Into the Heart

Increasing Lipid Metabolism

The balance between lipid deposition and lipid mobilization in adipose tissue (fat tissue) and the liver has a significant role in the overall regulation of lipid metabolism.

Exercise performed in the fasted state, shortly before a meal, leads to more favorable lipid metabolism during and after exercise than exercise performed shortly after a meal. Enhanced lipid metabolism will hold down synthesis of triglycerides.

Triglycerides contribute to the formation of small, dense LDL cholesterol. Small, dense LDLs are especially prone to oxidation and thus more likely to be taken up by macrophages in the artery wall, leading to the progression of the atherosclerotic plaque.

Understanding of the mechanisms that regulate and co-ordinating lipid metabolism in relation to everyday activities that either promote or inhibit lipid mobilization or deposition, e.g. (food intake and exercise), is important because a disturbance of the regulation and co-ordination of  lipid metabolism in adipose (fat) tissue and the liver can lead to metabolic diseases such as obesity and type 2 diabetes mellitus. Aggressively addressing obesity and preventing or reversing type 2 diabetes significantly lessens the risk factors associated with cardiovascular disease.

As such, according to the study noted below*enjoying a brisk walk prior to dinner leads to more favorable lipid metabolism, than a brisk walk after dinner. 

Source:
The combined effects of exercise and food intake on adipose tissue and splanchnic metabolism
L H Enevoldsen, L Simonsen, I A Macdonald, MD's
J Physiol. 2004 December 15; 561(Pt 3): 871–882.

The role of HDL-cholesterol in preventing atherosclerotic disease
Philip Barter MD
The European Society of Cardiology 2005.

Preventing Vascular Junk

Inflammation has a significant role in the development and progression of coronary artery disease (the pathophysiology of atherosclerosis). Arterial inflammation . . . can be described as a cellular nest within blood vessels, causing growth (blockage), aggregation and adhesion of cellular components, that brew. Quenching the cellular messengers/mediators of vascular inflammation helps prevent arterial buildup. Aerobic activity lowers the risk of coronary artery disease by simmering cellular inflammatory mediators.

In a cardiac rehabilitation study*, twenty eight patients, average age 64, participated in a 12-week aerobic exercise training program at 70-80% of individual maximal heart rate. Such training resulted in a significant reduction of all pro-inflammatory cytokines tested as well as a significant increase in the anti-inflammatory and immune regulatory cytokine IL-10.

Aerobic activity includes brisk walking, swimming, treadmill & stairmaster. During aerobic exercise or cardiovascular exercise the body uses oxygen from blood as the primary fuel for working muscles. During resistance/weight training the body works anaerobically using sources other than oxygen for fuel. Both aerobic and resistance exercise reduce the risk of cardiovascular disease development and progression.

Aerobic exercise training in individuals with coronary artery disease is a non-pharmaceutical effective means to reduce **C-reactive protein, IL-1, IL-6, INF-gamma levels, and increase in IL-10, thus, improving coronary risk profile and lessening the risk of heart attack.

**High sensitivity C-reactive protein (hs-CRP) is a plasma marker of inflammation. It identifies an increased risk of an acute coronary event independent of LDL cholesterol.

Sources:
*Exercise training modulates cytokines activity in coronary heart disease patients.
Goldhammer E, Tanchilevitch A, Maor I, Beniamini Y, Rosenschein U, Sagiv M. Dept of Cardiology, Bnai Zion Medical Center and Faculty of Medicine, Technion, Haifa 31048, Israel.
Int J Cardiol. 2005 Apr 8;100(1):93-9.

Aerobic exercise, but not flexibility/resistance exercise, reduces serum IL-18, CRP, and IL-6 independent of beta-blockers, BMI, and psychosocial factors in older adults.
Kohut ML, McCann DA, Russell DW, Konopka DN. Department of Health & Human Performance, Immunobiology, Gerontology, Animal Science, Iowa State University, Ames, IA, USA.
Brain Behav Immun. 2006 May;20(3):201-9.

The influence of exercise training on inflammatory cytokines and C-reactive protein.
Stewart LK, Flynn MG, Department of Kinesiology, Louisiana State University, Baton Rouge, LA, USA. Med Sci Sports Exerc. 2007 Oct;39(10):1714-9.

Years Free of Cardiovascular Disease

Physical in-activity is a modifiable risk factor for cardiovascular disease.
Moderate and high physical activity levels contribute to 1.3 and 3.7 years more in total life expectancy and 1.1 and 3.2 more years lived without cardiovascular disease for men age fifty years or older compared to those who maintain a low physical activity.

For women moderate and high physical activity levels contribute to 1.5 and 3.5 years more in total life expectancy and 1.3 and 3.3 more years lived free of cardiovascular disease,compared to women who maintain a low physical activity.

Avoiding a sedentary lifestyle during adulthood prevents cardiovascular disease independent of other risk factors . . . and substantially expands total life expectancy, and cardiovascular disease free life expectancy for men and women.

Source:
Effects of Physical Activity on Life Expectancy with Cardiovascular Disease
Oscar H. Franco, MD, PhD; Chris de Laet, MD,PhD
Arch Internal Med. 2005; 165:2355-2360.