Effect of Aerobic Exercise on the Blood Lipid Profile in Young Adults

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212 Indian Journal of Physiotherapy & Occupational Therapy. April-June 2014, Vol. 8, No. 2

Effect of Aerobic Exercise on the Blood Lipid Profile inYoung Adults

Choudhary S1

, Narwal R K2

1P.G. MPT(CP&IC) Department of Physiotherapy, HIPMS, 2Lecturer, Department of Physiotherapy, HIHT University, Dehradun, U.K

ABSTRACT

Aims & objectives: The aim of the present research was to determine the effect of aerobic exercisetraining on blood lipid profile in young adults. The path physiology of blood lipid in young adultsits increase the atherosclerosis formation on the coronary artery and during the physical inactivityresults it developed cardiac diseases. Therefore use of aerobic exercise will be helpful in setting up a

better aerobic exercise protocol for improving the lipid profile level and prevention of cardiac disease.

Methodology: This experimental study was carried out with 6 subjects including both male andfemale with age 20- 30year at college of Himalayan hospital. The data is collected by taking outcomevariables in form of blood lipid profile level, BP, THR time. Protocol: - Aerobic exercise 30 minutesession/ 5 days/ weeks for 4 weeks with 60 - 70 %THR.

Result: There was a beneficial effect of exercise on HDL variables, BP, & THR seen most clearly withthe 4 week of aerobic exercise training, other than HDL, BP &THR no other variable has been able todifferentiate among both groups.

Discussion: The increase in HDL and decreases the BP, THR time among both group after the aerobicexercise training. Minimal weekly exercise increases the HDL level. BP & THR time are due to theparasympathetic activity.

Conclusions: Aerobic exercise is widely believed to induce changes in the lipid profile, BP & THRtime of subjects.

Keywords: Aerobic exercise training, blood lipid profile level, HDL (High Density Lipoprotein), BP (BloodPressure) and THR (Target Heart Rate).

INTRODUCTION

Coronary heart disease (CHD) is the leading causeof death in India and the leading cause of deathworldwide. CHD leads to more death and disabilityin low and middle income countries and its affectspeople at younger ages in low and middle incomecountries 1. According to world health organization(WHO) bulletins, 1.2 million Indians died from heartdisease in 1990 and it predicts that by 2010, 100 millionIndians will have heart disease and by 2020, India willsuper cede all other nations in terms of CADprevalence. 2,3

The WHO reports that in India risk factors for thepremature CHD subjects could be multiple, rangingfrom smoking, sedentary lifestyle, improper diet,abnormal lipids, hypertension, diabetes and obesityand genetic factors 4. These studies also reported thatmore than 90 % of acute coronary events can be

predicted by major coronary risk factors 5. So, the AHAand other governing bodies have continued to

emphasize the importance of exercise in childhood asa means of preventing CHD later in life (Kavey et al.,2003)6,7.

CAD is almost always due to athermanousnarrowing and subsequent occlusion of the vessel.Growth mainly by lipid accumulation of first to thirddecade of life due to the fatty streak formation ,intermediate lesion and the atheroma formation of theintima & media and thrombosis/hematoma formationat the fourth decade of life and it is cause the CAD. 8

Regular exercise is effective in reducing the risk of developing arteriosclerotic disease as the biologicalmechanism (i.e. beneficial effects on atherosclerotic riskfactor, myocardial function, coronary artery size andvasodilator capacity and vascular tone, fibrinolysis,platelet function) in many intervention. 9,10 .

There is lack of dearth of literature regarding

research outcome related to effect of aerobic exercisein blood lipid profile. That’s why this study is design

DOI Number: 10.5958/j.0973-5674.8.2.088


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Indian Journal of Physiotherapy & Occupational Therapy. April-June 2014, Vol. 8, No. 2 213

on aerobic exercise to find a better effect for preventionof CAD in risk factor subjects and non risk factorsubjects.

