Effects of endurance training on serum lipids

Background and aims: Physical activity is recommended as part of the lifestyle modification for the treatment of hyperlipidemia, however, the literature reports heterogeneous quantitative effects of exercise on serum lipids. We therefore reviewed the effects of aerobic exercise on serum lipids with special focus on the training effectiveness. Methods: Data regarding effects of endurance training (ET) on total Cholesterol (TC), LDL-Cholesterol (LDL-C), HDL-Cholesterol (HDL-C) and triglycerides (TG) were evaluated in a selective literature search. To account for the observed heterogeneity of the training interventions, studies were analyzed according to effectiveness (duration, intensity, frequency) of training. Results: Unselected training intervention studies did not exert significant effects on serum LDL-C but showed minor positive effects on HDL-C and TG. Effective endurance training - defined as endurance training performed by an intensity of 65-75% of the heart rate reserve (corresponding to 75-85% maximum heart rate or 65-80% VO2max) for a duration of 40-50 min per training unit on 3-4 days/week over a period of 26-40 weeks showed improvement of serum lipids. Effective training lowered TC by - 3.75% (p = 0.0006), LDL-C by - 4.76% (p = 0.0015), TG by - 8.24% (p = 0.0004) and increased HDL-C by + 4.43% (p = 0.0061). Conclusion: The analysis suggests that a minimum exercise threshold is necessary to produce effects on serum lipids. Overall, the quantitative effect of physical activity on serum lipids is small.