Regulation of serum lipids by physical exercise

191 Pages·1982·4.358 MB·English

by  Hietanen, Eino

Regulation
of
Serum Lipids
by
Physical Exercise
Editor
Eino Hietanen, M.D.
Department of Physiology
University of Turku
Turku, Finland
Acting Professor in Physiology
University of Kuopio
Consultant in Clinical Physiology
University Central Hospital of Kuopio
Kuopio, Finland
BoCcaR RaCton P Lroendsosn, NIenwc Y.o rk
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First published 1982 by CRC Press
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Library of Congress Cataloging in Publication Data
Main entry under title:
Regulation of serum lipids by physical exercise.
Bibliography: p.
Includes index.
1. Blood lipoproteins—Metabolism.
2. Exercise—Physiological aspects.
3. Metabolic regulation. 4. Exercise therapy.
I. Hietanen, Eino, 1947– [DNLM:
1. Exertion. 2. Lipids—Blood. 3. Lipids—
Metabolism. 4. Lipoproteins—Blood.
5. Lipoproteins—Metabolism. QU 85 R344]
QP99.3.L52R43 616.1’05 81-38526
ISBN 0-8493-6330-6 AACR2
A Library of Congress record exists under LC control number: 81038526
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PREFACE
Regular exercise training is known to increase both psychical satisfaction and phys-
ical fitness by improving cardiorespiratory performance and muscular capacity. Large
retrospective and prospective studies have indicated that physical activity most probably
decreases cardiovascular mortality. Recently, numerous studies have shown that ath-
erosclerosis and coronary heart disease are related to lipid disorders. Regular exercise
may alter serum lipid and lipoprotein profiles. Whether exercise training prevents cor-
onary heart disease by a direct improvement of capillary perfusion in the heart, by
decreasing blood pressure, by stabilizing autonomic nervous system, by increasing fi-
brinolysis and decreasing blood clotting, or whether increased HDL levels improve the
transport of cholesterol from vascular walls or decreased LDL levels lower cholesterol
accumulation in the vascular intima, is an unanswered question. Possibly physical ex-
ercise has multitudinous effects; when a person develops a life style with a regular
physical exertion, also other changes in personal habits might take place simultaneously
and possibly the number of risk factors decreases.
The aim of this book is to concentrate on the role of physical training in the regulation
of serum lipids in healthy man. Exercise conditioning is common among healthy per-
sons and public information advises people to exercise regularly. On the other hand,
lipid disorders are among the most common as risk factors of coronary heart disease.
It has even been estimated that, when serum cholesterol concentration is normal, the
power of other risk factors would be rather low but when cholesterol is high, the power
of other risk factors is also multiplied. Regular exercise might also enhance peripheral
removal of cholesterol by increasing high density lipoprotein concentration in serum.
The object of this book is to estimate the power of regular exercise and the intensity
of exercise in the regulation of plasma lipid and lipoprotein concentrations. The mech-
anisms which mediate the effects of exercise training on serum lipoproteins have first
recently begun to be understood. The regulation of lipid metabolism involves numerous
pathways and regulatory systems from various hormones to specific enzymes involving
many tissues. Our ultimate goal is to find out the basic mechanisms which mediate the
exercise-induced changes in serum lipid profile. Thus, basic biochemistry also is of
help in evaluating experimental data in this sense.
Finally, specific features of exercise in certain populations will be dealt with. The
lipid disorders may originate from childhood which makes it important to practice pre-
ventive methods even at these early ages. Thus, attention will be given to estimate the
influence of exercise in children. Although our aim is not to provide any profound
therapeutic approaches to treat diseases, a short estimation is given on the possibilities
of improving physical fitness of persons with coronary heart disease or metabolic dis-
orders. It is our hope that the reader will find this book useful when judging the means
of physical exercise in preventive medicine.
Eino Hietanen
THE EDITOR
Eino Hietanen, M.D., is acting professor in physiology at the University of Kuopio
and consultant at the Department of Clinical Physiology at the University Hospital in
