not permitted.

It is not permitted to remove, cover, overlay, obscure, block, or change any copyright notices or terms of use which the Publisher may post on the Article. It is not permitted to frame or use framing techniques to enclose any trademark, logo,
means which may allow access to the Article. The use of all or any part of the Article for any Commercial Use is not permitted. The creation of derivative works from the Article is not permitted. The production of reprints for personal or commercial use is
This document is protected by international copyright laws. No additional reproduction is authorized. It is permitted for personal use to download and save only one file and print only one copy of this Article. It is not permitted to make additional copies
(either sporadically or systematically, either printed or electronic) of the Article for any purpose. It is not permitted to distribute the electronic copy of the article through online internet and/or intranet file sharing systems, electronic mailing or any other


J SPORTS MED PHYS FITNESS 2015;55:1037-45

Strength exercise and training

in postprandial lipaemia
C. SILVA CORREA 1, R. C. REBOLLEDO COBOS 2, Á. REISCHAK-OLIVEIRA 3

® A
T C
H DI
The development of cardiovascular diseases (CVD) has been 1Instituto Federal
associated to alterations on lipid profile as well found dur- Farroupilha - Campus Santo Augusto, RS, Brazil
ing postprandial period, phenomenon known as postprandial 2Physiotherapy Program, Univiersidad Metropolitana

lipaemia (PL). Physical exercise is currently the major non- Barranquilla, Colombia

IG E
pharmacological intervention used to prevention and reduction
of risk factors to developing of CVD. For this reason, there is
growing interest under the effects of physical exercise, espe-
3Exercise Research Laboratory
School of Physical Education
Federal University of Rio Grande do Sul
R M
cially strength training, on regulation and balance of lipid me- Porto Alegre, RS, Brazil
tabolism, particularly of risk groups such as post-menopausal
women that have more prone to CVD than men and lose much
of the cardioprotective effect of estradiol during and after men-
P A

opause period. In this review, we seek to compare the results of (FFA), often seen in sedentary or overweight indi-
articles that addressed the beneficial effects of strength training viduals. High rate of β-oxidation induces electrons
O V

on PL. We used articles selected in databases PubMed, Scopus accumulation followed by an increase in free radical
and EBSCO dating from the year 1975-2012, with many quotes production (e.g., superoxide radical), which diverts
from leading researchers in subject and published in interna- the course of nitric oxide (NO) utilization, decreas-
C ER

tional journals. All studies were obtained to report at least three ing the availability of this potent vasodilator and me-
variables of interest. The authors of this review concluded that
Y

strength training proves to be effective in reducing PL concen-

diator in defense against atherosclerosis. Endothelial
trations by inducing an improvement of basal energy demand, function deteriorates in the same proportion of in-
can be seen as an important strategy to treatment of chronic crease in lipaemia as an acute response to systemic
IN

diseases such as atherosclerosis. changes, whether chronic or postprandial.1, 2

Key words: Postprandial period - Cardiovascular diseases - This phenomenon is associated with increased se-
Muscle strength - Lipoproteins - Postmenopause. cretion of pro-inflammatory cytokines, high expres-
sion of adhesion molecules (ICAM, VCAM-1) and
M

pro-oxidative activity. Endothelium damage found

C hanges in lipid profile representing a risk fac-
tor to development of cardiovascular disease
(CVD) commonly observed during atherosclerotic
plaque formation and subsequent inflammatory re-
sponse. The postprandial lipaemia (PL) is a phe-
nomenon known that inducing endothelial dysfunc-
or other proprietary information of the Publisher.
during this process promotes recruitment of cells
responsive to injury by promoting an infiltration of
monocytes to subendothelial space which are differ-
entiated to macrophages (foam cells), as well known
to exhibit ability to accumulate large amounts of lip-
ids coming from the cytoplasm generating products

tion by increasing the availability of free fatty acids that inducing tissue damage and reactive oxygen and
nitrogen species. Thus, hypertriglyceridemia is a
Corresponding author: C. Silva Correa, Exercise Research Laboratory factor that can stimulates the atherogenic potential.3
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Feli-
zardo 750, Bairro Jardim Botânico 90690-200, Porto Alegre, RS, Brazil. Some studies support the important role of regular
E-mail: cleitonesef@yahoo.com.br aerobic exercise on the PL reduction, prevention and