METHODOLOGY

This pilot study was carried out with sample size

of 6 subjects who have been selected fromphysiotherapy department of Himalayan hospital,with CAD risk factors or non risk factor-normalsubjects.

Inclusion criteria: Male and female subjects between ages 20 – 30 yrs were taken with history of smoking, alcoholic, family history of CAD anddiabetic, hypertension, obesity , high blood lipid profilelevel , THR>60-70%max.HR and asymptomatic withall risk factor subjects.

Exclusion criteria: All symptoms with cardiac,

vascular, pulmonary, neurological, orthopedic andsurgical conditions , THR < 80% max.HR on exercisetesting.

Variables: Independent variables were aerobicexercise. Dependent variables were in form of bloodlipid profile level (Total cholesterol-TC, Low densitylipoprotein-LDL, High density lipoprotein HDL, Verylow density lipoprotein VLDL, &Triglysrides TG),Blood Pressure-BP and Target Hear Rate AchievementTime-THART.

Instrumentation: Treadmill, polar heart rate

monitor, syphagnomanometer, stethoscope

DATA ANALYSIS

The data was analyzed by the statistical packageof SPSS -17, graphical pad software as required andsignificant level was set at pd”0.05 and confidenceinterval was 95 %. The dependent variables used forthe comparisons of scientific analysis were blood lipidprofile (TC, LDL, HDL, VLDL, and TG), blood pressureand THR time by parametric test in form of pre andpost intervention. The intra group comparison wasdone with the help of mean and standard deviationanalysis by paired t test by taking two values in bothgroups. Inter group comparison was done by unpairedt test as required.

Procedure flow chart

RESULT

The result presentation of data is based on the twogroups including risk factor group-A and non risk

factor group-BComparison of Blood Pressure Variables (BP)

Table 1.1: The comparison of mean of blood pressure intervention both risk factor (group A) and non risk factor(group B).

Variable Pre (Mean±SD) Post(Mean±SD) T valve P valve

Group A BP Sys. 130±10.0 125.6±5.7 0.017 0.001Dias. 100±10.0 93.3±5.7 1.242 0.001

Group B BP Sys. 128±10.0 120±0.0 0.354 0.001

Dias. 93.3±10.0 86±10.0 0.761 0.001

Significance Level (Pd”0.05)


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Comparison of Cholesterol & Target Heart RateAchievement Time(THRAT) Variables

Thus an overall analysis of various scores showedthat HDL increase, blood pressure and target heart ratetime valve decreased more significantly with fourweeks of aerobic exercise training.

DISCUSSION

Result of this research is derived from the sampleof six subjects with abnormal blood lipid profile level,

blood pressure and THR time based on ratio of maleand female 1:1 with a mean age of 20 -30 years. Settingof this study is supported that the atherosclerosisformation in the form of fatty streaks formation startat the second to third decade of life and increase theprevalence of coronary artery disease in young adults.

Our study is based on number of physiologicalvariables in form of total cholesterol, low densitylipoprotein, high density lipoprotein, very low densitylipoprotein, triglycerides, blood pressure & THR time.All these variables are able to represent theimprovement of cardiac rehabilitation intervention as

described by victor F. Froelicherin their textbook forexercise testing & training 11. These outcome variables

Fig. 1.1. Comparison of mean of cholesterol Level between riskfactor (group A) and non risk factor (groupB).

Fig. 1.2. Comparison of mean of LDL intervention between riskfactor (group A) and non risk factor (group B).

Fig. 1.3. Comparison of mean of VLDL Level between risk factor

(grp A) and non risk factor (grp B).

Fig. 1.4. Comparison of mean of THRAT level between risk factor(grp A) and non risk factor (grp B).

Fig. 1.5. Comparison of mean of TG level between risk factor (grpA) and non risk factor (grp B).

Fig. 1.6. Comparison of mean of HDL Level between risk factor(grp A) and non risk factor (grp B).