Kuopio, Finland. He is also conducting research at the Department of Physiology,
University of Turku and at the Rehabilitation Research Centre of the Finnish Social
Insurance Institution.
He obtained his M.D. degree at the University of Turku in Finland and served his
residency in clinical physiology at the Departments of Clinical Physiology in Kuopio
and Turku University Hospitals. He has been a postdoctoral fellow at the Institute of
Human Nutrition, College of Physicians and Surgeons, Columbia University, New
York, 1975-1976 and shorter periods at Karolinska Institutet in Stockholm and Uni-
versity of Ulm in West Germany.
His thesis was in physiology of intestinal hydrolytic enzymes and their regulation by
nutritional factors. Dr. Hietanen has also conducted research on the role of nutritional
factors in the regulation of hepatic and extrahepatic drug metabolism and on the role
of dietary factors in experimental carcinogenesis. Other main research objectives in-
clude the development of obesity, the role of lungs in lipid metabolism, and especially
the regulation of serum lipid metabolism by training and exercise. He has written about
100 original articles and reviews to various international journals and books.
CONTRIBUTORS
Eino Hietanen, M.D. Matti Uusitupa, M.D.
Department of Physiology Department of Medicine
University of Turku University Central Hospital of Kuopio
Turku , Finland Kuopio, Finland
Katriina Kukkonen, M.D. Ilkka Valimaki, M.D., M.Sc.
Kuopio Regional Institute Department of Pediatrics
of Occupational Health University Central Hospital of Turku and
Kuopio, Finland Cardiorespiratory Research Unit
University of Turku
Esko Lansimies, M.D. Turku, Finland
Department of Clinical Physiology
University Central Hospital of Kuopio Jorma Viikari, M.D.
Kuopio, Finland Department of Medicine
University Central Hospital of Turku
Aapo Lehtonen, M.D. Turku, Finland
Department of Medicine
University Central Hospital of Turku Erkki Voutilainen, M.D.
Turku, Finland Department of Medicine
University Central Hospital of Kuopio
Jukka Marniemi, Ph.D. Kuopio, Finland
Rehabilitation Research Centre of the
Social Insurance Institution Veli Ylitalo, M.D.
Turku, Finland Department of Pediatrics
University Central Hospital of Turku
Rainer Rauramaa, M.D., M.Sc. Turku, Finland
Institute of Exercise Medicine
Kuopio, Finland
TABLE OF CONTENTS
CHARACTERIZATION OF LIPOPROTEINS AND THEIR METABOLISM
Chapter 1
Synthesis and Catabolism ............................................... .l
E. Voutilainen and E. Hietanen
Chapter 2
Isolation and Determination of Lipoproteins ................................1 1
E. Voutilainen and E. Hietanen
Chapter 3
Lipids as a Risk Factor of Coronary Heart Disease .......................... 19
E. Voutilainen and E. Hietanen
Chapter 4
Regulation of Lipoprotein Metabolism by Nutritional Factors ................. 35
E. Hietanen
Chapter 5
Hormones in the Regulation of Lipoprotein Metabolism ..................... .47
E. Hietanen
Chapter 6
Environmental Factors and Lipoproteins .................................. -55
E. Hietanen
EXERTION, LIPOPROTEINS AND THEIR METABOLISM
Chapter 7
Dynamic Exercise Tests ............................................... .65
R. Rauramaa, K. Kukkonen, and E. Lansimies
Chapter 8
Exercise Training and Serum Lipids ..................................... .7 1
A. Lehtonen
Chapter 9
The Effect of Continuous, Long-Term Exercise on Serum Lipids ............. .89
J. Marniemi
Chapter 10
Effect of Exercise on Hormones Regulating Lipoprotein Metabolism ........... 95
J. Marniemi and E. Hietanen
Chapter 11
Exercise and Lipolytic Enzymes ....................................... .l05
J. Marniemi and E. Hietanen
Chapter 12
Response of Serum Lecithin Cholesterol Acyltransferase Activity to
ExerciseTraining ...................................................1.1 5
J. Marniemi and E. Hietanen
Chapter 13
Relation between Serum Lipids and Physical Exercise in Children ............1 19
J. Viikari, V. Ylitalo, and I. Valimaki
METABOLIC AND CARDIOVASCULAR DISEASES AND EXERCISE
Chapter 14
Physical Training in Obesity and Diabetes Mellitus ......................... 13 1
K. Kukkonen, R. Rauramaa, and E. Lansimies
Chapter 15
Antihypertensive Medication and Physical Training ......................... l41
M. Uusitupa
Chapter 16
Prognostic and Preventive Value of Exercise in Coronary Heart
Disease .............................................................1 49
E. Hietanen
INDEX .............................................................1 65

Characterization of Lipoproteins
and their Metabolism