Weight loss is superior to exercise in improving the atherogenic lipid profile in a sedentary, overweight population with stable coronary artery disease: A randomized trial. Academic Article uri icon


  • BACKGROUND: Dyslipidemia and low-grade inflammation are integral in the pathogenesis of atherosclerosis. We aim to compare the effects of a considerable weight loss and intensive exercise training on lipid atherogenicity and low-grade inflammation in a high-risk population with coronary artery disease (CAD). METHODS: Seventy non-diabetic participants with CAD, BMI 28-40 kg/m(2), age 45-75 years were randomized to 12 weeks' aerobic interval training (AIT) at 85-90% of peak heart rate three times/week or a low energy diet (LED, 800-1000 kcal/day) for 8-10 weeks followed by 2-4 weeks' weight maintenance diet. Lipid profile atherogenicity was described using lipoprotein particle size and density profiling. Low-grade inflammation was evaluated by tumor necrosis factor alpha (TNF), C-reactive protein, interleukin 6 and soluble urokinase plasminogen activator receptor. RESULTS: Twenty-six (74%) AIT and 29 (83%) LED participants completed intervention per protocol. AIT and LED decreased total (AIT: -518 {-906;-129},P = 0.011, LED: -767 {-1128:-406},P < 0.001) and low-density lipoprotein (LDL, AIT: -186 {-306;-65},P = 0.004, LED: -277 {-433;-122},P < 0.001) assessed as the area under the density profile curve. LED was superior to AIT in decreasing atherogenicity reflected by increased LDL (between-group: 1.0 {0.4; 1.7},P = 0.003) and high-density lipoprotein (between-group: 1.2 {0.2; 2.4},P = 0.026) particle size and a decreased proportion of total lipoprotein constituted by the small, dense LDL5 subfraction (between-group: -5.0% {-8.4;-1.7},P = 0.004). LED decreased TNF (9.5% {-15.8;-2.6},P = 0.009). No changes were seen following AIT. CONCLUSION: LED and AIT decreased total and LDL lipoprotein. LED was superior in decreasing atherogenicity assessed by a shift in density profile and increased particle size. Effect on low-grade inflammation was limited.

published proceedings

  • Atherosclerosis

altmetric score

  • 6.1

author list (cited authors)

  • Pedersen, L. R., Olsen, R. H., Anholm, C., Walzem, R. L., Fenger, M., Eugen-Olsen, J., Haugaard, S. B., & Prescott, E.

citation count

  • 26

complete list of authors

  • Pedersen, Lene Rørholm||Olsen, Rasmus Huan||Anholm, Christian||Walzem, Rosemary L||Fenger, Mogens||Eugen-Olsen, Jesper||Haugaard, Steen Bendix||Prescott, Eva

publication date

  • March 2016