ApoB but not LDL‐cholesterol is reduced by exercise training in overweight healthy men. Results from the 1‐year randomized Oslo Diet and Exercise Study

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Abstract
: Objectives. (i) To estimate changes in apoB and apoB/apoA‐I, reflecting the balance between atherogenic and anti‐atherogenic lipoprotein particles, by exercise training and compare with changes in LDL‐C and TC/HDL‐C ratio, and (ii) To compare strengths of relationships between physical fitness and various lipoprotein variablesDesign, setting, and subjects. The study was a 1‐year open randomized trial comprising 219 healthy middle‐aged subjects aged 40–49 years who were allocated to exercise or no exercise, dietary advice or no advice in a 2 × 2 factorial design. This study includes 188 men who completed the trial, 45 to diet, 48 to exercise, 58 to diet + exercise and 37 to control.Interventions. Exercise; supervised endurance exercise three times a week. Diet; reduce weight, increase intake of fish and reduce total fat intake.Main outcome measure. One‐year change in apoB and apoB/apoA‐I ratio.Results. Exercisers decreased their ApoB and ApoB/ApoA‐I values significantly compared to non‐exercisers. LDL‐C was not, but LDL‐C/HDL‐C was marginally but statistically significantly reduced by exercise. One‐year change in ApoB and ApoB/ApoA‐I correlated more strongly to 1‐year changes in physical fitness than LDL‐C or LDL‐C/HDL‐C. Adjusting for changes in LDL‐C or LDL‐C/HDL‐C did not influence the correlation between changes in fitness and ApoB or ApoB/ApoA‐I. However, adjusting for changes in ApoB or ApoB/ApoA‐I wiped out the correlation between change in fitness and LDL‐C or LDL‐C/HDL‐C. Relationships weakened when adjusting for changes in waist circumference, but Apo B or ApoB/ApoA‐I still correlated significantly to changes in fitness.Conclusion. Physical exercise reduced the atherogenic burden as experienced by the reduction in apoB or apoB/apoA‐I levels, but not by LDL‐C in healthy middle‐aged men. Possibly, regular physical activity might increase the LDL‐C particle size, thereby making LDL less atherogenic. Monitoring of apolipoproteins rather than the cholesterol moiety of lipoproteins might improve the assessment of lipoprotein changes after exercise training.