Vol. 55 - No. 9 THE JOURNAL OF SPORTS MEDICINE AND PHYSICAL FITNESS 1037
not permitted. It is not permitted to remove, cover, overlay, obscure, block, or change any copyright notices or terms of use which the Publisher may post on the Article. It is not permitted to frame or use framing techniques to enclose any trademark, logo,
means which may allow access to the Article. The use of all or any part of the Article for any Commercial Use is not permitted. The creation of derivative works from the Article is not permitted. The production of reprints for personal or commercial use is
This document is protected by international copyright laws. No additional reproduction is authorized. It is permitted for personal use to download and save only one file and print only one copy of this Article. It is not permitted to make additional copies
(either sporadically or systematically, either printed or electronic) of the Article for any purpose. It is not permitted to distribute the electronic copy of the article through online internet and/or intranet file sharing systems, electronic mailing or any other
SILVA CORREA STRENGTH EXERCISE AND TRAINING IN POSTPRANDIAL LIPAEMIA
control of CVD.4 For this reason there is growing in-
terest upon research that aims the effects of exercise
on lipid metabolism.2 Nevertheless, little is known
about the preventive action of strength exercises on
the developing of CVD through changes in impor-
tant risk factors like PL. Strength training appar-
ently reduces total cholesterol (TC) concentration of
adults. However, the strength exercise is still used as
a simple additional alternative to aerobic training.4-6
The skeletal muscle has a major effect on energy
expenditure and is considered to be an important de-
® A
terminant of resting metabolic rate due to the greater
oxygen uptake of the skeletal muscle compared to that
T C
of other tissues.4 Accordingly, it has been suggested
that strength training (ST) and the consequent increase
in muscle mass can reduce multiple risk factors for car-
H DI
diovascular disease. ST is known to induce a marked
improvement in insulin sensitivity, decrease fasting tri-
glycerides and markedly increase the rate of fat oxida-
IG E
tion rate at rest and 24 h following a single RT episode.5
This increase in fat oxidation suggests that resistance
R M
exercise may be particularly useful in reducing lipemia
both at rest and in the postprandial period.
It is believed that strength exercise like aerobic
exercise can help to decreasing PL in response to
P A
increased activity of lipoprotein lipase (LPL) (e.g.,
a key enzyme in triglyceride hydrolysis).5, 7, 8 In ad-
O V
dition, strength training increases insulin sensitiv-
ity,9, 10 decreases the plasma concentration of fasting
C ER
triglycerides (TAG) and markedly increases basal fat
oxidation until 24 hours after single bout of strength
Y
exercise.11 This mobilization and utilization of body
fat can be particularly useful to reduce PL.
IN
The population aging is a growing worldwide phe-
nomenon. Currently, in most developed countries,
10% of the populations are over 50 years and 95%
of women reach menopause (i.e., last menstrual pe-
M
riod confirmed after 12 months of amenorrhea due
to ovarian failure). Changes in physical aspects of
general health and declined emotional well-being
can be observed during the menopausal transition.
Climacteric symptoms affect between 60-80% of
women and are recognized as inducers of physical
and emotional discomfort that increases with the se-
or other proprietary information of the Publisher.
verity of symptoms. Physical exercise is frequently
associated with prevention of metabolic and cardio-
vascular diseases (CVD) are often seen as the main
non-pharmacological intervention to treatment of
these disorders.
1038 THE JOURNAL OF SPORTS MEDICINE AND PHYSICAL FITNESS September 2015
Most investigations involving exercise have been
dedicated to studying the effects of aerobic and
anaerobic exercise on the lipids metabolism of post-
prandial period.12, 13 Some authors have found the
changes in blood parameters induced by exercise in
populations with increased risk of developing CVD
such as postmenopausal women.4, 14
The CVD accounts for more than 33% of deaths
worldwide, and 23% female mortality, making it the
leading cause of death in women over 60 years of
age.8, 15 It is believed that this increased vulnerability
is related to the reduction in hormone levels of estro-
gen for its cardio protective effects and the promo-
tion of an antiatherogenic lipid profile with direct ac-
tion on the endothelium. Additionally, the incidence
of obesity in women in this age group is greater than
men by physical inactivity, and a high fat diet, which
further increases the propensity to development of
CVD.16, 17 However, very little is known concerning
the effects of strength training in the LP of postmen-
opausal women.
Thus, the purpose of this review was to compare
the results found in the literature about the effects of
strength training on plasma lipoproteins in the post-
prandial period associated with the development of
cardiovascular disease, particularly of risk groups
such as postmenopausal women.
Materials and methods
To conduct this review, current references were
required about the subject addressed, with articles
selected in the databases PubMed, EBSCO and
SPORTDiscus dating from the year 1975-2015, and
published in international journals. For this search,
we used terms such as: strength training, resistance
training, postprandial lipaemia, lipoproteins, car-
diovascular diseases, post-menopausal women. The
articles selected for this study were those who ad-
dressed the combination of at least three of the six
keywords of interest aforementioned.
Role of lipoproteins
Lipoproteins have been described with several im-
portant functions including solubilize and transport
of lipids, generally hydrophobic substances from
aqueous plasma. The main target lipids are the fatty
not permitted. It is not permitted to remove, cover, overlay, obscure, block, or change any copyright notices or terms of use which the Publisher may post on the Article. It is not permitted to frame or use framing techniques to enclose any trademark, logo,
means which may allow access to the Article. The use of all or any part of the Article for any Commercial Use is not permitted. The creation of derivative works from the Article is not permitted. The production of reprints for personal or commercial use is
This document is protected by international copyright laws. No additional reproduction is authorized. It is permitted for personal use to download and save only one file and print only one copy of this Article. It is not permitted to make additional copies
(either sporadically or systematically, either printed or electronic) of the Article for any purpose. It is not permitted to distribute the electronic copy of the article through online internet and/or intranet file sharing systems, electronic mailing or any other

