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Atherosclerosis: Can exercise help with cholesterol level?

 


What is LDL and HDL cholesterol?

As you may know LDL is the villain and HDL is the hero when it comes to cholesterol, but why is that the case and what is the reason that we would want to have more of the latter?

Low density lipase (LDL) is made up mostly of cholesterol and other molecules , such as phospholipids and triglyceride and proteins. The low density of these particles makes them float in the blood and thus in the vasculature. LDL particles donate cholesterol to non-hepatic tissues, so tissues other than the liver. Now, as with everything else in the body, cholesterol is crucial for the body; however, too much of it causes problems. Problems such as atherosclerosis and plaque build-up. Thus, LDL is also known as “atherogenic.”  

On the other hand, high density lipase (HDL) is made up of mostly proteins which make these particles weigh more, hence the higher density. Their role in the body is to circulate in the bloodstream and collect cholesterol from non-hepatic tissues. In other words, HDL is “atheroprotective,” so it protects against atherosclerosis.  

Ok… but what is it about them that initiates atherosclerosis?

            Well, there are regions in blood vessels that make them more susceptible to atherosclerosis. Those regions meet a turbulent flow (where the blood is not moving in a straight path with different speeds at different points) rather than a laminar flow (where blood is moving in a constant speed in a direct path).Thus, substances such as LDL get to spend more time in those regions and interact more with the inner surface of vessels (i.e., endothelial cells). However, it is important to note that laminar flow is important for the health of the endothelial cells. With turbulent flow, helpful reactions would not occur and instead there will be more attachment points on the vessel wall for substances such as LDL. Thus, with more time, more LDL interaction with the vessels that are not functioning in a healthy way will lead to oxidation of LDL. And that is when the whole process of atherosclerosis begins.

 

Research 

It is important to recognize that elderly individuals have the capacity to improve their cholesterol level through exercise. One study looking into the effects of aerobic exercise (60 minutes of dancing to music and using resistance bands at 65-75% of HRmax) on cardiovascular disease in prehypertensive elderly women (mean age of 69) and recorded that HDL cholesterol significantly rose after aerobic exercise programs (Ahn & Kim, 2020). An additional study looked into similar parameters of aerobic exercise and elderly women; except this time the women were aged 70-87 and walked 3 days a week at 70% heart rate reserve for 20-50 minutes (lasted for 10 weeks) (Fahlman et al., 2002). These participants also experienced increased HDL cholesterol as well due to the exercise modality (Fahlman et al., 2002). A study investigating both men and women aged between 63-71, recorded a significant increase in HDL when participants completed a stationary bike training protocol at an intensity of 50% estimated VO2max for 60 minutes, two to four times per week for 5 months (Sunami et al., 1999). Therefore, aerobic exercise can help improve an elderly individual’s cholesterol level.

 

Exercise

As seen in the research, there are a wide variety of aerobic exercise training modalities that can help elderly individuals improve their cholesterol levels. Which exercise is best for a given person comes down to a lot of variables such as safety, personal mobility, personal preference, and so on. However, what does seem to be the one commonality in the current scientific research is that whatever aerobic modality one picks, that it has to be at a fairly high intensity. It seems that benefits begin to occur when the exercise is at or greater than an individual’s 50% VO2 max. Estimating a person’s VO2max can be done through looking at a person’s maximal heart rate and such equations that estimate VO2max from heart rate do exist. These equations though are just estimations and are not 100% accurate, with a general rule being that 60%-90% of an individual’s maximal heart rate results in about 50-85% VO2max. In summary, this means that there are a wide variety of aerobic exercises that can help improve a person’s cholesterol levels.

 


**If you believe that aerobic exercise will help you or someone you know, please contact a registered healthcare professional for more information.

**For more detail on this topic or to recommend future content, please email us.

Studies Referenced:

Ahn, N., & Kim, K. (2020). Can Active Aerobic Exercise Reduce the Risk of Cardiovascular Disease in Prehypertensive Elderly Women by Improving HDL Cholesterol and Inflammatory Markers?. International journal of environmental research and public health, 17(16), 5910.

Fahlman, M. M., Boardley, D., Lambert, C. P., & Flynn, M. G. (2002). Effects of endurance training and resistance training on plasma lipoprotein profiles in elderly women. The journals of gerontology. Series A, Biological sciences and medical sciences, 57(2), B54–B60.

Sunami, Y., Motoyama, M., Kinoshita, F., Mizooka, Y., Sueta, K., Matsunaga, A., Sasaki, J., Tanaka, H., & Shindo, M. (1999). Effects of low-intensity aerobic training on the high-density lipoprotein cholesterol concentration in healthy elderly subjects. Metabolism: clinical and experimental, 48(8), 984–988.

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