Effects of Fitness on Lipid Profiles

Studies have shown that being physically fit, especially aerobically fit, protects against some of the detrimental effects of being overweight or obese. A recent study published in the April issue of Medicine & Science in Sports & Exercise, investigated the relationship between fitness and lipid profile.

The subjects were healthy male reservists, aged 18 to 48 years, in the Finnish military. Their height and weight were accurately measured, Body Mass Index (BMI) calculated, and classified as normal weight, overweight, or obese according to World Health Organization (WHO) guidelines. Aerobic and muscular fitness were assessed using standardized techniques and classified as unfit, average, or fit. Fasting blood samples were assayed for their lipid profile. Specific measures were total serum cholesterol, oxidized-LDL (ox-LDL), HDL, ratio of ox-LDL to HDL cholesterol, and serum triglycerides. For simplicity, this article will simply refer to the lipid profile as either improved, regardless of whether the improvement was across the entire profile or only partially, or not improved.

Consistent with known data, lipid profiles differed by BMI group with increasing BMI associated with a higher risk lipid profile. Within the normal weight group, there was no difference among the aerobic fitness groups but being aerobically fit eliminated the difference between overweight and normal weight in the lipid profile. Similarly, muscular fitness conferred a benefit on the overweight group compared to being unfit.

The authors conclude: “ … good physical fitness could prevent the development of an atherogenic lipid profile in overweight or obese subjects ….” and that “… good cardiorespiratory fitness and muscular fitness seem to protect overweight subjects from the atherogenic lipid profile.”

Many people exercise with the intent of losing weight and stop exercising when they fail to reach their target weight. This ignores the independent health protective effects of exercise for those who are overweight.

Practical Health Strategies ( www.practicalhealthstrategies.com ), offers wellness programs in the Pensacola and Mobile area, and throughout north Florida, and south Alabama, Georgia, and Mississippi. Practical Health Strategies offers Wellness Plans you can Live With!

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Commentary on Periodontal Disease and Atherosclerotic Vascular Disease:

A recent literature review published in Circulation, the journal of the American Heart Association, was widely referenced in the general media as “debunking” the “myth” that gum disease can cause heart disease.

The literature review covered 537 peer-reviewed publications between 1950 and July, 2011, on the association between periodontal disease (PD) and “any cerebrovascular, peripheral vascular, or cardiovascular disease” (ASVD) excluding certain other complicating diseases. The search did not include dental caries. The review was motivated, in part, because “Patients and providers are increasingly presented with claims that PD treatment strategies offer ASVD protection; these claims are often endorsed by professional and industrial stakeholders.”

Quoting from the article: “The link between ASVD and inflammatory mediators in blood is well established, with consistent associations between levels of systemic inflammatory markers and increases in clinical events such as MI and nonhemorrhagic stroke ….” and “Chronic periodontal infection contributes to systemic inflammation characterized by elevation of … CRP. CRP has been linked to incident MI, stroke, peripheral arterial disease, and sudden cardiac death in multiple prospective epidemiological studies…”

The article concluded that: “Extensive review of the literature indicates that PD is associated with ASVD independent of known confounders. This information comes mostly from observational studies, however, and therefore does not demonstrate that PD is a cause of ASVD, nor does it confirm the contention that therapeutic periodontal interventions prevent heart disease or stroke or modify the clinical course of ASVD.” And from the abstract: “Although periodontal interventions result in a reduction in systemic inflammation and endothelial dysfunction in short-term studies, there is no evidence that they prevent ASVD or modify its outcomes.”

Contrary to the contention by the NY Times that it “debunked” the “myth” the review showed that: (1) PD is independently associated with ASVD, (2) the nature of the studies to date, and the confounding mutual risk factors, preclude drawing inferences as to any causative relationship, (3) certain associated biomarkers co-vary with PD and ASVD, and (4) data does not support claims that treating established periodontal disease will reduce or prevent ASVD. In consideration of the independent association of PD and ASVD, one would still be well advised to establish good oral hygiene at a young age which should be maintained throughout adulthood.

Practical Health Strategies ( www.practicalhealthstrategies.com ), offers wellness programs in the Pensacola and Mobile area, and throughout north Florida, and south Alabama, Georgia, and Mississippi. Wellness Plans you can Live With!

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Activity, Mortality and Quality of Life

Obesity and physical inactivity are known, modifiable contributors to morbidity and mortality but the relative importance of each is often confused. Two recent studies investigated the proportional contributions.

One study, published in the April, 2012, issue of the American Journal of Public Health, looked at the effect of type and intensity of activity on all cause mortality in a sample of 7456 British civil servants. Activities were classified as mild, moderate, or vigorous based upon published energy expenditure levels. In statistical models controlling for age, those with the lowest activity levels had a higher mortality risk than those with intermediate or high activity levels. Those with at least one hour of moderate activity per week had a one-third lower risk of death than those with less than one hour.

In another study, published in the April, 2012, issue of Medicine & Science in Sports & Exercise, looked at leisure time physical activity, body mass index (BMI), and the health related quality of life in a sample of 110,986 Canadian adults. The investigators used validated measures of the impact of health status on quality of life. Both BMI and physical inactivity were independent predictors of a diminished quality of life and, when considered together, physical inactivity was the stronger predictor.

These studies are consistent with other studies that have shown cardiovascular conditioning to be more important that weight status in predicting adverse cardiovascular events. They also show the value of increasing physical activity even in the absence of weight loss.

Practical Health Strategies (www.practicalhealthstrategies.com), based in Pensacola, offers wellness programs throughout northern Florida, and southern Alabama, Georgia, and Mississippi. Practical Health Strategies develops Wellness Plans you can Live With!

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