STRENGTH EXERCISE AND TRAINING IN POSTPRANDIAL LIPAEMIA SILVA CORREA

acids, cholesterol and triglycerides (TAG). TAG is
the most important energy storage of the body de-
posited in adipose and muscle tissues, and consists of
three fatty acids and one glycerol molecule.18, 19 Cho-
lesterol is an element of the group of fats essential for
life, since it is used in the production of hormones,
bile acids and cell membranes. Only 30% of the cho-
lesterol present in the body comes from of diet, the
remainder is synthesized and may be accumulated
in arterial walls when is found in excess. Hypercho-
lesterolaemia can be originated by dietary or genetic
above, mainly concentrations of TC, TAG, HDL-C
and LDL-C levels are often evaluated to determine
the presence of dyslipidemias and if there are pro-
pensity to CVD.23
The mechanism of blood TAG depuration, after
strength training, and the sources of fatty acids sup-
plying are schematically shown in Figure 1. In the
fasting state, after strength training, most of the fatty
acids used for the synthesis of VLDL-TAG are de-
rived from blood non-esterified fatty acids (NEFA)
which are originated from adipose tissue. Some fatty

® A
causes, and in most cases occurs by an unbalanced acids can be also derived from hepatic TAG drop-
diet rich in saturated fats and lack of physical activity. lets, despite the relative contribution of this source

T C
The blood cholesterol is transported by lipopro- is still unknown. In the fed state, VLDL synthesis
teins. There are four known major classes of lipo- is inhibited temporarily (about 1 hour) by the insu-
proteins that can be separated into two groups: A) lin action. The NEFA release could contribute to the

H DI
TAG-rich, larger and less dense, represented by chy- fatty acids release in the postprandial state, but its
lomicrons from the intestinal origin (responsible for concentration is low during postprandial period due
transporting lipids absorbed by the intestine origi- to the antilipolytic effect of insulin in adipose tissue.

IG E
nating diet and liver enterohepatic circulation), and
the very low density lipoproteins (VLDL), of hepatic
Finally, lipids remnants of chylomicron could pro-
vide a large amount of fatty acids to the liver, which
R M
origin; B) low density lipoprotein (LDL) and high could be esterified again to VLDL and secreted. The
density lipoprotein (HDL) cholesterol-rich. There is contribution of this source of VLDL-TAG has not yet
also a class of intermediary density lipoprotein (IDL) been measured in humans. As the case of lipogenesis
and lipoprotein (a) [Lp (a)], which is the result of de novo intestinal is occur a supply of new fatty acids
P A

covalent attachment of LDL particle to apo (a).20-22 for chylomicrons and TAG production, but this proc-
Among these four classes of lipoproteins listed ess has not yet been measured.
O V
C ER
Y
IN
M
or other proprietary information of the Publisher.

