolism. 1971 Nov;20(11):1044–1051. doi: 10.1016/0026-0495(71)90028-x. [DOI] [PubMed] [Google Scholar]
- Ginter E., Ondreicka R., Bobek P., Resovský S., Peter V., Chrappa V. Influence of differences in physical activity on fatty acid composition in the lipid fractions of turkey and rat blood serum and tissues. Physiol Bohemoslov. 1973;22(6):645–652. [PubMed] [Google Scholar]
- Glomset J. A. Physiological role of lecithin-cholesterol acyltransferase. Am J Clin Nutr. 1970 Aug;23(8):1129–1136. doi: 10.1093/ajcn/23.8.1129. [DOI] [PubMed] [Google Scholar]
- Glueck C. J., Gartside P., Fallat R. W., Sielski J., Steiner P. M. Longevity syndromes: familial hypobeta and familial hyperalpha lipoproteinemia. J Lab Clin Med. 1976 Dec;88(6):941–957. [PubMed] [Google Scholar]
- Gollnick P. D., King D. W. Effect of exercise and training on mitochondria of rat skeletal muscle. Am J Physiol. 1969 Jun;216(6):1502–1509. doi: 10.1152/ajplegacy.1969.216.6.1502. [DOI] [PubMed] [Google Scholar]
- Gollnick P. D., Simmons S. W. Physical activity and liver cholesterol. Int Z Angew Physiol. 1967 Mar 7;23(4):322–330. doi: 10.1007/BF00698041. [DOI] [PubMed] [Google Scholar]
- Gwinup G., Chelvam R., Steinberg T. Thickness of subcutaneous fat and activity of underlying muscles. Ann Intern Med. 1971 Mar;74(3):408–411. doi: 10.7326/0003-4819-74-3-408. [DOI] [PubMed] [Google Scholar]
- Gyntelberg F., Brennan R., Holloszy J. O., Schonfeld G., Rennie M. J., Weidman S. W. Plasma triglyceride lowering by exercise despite increased food intake in patients with type IV hyperlipoproteinemia. Am J Clin Nutr. 1977 May;30(5):716–720. doi: 10.1093/ajcn/30.5.716. [DOI] [PubMed] [Google Scholar]
- Hagenfeldt L., Wahren J. Effect of exercise on splanchnic exchange of free fatty acids. Metabolism. 1973 Jun;22(6):815–820. doi: 10.1016/0026-0495(73)90052-8. [DOI] [PubMed] [Google Scholar]
- Hebbelinck M., Casier H. Effect of muscular exercise on the metabolism of 4-C14 labelled cholesterol in mice. Int Z Angew Physiol. 1966 Jul 8;22(3):185–189. doi: 10.1007/BF00695007. [DOI] [PubMed] [Google Scholar]
- Hunter J. D., Buchanan H., Nye E. R. The mobilization of free fatty acids in relation to adipose tissue triglyceride fatty acids in the rat. J Lipid Res. 1970 May;11(3):259–265. [PubMed] [Google Scholar]
- Hurter R., Peyman M. A., Swale J., Barnett C. W. Some immediate and long-term effects of exercise on the plasma-lipids. Lancet. 1972 Sep 30;2(7779):671–674. [PubMed] [Google Scholar]
- Jones N. L. New tests to asses lung function. Exercise tesing in pulmonary evaluation: clinical applications. N Engl J Med. 1975 Sep 25;293(13):647–650. doi: 10.1056/NEJM197509252931308. [DOI] [PubMed] [Google Scholar]
- Kannel W. B. Habitual level of physical activity and risk of coronary heart disease: the Framingham study. Can Med Assoc J. 1967 Mar 25;96(12):811–812. [PMC free article] [PubMed] [Google Scholar]
- Lewis S., Haskell W. L., Wood P. D., Manoogian N., Bailey J. E., Pereira M. B. Effects of physical activity on weight reduction in obese middle-aged women. Am J Clin Nutr. 1976 Feb;29(2):151–156. doi: 10.1093/ajcn/29.2.151. [DOI] [PubMed] [Google Scholar]
- Lipman R. L., Raskin P., Love T., Triebwasser J., Lecocq F. R., Schnure J. J. Glucose intolerance during decreased physical activity in man. Diabetes. 1972 Feb;21(2):101–107. doi: 10.2337/diab.21.2.101. [DOI] [PubMed] [Google Scholar]
- Lopez A., Rene A., Bell L., Hebert J. A. Metabolic effects of exercise. I. Effect of exercise on serum lipids and lipogenesis in rats. Proc Soc Exp Biol Med. 1975 Mar;148(3):640–645. doi: 10.3181/00379727-148-38600. [DOI] [PubMed] [Google Scholar]
- Lopez A., Vial R., Balart L., Arroyave G. Effect of exercise and physical fitness on serum lipids and lipoproteins. Atherosclerosis. 1974 Jul-Aug;20(1):1–9. doi: 10.1016/0021-9150(74)90073-2. [DOI] [PubMed] [Google Scholar]
