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July 17, 1996

Effects of a Single Bout of Ultraendurance Exercise on Lipid Levels and Susceptibility of Lipids to Peroxidation in Triathletes

Author Affiliations

From the Departments of Cardiology (Dr Ginsburg) and Laboratory Medicine (Dr Rifai), Children's Hospital, Boston, Mass; Department of Pharmacology, University of Granada (Spain) (Dr Agil); Department of Orthopedics, University of Tennessee, Memphis (Dr O'Toole); Department of Nutrition, Harvard School of Public Health, Boston (Dr Rimm); Cardiovascular; Division, Beth Israel Hospital, Boston (Drs Ginsburg and Douglas); and Departments of Medicine (Drs Ginsburg and Douglas) and Pathology (Drs Agil and Rifai), Harvard Medical School, Boston.

JAMA. 1996;276(3):221-225. doi:10.1001/jama.1996.03540030055032

Objective.  —To determine the effects of a single bout of ultraendurance exercise, as a model for physiologic stress, on lipid and lipoprotein levels, and oxidative susceptibility of lipids in highly trained athletes.

Design.  —Observational trial.

Population and Setting.  —Thirty-nine volunteer subjects (26 men, 13 women; mean age, 38±10 years) who competed in and completed the 1994 Hawaii lronman World Championship Triathlon consisting of a consecutive 3.9-km (2.4-mi) swim, 180.2-km (112-mi) bike ride, and a 42.2-km (26.2-mi) run. Subjects answered questionnaires and had blood samples obtained 2 days prior to and within 15 minutes of completion of the triathlon.

Main Outcome Measures.  —Prerace vs postrace changes in lipid and lipoprotein levels, and susceptibility of lipids to peroxidation.

Results.  —The mean duration of exercise was 753± 128 minutes. With exercise, plasma volume—corrected levels of triglycerides decreased 39% from 1.58±0.83 to 0.97±0.68 mmol/L (139.6±73.6 to 85.8±60.5 mg/dL) (P<.001). Levels of total cholesterol decreased 9% from 4.94±0.88 to 4.50±0.79 mmol/L (190.8±33.8 to 173.8±30.6 mg/dL) (P<.001), low-density lipoprotein cholesterol decreased 11% from 2.59±0.77 to 2.30±0.86 mmol/L (100.1±29.9 to 88.7±33.3 mg/dL) (P=.02), and apolipoprotein B decreased 10% from 0.91± 0.20 to 0.82±0.18 g/L (90.7±20.0 to 82.0± 17.9 mg/dL) (P<.001). High-density lipoprotein cholesterol and apolipoprotein A-l increased with exercise but not significantly. The susceptibility of lipids to peroxidation decreased significantly (4.51±1.91 μmol/L, preexercise, vs 2.42±2.27 μmol/L, postexercise, P<.001), an effect that was not related to antioxidant use or levels of vitamins A, C, or E. Serum iron, a potential pro-oxidant, also decreased by 45% with exercise from 15.75±5.55 to 8.59±4.30 μmol/L (88±31 to 48±24 μg/dL) (P<.001), an effect that was weakly correlated with changes in lipid peroxidation (P=.05).

Conclusions.  —These data suggest that a single bout of prolonged exercise can reduce lipid and lipoprotein risk factors for developing cardiovascular disease. Moreover, susceptibility of lipids to peroxidation is reduced by exercise, thereby adding to the benefits of physical activity. This effect appears to be independent of antioxidant supplement use and may be mediated by induction of endogenous antioxidants. These observations may explain in part the reduced risk of developing vascular and other diseases in individuals who are physically active.