Figure 1.—Graphic representation of the pathogenesis an atherosclerosis and atherosclerotic plaque formation: A) early endothelial
injury by lipoproteins such as VLDL and LDL in the subendothelial layer; B) attraction of monocytes; c) action of chemokines, growth
factors that promote blood diapedesis of monocytes in the intima and differentiation of monocytes into macrophages; d) beginning the
formation of foam cells due to internalization of oxidized lipoproteins, mainly LDL; e) start the accumulation of a layer of fat on the
endothelial wall of the large local deposition foam cells.

Vol. 55 - No. 9 THE JOURNAL OF SPORTS MEDICINE AND PHYSICAL FITNESS 1039
not permitted. It is not permitted to remove, cover, overlay, obscure, block, or change any copyright notices or terms of use which the Publisher may post on the Article. It is not permitted to frame or use framing techniques to enclose any trademark, logo,
means which may allow access to the Article. The use of all or any part of the Article for any Commercial Use is not permitted. The creation of derivative works from the Article is not permitted. The production of reprints for personal or commercial use is
This document is protected by international copyright laws. No additional reproduction is authorized. It is permitted for personal use to download and save only one file and print only one copy of this Article. It is not permitted to make additional copies
(either sporadically or systematically, either printed or electronic) of the Article for any purpose. It is not permitted to distribute the electronic copy of the article through online internet and/or intranet file sharing systems, electronic mailing or any other
SILVA CORREA STRENGTH EXERCISE AND TRAINING IN POSTPRANDIAL LIPAEMIA
In the scientific literature, understanding the
mechanisms of TAG release is of paramount impor-
tance for the design of which could have been affect-
ed. The first is mediated by breaking and removal of
fatty acids to outside of TAGs and of the particle-rich
lipoproteins that circulate in the blood. Blood TAG
reduction can be observed according of LPL activity.
The second method of calculation of plasma TAG oc-
curs when the particle of triacylglycerol is absorbed
by liver through its receptor. When consumed in ex-
cess, TAG tends to deposit on the walls of arteries
® A
and form fat plaques, atheroma, can impair the blood
flow, stimulate the production of clots and contribut-
T C
ing to the narrowing of blood vessels, especially if
plasma HDL-c is found low (Figure 1).24, 28-30
H DI
Physical exercise on the enzyme lipoprotein lipase
activity
IG E
The physical activity, both aerobic as the strength,
or a combination of both associated with a control-
R M
led diet can effectively prevent and improve obes-
ity, hyperlipidemia and CVD due to its effect on the
increased activity of the enzyme lipoprotein lipase
(LPL).10, 25-27, 32 The LPL is found in the capillaries
P A
of adipose tissue, heart and skeletal muscle. This en-
zyme is known to aid in the removal of blood chy-
O V
lomicrons and catalysing the TAG to free fatty ac-
ids and glycerol. LPL may also have a function of
C ER
anchor, attaching the chylomicron remnants to the
liver wall, where re-esterification process occurs.24
Y
In adipose tissue and skeletal muscle LPL activity is
regulated in a dependent manner (i.e., increased LPL
IN
activity one of tissue is closely associated with a de-
crease in the LPL activity of the other).33 Insulin re-
lease attenuates the LPL activity in skeletal muscle,
but potentiates its activity in adipose tissue, which
M
is important during fasting periods. The LPL activ-
ity is stressed by exercise, especially in the recovery
period after one bout of strength exercise.34, 35
Strength exercise and training on postprandial li-
paemia
or other proprietary information of the Publisher.
Aerobic exercise performing between 15-18 hours
prior to ingestion of a high fat meal may attenuate
the response of PL.36-38 The energy expended dur-
ing aerobic exercise is an important factor to induce
PL reduction.38 Few studies have evaluated the in-
1040 THE JOURNAL OF SPORTS MEDICINE AND PHYSICAL FITNESS September 2015
fluence of strength exercises on the PL. Neverthe-
less, the strength exercise is widely recommended
by health associations to improve the quality of life,
weight management and prevention of several dis-
eases.19
To our knowledge only five studies analyzed
the influence of the main variables like volume
(number of sets) and intensity (% 1RM) of strength
training on the PL. Furthermore, these studies are
controversial, when compared to different volumes,
only the study 39 reported an acute reduction of PL
concentrations. On the other hand,27, 40, 41 observed
no reduction in PL after single session of strength
exercises.
The work by Shannon et al.41 was the only study
that examined the effects of dose-response of three
different volumes (one, three and five sets of ten
maximum repetitions) of strength exercises on PL
finding no significant difference after performing,
where the subjects consumed proportionately more
energy and fat when compared to control group the
night before the fat tolerance test. This may have
increased the possibility of modifying the diet as a
confounding factor masking the effect of strength
training on glycemic response. Thus it would be in-
teresting to examine the effect of different amounts
of strength training on PL without suppression of ex-
ercise-related events, including the energy deficit as
well as physiological, metabolic and hormonal dis-
turbances. Moreover, the authors of that study based
their results on a mixed sample of men and women,
although they reported different responses of PL be-
tween the sexes.
Singhal 6 were the ones who evaluated the effect
of different intensities of strength exercises in PL,
moderate (60-65% 1RM, P=0.052) and high inten-
sity (85-90% of 1RM, P=0.014). In both cases there
was a decreased of PL in 26% and 35% respectively,
whereas in the first case the reduction was signifi-
cantly greater. Indeed, it seems that single series of
moderate intensity 40, 41 when compared with the
multiple series (Zafeiridis et al., 2007) 27 and high
intensity,6 substantially reduces the total time and
muscular recovery period followed by lower plasma
concentration of CRP, TNF-α and IL-6.42, 43
Still several studies indicate the superiority of
multiple sets of the single series of exercise in the
neuromuscular and morphological adaptations,44-47
although little is known about the answers metabolic
not permitted. It is not permitted to remove, cover, overlay, obscure, block, or change any copyright notices or terms of use which the Publisher may post on the Article. It is not permitted to frame or use framing techniques to enclose any trademark, logo,
means which may allow access to the Article. The use of all or any part of the Article for any Commercial Use is not permitted. The creation of derivative works from the Article is not permitted. The production of reprints for personal or commercial use is
This document is protected by international copyright laws. No additional reproduction is authorized. It is permitted for personal use to download and save only one file and print only one copy of this Article. It is not permitted to make additional copies
(either sporadically or systematically, either printed or electronic) of the Article for any purpose. It is not permitted to distribute the electronic copy of the article through online internet and/or intranet file sharing systems, electronic mailing or any other