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also supported by research studies of Georg A, Kelley,U.Narayani, Kerstin stoedefalke, satoru kodamaet al 12, 13, 14.

Pre exercise Comparison of Data

The comparison of all variables before exercise

prescription suggest that both group lie at samephysiological state ( HDL, BP & THR time) and showsno significant difference, so it can be concluded that

both groups before treatment lie at same physiologicalcondition.

Post exercise Comparison of Data

1. Discussion of blood cholesterol variable.

The comparison of both group (risk factor & nonrisk factor group) to see between & within groups

shows improvement of blood lipid profile andcholesterol level after four weeks of aerobic exercisetraining. But this improvement is not significant andit may be due to the aerobic exercise training requiredmore than 4 weeks of aerobic exercise training to showssignificant effect.

George A, Kelley et al have suggested that morethan 4 week of aerobic exercise reduces totalcholesterol, triglycerides and increases high densitylipoprotein in adults 18 years of age and older 12.U.Narayani et al have suggested that the total cholesteroldecreases and increase high density lipoproteincholesterol in obese women after six weeks of aerobicexercise and endurance training 13.

2. Discussion of low density lipoprotein variables.

Risk factor and normal group showed notsignificant decline in low density lipoprotein from fourweek by the physiotherapy intervention in the formof aerobic exercise training.

Kelley et al suggest that the effect of aerobic exercisetraining > 8 week are effective in low densitylipoproteins level in blood 12.Kerstin Stoedefalke et al,shows that the 15 week aerobic exercise trainingprogram resulted in significant decreases in lowdensity lipoproteins 14.

3. Discussion of high density lipoprotein variable.

The third important finding both the risk factor andnormal subject groups shows significant effect afterfour weeks of aerobic exercise training and this findingsupporting the effect of aerobic exercise on highdensity lipoprotein cholesterol.

Satoru Kodama et al, study conclude that theregular aerobic exercise increases high densitylipoprotein level it can also shows that the minimalweekly exercise volume for increasing HDL level wasestimated to be 900kcal of energy expenditure per weekor 120 minutes of exercise per week 15.

Gilliam and Burke (1978) showed a significantincrease in HDL levels with no changes in triglycerideslevels in the six week aerobic exercise 16.Paul D.Thompson et al, suggested that the effect of aerobicexercise training in risk factor subjects and normalindividual showed a significant effect and increase thehigh density lipoproteins with the changes of lowdensity lipoprotein. 17

4. Discussion of very low density lipoproteinsvariable.

Both groups the risk factor and normal subjectgroup showed non- significant improvement in thevery low density lipoproteins outcome from onemonth after doing aerobic exercise training. The fact

behind these changes may be due to the aerobicexercise training more than four week of aerobicexercise training to shows significant effect.

William E. Kraus et al, shows the highest amountof weekly exercise, with minimal weight change, hadwidespread beneficial effects on the lipoprotein profile.

The improvements were related to the amount of activity and the intensity of exercise or improvementin physical activity of the subject. 18

5. Discussion of triglycerides variable.

The risk factor and normal subjects group showsnot significant effect in the triglycerides level outcomefrom one month aerobic exercise training protocol. Itmay be due to the duration of the aerobic exercisetraining.

George A. Kelley et al, suggest that the more than 8weeks of aerobic exercise training reduces thetriglyceride level of the lipoprotein in men 18 years of age and older. 12William E . Kraus et al, showed theduration and the amount of the aerobic exercisetraining had beneficial effects on the lipoproteinprofile. 18Ignigo and Mahon et al, suggest that the effectof ten week aerobic exercise training program had ontriglycerides. 19

6. Discussion of blood pressure variable.

The next important physiological finding in the


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form of BP within group and between groups showssignificant effect after four weeks of aerobic exercisetraining.

Robert H. Fagard et al, have suggest that aerobicexercise training decreases blood pressure through avascular resistance , in which the sympathetic nervoussystem and due to the involvement of the renninangiotensin system 20.