- MAYER J., MARSHALL N. B., VITALE J. J., CHRISTENSEN J. H., MASHAYEKHI M. B., STARE F. J. Exercise, food intake and body weight in normal rats and genetically obese adult mice. Am J Physiol. 1954 Jun;177(3):544–548. doi: 10.1152/ajplegacy.1954.177.3.544. [DOI] [PubMed] [Google Scholar]
- Malinow M. R., McLaughlin P., Pierovich I. Muscular activity and the degradation of cholesterol by the liver. Atherosclerosis. 1972 Mar-Apr;15(2):153–162. doi: 10.1016/0021-9150(72)90065-2. [DOI] [PubMed] [Google Scholar]
- Mann G. V., Garrett L., Long A. The amount of exercise necessary to achieve and maintain fitness in adult persons. South Med J. 1971 May;64(5):549–553. doi: 10.1097/00007611-197105000-00007. [DOI] [PubMed] [Google Scholar]
- Mann G. V. Letter: Sneakers and supporters to fight CHD. N Engl J Med. 1975 Apr 3;292(14):758–758. doi: 10.1056/NEJM197504032921423. [DOI] [PubMed] [Google Scholar]
- Miller G. J., Miller N. E. Plasma-high-density-lipoprotein concentration and development of ischaemic heart-disease. Lancet. 1975 Jan 4;1(7897):16–19. doi: 10.1016/s0140-6736(75)92376-4. [DOI] [PubMed] [Google Scholar]
- Molé P. A., Oscai L. B., Holloszy J. O. Adaptation of muscle to exercise. Increase in levels of palmityl Coa synthetase, carnitine palmityltransferase, and palmityl Coa dehydrogenase, and in the capacity to oxidize fatty acids. J Clin Invest. 1971 Nov;50(11):2323–2330. doi: 10.1172/JCI106730. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Monsen E. R., Arlin M. T., Rumery R. E. Effects of dietary cholesterol and voluntary exercise on histopathology, plasma and hepatic lipids of the male rat. Int Z Angew Physiol. 1972;30(4):258–268. doi: 10.1007/BF00696117. [DOI] [PubMed] [Google Scholar]
- Moore R. B., Anderson J. T., Taylor H. L., Keys A., Frantz I. D., Jr Effect of dietary fat on the fecal excretion of cholesterol and its degradation products in man. J Clin Invest. 1968 Jul;47(7):1517–1534. doi: 10.1172/JCI105845. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Morgan T. E., Short F. A., Cobb L. A. Effect of long-term exercise on skeletal muscle lipid composition. Am J Physiol. 1969 Jan;216(1):82–86. doi: 10.1152/ajplegacy.1969.216.1.82. [DOI] [PubMed] [Google Scholar]
- Morris J. N., Chave S. P., Adam C., Sirey C., Epstein L., Sheehan D. J. Vigorous exercise in leisure-time and the incidence of coronary heart-disease. Lancet. 1973 Feb 17;1(7799):333–339. doi: 10.1016/s0140-6736(73)90128-1. [DOI] [PubMed] [Google Scholar]
- Naito H. K. Effects of physical activity on serum cholesterol metabolism: a review. Cleve Clin Q. 1976 Spring;43(1):21–49. doi: 10.3949/ccjm.43.1.21. [DOI] [PubMed] [Google Scholar]
- Olson A. L., Edelstein E. Spot reduction of subcutaneous adipose tissue. Res Q. 1968 Oct;39(3):647–652. [PubMed] [Google Scholar]
- Oscai L. B., Babirak S. P., McGarr J. A., Spirakis C. N. Effect of exercise on adipose tissue cellularity. Fed Proc. 1974 Aug;33(8):1956–1958. [PubMed] [Google Scholar]
- Oscai L. B., Patterson J. A., Bogard D. L., Beck R. J., Rothermel B. L. Normalization of serum triglycerides and lipoprotein electrophoretic patterns by exercise. Am J Cardiol. 1972 Nov;30(7):775–780. doi: 10.1016/0002-9149(72)90154-3. [DOI] [PubMed] [Google Scholar]
- Paffenbarger R. S., Hale W. E. Work activity and coronary heart mortality. N Engl J Med. 1975 Mar 13;292(11):545–550. doi: 10.1056/NEJM197503132921101. [DOI] [PubMed] [Google Scholar]
- Pruett E. D. Glucose and insulin during prolonged work stress in men living on different diets. J Appl Physiol. 1970 Feb;28(2):199–208. doi: 10.1152/jappl.1970.28.2.199. [DOI] [PubMed] [Google Scholar]
