In recent years, the atherosclerotic diseases have been increasing in our country and it is well known that the disorders of lipoprotein metabolism are one of the important factors which lead to the development of atherosclerotic diseases. On the other hand, there have been many reports that athletes are rarely suffered from atherosclerotic diseases and in these days many people tend to take exercise such as jogging and tennis to promote their health. However, studies on effects of physical exercise on lipoprotein metabolism are quite few. In this report we investigated the effects of physical exercise on serum lipids and lipoproteins in massive obese patients during the strict treatment of weight reduction who were thought to have atherosclerotic risk factors.
　In the first study, 20 massive obese patients with weight 101±26kg (190±43% of IBW) were admitted and treated with a very low calorie diet (2.52-4.2MJ (600-1000kcal)/day). Through weight reduction serum triglycerides and total cholesterol significantly decreased. In addition, HDL-cholesterol was also lowered from 43±11mg/dl to 36±9mg/dl (p<0.001). However, HDL-cholesterol recovered to the level before weight reduction two weeks after discharge, while weight, triglycerides and total cholesterol remained decreased. In the second study, eight obese patients (184±39% of IBW) were treated with physical exercise, which included 50 watts of ergometer for 45 min. and 10000 step of walking/day, from the third week after admission in addition to the diet therapy described above. Although body weight, triglycerides and total cholesterol reduced equally to the first study, HDL-cholesterol increased from 30±7mg/dl (just before exercise) to 40±11mg/dl (p<0.01) after exercise. Therefore marked reduction of atherogenic index, (tota-HDL)-cholesterol/HDL-cholesterol, was obtained. These results suggest that the decreased of HDL-cholesterol during a very-low calorie diet in admission is temporary and probably due to the lack of physical activity. We conclude that physical exercise during weight reduction increases HLD-cholesterol which is an anti-atherogenic factor, and is essential for reducing atherogenic risk factors.

DESCENTE SPORTS SCIENCE Vol.5/THE DESCENTE AND ISHIMOTO MEMORIAL FOUNDATION FOR THE PROMOTION SPORTS SCIENCE