The fact that the decrease of HR is counterbalanced by an increase in stroke volume with unchanged COis compatible with the generally accepted effect of aerobic exercise training on resting hemodynamic. Adecrease in the activity of the autonomic nervoussystem is most likely involved in the training inducedreduction of BP.

7. Discussion of THR time variable.

The next important finding comparison of THRtime in risk factor group shows significant effect onexercise training this may be due to the both grouphaving the low level of parasympathetic tonicity oractivities which is significantly strengthen by the fourweek of aerobic exercise training. So one week of aerobic exercise training is effective for THR time andincreasing the endurance capacity.

CONCLUSION

On the basis of our result it can be concluded thatTC, TG, VLDL and LDL required more than four weekof aerobic exercise training for improvement by bothgroups.

HDL is the only cholesterol variables which showthe significant effect .so four weeks of aerobic exercisetraining are improve the HDL lipid valves. It can beassociated HDL is a heart protective cholesterol. It can

be to counter effect the LDL, VLDL level.

Aerobic exercise training significant effects on BPmean systolic and diastolic and it can improve cardiacendurance and better parasympathetic activity. Fourweek of aerobic exercise training is effective for inincreasing the endurance capacity.

Therefore aerobic exercise training should beincorporated in rehabilitation protocol of CAD patientswhich in turn will help in improving their quality of life and improvement of physiological parameters.

Clinical Relevance

Aerobic exercise training is best for improvementof the marked decrease in the serum cholesterol level.So exercise training improves the endothelial functionof arteries ,reduces the risk factors & and decrease inthe incidence of CAD after aerobic exercise training.

Therefore, aerobic exercise has proved as a valuableand preventable tool of cardiac rehabilitation. Aerobicexercise improves cardio-pulmonary endurance,quality of life, makes them fit and its help in betterlife.

Future research & Limitation of study

This study is limited to a very small sample size.So it is strongly recommended for future research

based on large sample size and aerobic exerciseprotocols may be tried more than four weeks.

ACKNOWLEDGEMENT

We are very grateful to our Deputy Dean Dr.Anuradha Kusum & HOD, Department of physiotherapy, Dr. R. Maheshwari who provided usvaluable guidance, all facilities and endless supportwithout which we would not have been able tocomplete this clinical research .

Source of Funding & conflict of interest

Research work is supported and funded byHimalayan Institute Hospital Trust, Dehradun-UK.There is no conflict of interest related to this clinicalresearch.

REFERENCE

1. Lim S, Gaziano et al, prevention of cardiovasculardisease in high risk individuals in low incomeand middle income countries, health effects and

costs lancet, 2007, volume 370, 2054 – 2062.2. Soumitra kumar et al, coronary artery disease inIndia, Indian heart journal, 1997, volume 49, 25 –34.

3. Gupta R, Joshi P , Mohan V et al, epidemiologyand causation of coronary heart disease andstroke in india, Indian heart journal, 2008, volume94, 16-26.

4. Jominin V et al , contribution of majorcardiovascular risk factors to familial premature


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coronary artery disease: American journal of cardiology, 2002, volume 40, 676-684.

5. Greenland P, knoll MD et al, major risk factors asantecedents of fatal and nonfatal coronary heartdisease events, JAMA, 2003, volume 290, 891- 897.

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association guidelines for primary prevention of atherosclerotic cardiovascular disease beginningin childhood, American heart journal circulation,2003, volume 107, 1562-1566.

7. Benerson, G.S et al, association between multiplecardiovascular risk factor and atherosclerosis inchildren and young adults, new England journalof medicine , 1998, volume 338,1650-1656.

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association,2003, volume 107, 3109-3116.18. William E. Kraus et al, effects of the amount andintensity of exerciseon plasma lipoproteins, newEngland journal of medicine , 2002, volume 347,1483- 1492.

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Effect of Aerobic Exercise on the Blood Lipid Profile in Young Adults

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