- ROWELL L. B., BLACKMON J. R., BRUCE R. A. INDOCYANINE GREEN CLEARANCE AND ESTIMATED HEPATIC BLOOD FLOW DURING MILD TO MAXIMAL EXERCISE IN UPRIGHT MAN. J Clin Invest. 1964 Aug;43:1677–1690. doi: 10.1172/JCI105043. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Ramsbottom N., Hunt J. N. Effect of exercise on gastric emptying and gastric secretion. Digestion. 1974;10(1):1–8. doi: 10.1159/000197517. [DOI] [PubMed] [Google Scholar]
- Riddle M. C., Ryan W. G., Schwartz T. B. Human plasma free fatty acid concentration at rest and after norepinephrine infusion: effect of preceding physical activity. Metabolism. 1972 Nov;21(11):1063–1072. doi: 10.1016/0026-0495(72)90037-6. [DOI] [PubMed] [Google Scholar]
- Rochmis P., Blackburn H. Exercise tests. A survey of procedures, safety, and litigation experience in approximately 170,000 tests. JAMA. 1971 Aug 23;217(8):1061–1066. doi: 10.1001/jama.217.8.1061. [DOI] [PubMed] [Google Scholar]
- SIMKO V., BABALA J. PHYSICAL ACTIVITY AND THE FAT METABOLISM IN RATS. Med Exp Int J Exp Med. 1964;10:286–291. doi: 10.1159/000135429. [DOI] [PubMed] [Google Scholar]
- SIMKO V., GINTER E., CERVEN J. The influence of physical work upon the resorption of triolein I-131 in rats. Med Exp Int J Exp Med. 1963;8:156–158. doi: 10.1159/000135280. [DOI] [PubMed] [Google Scholar]
- Sharrock N., Garrett H. L., Mann G. V. Practical exercise test for physical fitness and cardiac performance. Am J Cardiol. 1972 Nov;30(7):727–732. doi: 10.1016/0002-9149(72)90146-4. [DOI] [PubMed] [Google Scholar]
- Simko V., Chorváthová V. Plasma cholesterol levels in rats exposed to regular exercise. Cor Vasa. 1968;10(4):305–307. [PubMed] [Google Scholar]
- Simko V., Chorváthová V. Response of plasma free fatty acids and intraperitoneal glucose tolerance test to exercise in trained and untrained rats. Med Exp Int J Exp Med. 1969;19(2):71–78. doi: 10.1159/000137182. [DOI] [PubMed] [Google Scholar]
- Simko V., Chorváthová V. The effect of short-term exercise on the degradation of cholesterol in rats. Physiol Bohemoslov. 1968;17(6):583–586. [PubMed] [Google Scholar]
- Simko V., Merrifield H. H., Stouffer J. R. Mild exercise: effect on body composition and metabolism. N Y State J Med. 1974 Aug;74(9):1563–1567. [PubMed] [Google Scholar]
- Simko V. Muscular activity, fat metabolism, and atherosclerosis. N Y State J Med. 1970 Jul 15;70(14):1888–1894. [PubMed] [Google Scholar]
- Simko V., Ondreicka R., Chorváthová V., Bobek P. Effect of long-term physical exercise on bile sterols, fecal fat and fatty acid metabolism in rats. J Nutr. 1970 Nov;100(11):1331–1339. doi: 10.1093/jn/100.11.1331. [DOI] [PubMed] [Google Scholar]
- Simko V. Protective effect of muscle mass. Antagonism between body fat and muscles. N Y State J Med. 1973 Dec 15;73(24):2891–2897. [PubMed] [Google Scholar]
- Taylor H. L. Occupational factors in the study of coronary heart disease and physical activity. Can Med Assoc J. 1967 Mar 25;96(12):825–831. [PMC free article] [PubMed] [Google Scholar]
- Therriault D. G., Beller G. A., Smoake J. A., Hartley L. H. Intramuscular energy sources in dogs during physical work. J Lipid Res. 1973 Jan;14(1):54–60. [PubMed] [Google Scholar]
- Watt E. W., Foss M. L., Block W. D. Effects of training and detraining on the distribution of cholesterol, triglyceride, and nitrogen in tissues of albino rats. Circ Res. 1972 Dec;31(6):908–914. doi: 10.1161/01.res.31.6.908. [DOI] [PubMed] [Google Scholar]
- White P. D. Place of exercise in cardiology. Am J Cardiol. 1972 Nov;30(7):716–717. doi: 10.1016/0002-9149(72)90143-9. [DOI] [PubMed] [Google Scholar]
- Wood P. D., Haskell W., Klein H., Lewis S., Stern M. P., Farquhar J. W. The distribution of plasma lipoproteins in middle-aged male runners. Metabolism. 1976 Nov;25(11):1249–1257. doi: 10.1016/s0026-0495(76)80008-x. [DOI] [PubMed] [Google Scholar]
