EFFECTS OF DIET AND EXERCISE ON APOLIPOPROTEINS AND LIPOPROTEIN(A) - RESULTS OF A RANDOMIZED CONTROLLED-STUDY IN MEN

To study the effects of diet (D, n = 40), exercise (E, n = 39), and di et plus exercise (DE, n = 39) in relation to no active intervention [c ontrols (C, n = 39)], 157 healthy men aged 35-60 years (mean +/- SD: 4 6 +/- 5) were recruited from a prevention program in a primary health care area. Serum concentrations of major lipoproteins, apolipoprotein A-I, apolipoprotein B, and lipoprotein(a) [Lp(a)], were analyzed befor e and after a 6-month intervention period. Total energy intake was red uced in group DE and the fat consumption was reduced in groups D and D E (-3% of total energy). In the same groups the carbohydrate intake in creased (+2%, -3% of total energy). Among the men in groups E and DE, the number of exercise sessions per month increased from five to ten a nd the duration of each session from 39 to 53 and from 30 to 56 min, i n each group respectively. Serum cholesterol decreased in the DE group only [mean (95% confidence intervals): -0.45 (-0.77, -0.13) mmol/l], whereas low-density lipoprotein cholesterol decreased in both group D and group DE [-0.30 (-0.54, -0.06) and -0.35 (-0.64, -0.05) mmol/l, re spectively]. High-density lipoprotein cholesterol and triglycerides we re unaffected. There was a small but significant reduction in apolipop rotein A-I in groups DE and C of - 0.06 (-0.01, -0.02) and -0.08 (-0.1 4, -0.02) g/l, respectively. Apolipoprotein B decreased only in group DE [-0.10 (-0.17, -0.03) g/l]. Lp(a) levels had a skewed distribution ranging from 2 to 880 mg/l, with a geometric mean of 112 mg/l at basel ine. In the three intervention groups, no significant changes were see n in Lp(a) levels. In the control group, the levels increased signific antly during the 6-month period [+40.5 (+17.6, +63.4) mg/l]. Thus, nei ther diet nor exercise, nor the combination of diet plus exercise, aff ected Lp(a) levels despite reductions in several important risk factor s, including apolipoprotein B.