STRENGTH EXERCISE AND TRAINING IN POSTPRANDIAL LIPAEMIA SILVA CORREA

Table I.—Methods and results of investigations that reported the effects of strength exercise on PL. Adapted from Singhal et al.6

Reference MR Series Interval Total time of Total of EE (kcal/min and total) ↓ PL- TAG in AUC
(min) SEB (min) relative to control (%)
Petitt et al.39 10 3 2 88 4.62 (406.6) 14 (P=0.05)
Shannon et al.41 10 1 1 20 6.85 (137.0) NS
10 3 1 48 6.85 (328.8) NS
10 5 1 90 6.85 (616.5) NS
Burns et al.40 10 4 2 88 6.25 (550.0) NS
Zaifeiridis et al.27 12 2 1.5 39 4.66 (181.7) 20 (P=0.017)
12 4 1.5 79 4.24 (335.0) 24 (P=0.004)
Singhal et al.6 8 3 3 90 4.18 (376.2) 26 (P=0.052; NS)
16 3 2.3 90 4.81 (432.9) 35 (P=0.014)

® A
Correa et al.65 15 3 0.5 50 2.92 (143.3) NS
15 1 0.5 50 2.96 (74.1) NS
MR: maximum repetition; SEB: strength exercise bout; EE: energy expenditure; PL: postprandial lipaemia; TG: triglycerides; AUC: area under curve;

T C
NS: not significant.

H DI
and biochemical changes in different volumes and
intensities of strength training.
Based on the contradictory results described, the ef-
Strength exercise session and training in cardiovas-
cular disease (CVD)
Strength training is known to be a strong inducer

IG E
fects of strength training on PL require further inves-
tigation. We did not find studies that investigated the
effects of different volumes before and after strength
of changes in neuromuscular, morphological and
metabolic conditions. The adaptations found during
R M
training. At work Zafeiridis et al.27 presented the ef- this period were associated to a protective effect by
fects of strength training on the response of TAG in induce reduction of mortality and metabolic syn-
the postprandial period and observed a reduction in drome.32, 49 Evidences from epidemiological studies
show that there is a relationship between reduced
P A

the total of 6 hours and increase the area under the

curve (AUC) after the PL conducting a session of risk of coronary heart diseases and regular perform-
ing of strength training.50
O V

strength training. In this protocol, there were con-

sumed 0.76 and 1.40 MJ. The same author recently Paffenbarger and Hale investigated the occupa-
completed a study that evaluated the effects of aero- tional activity on the development of CVD in dock-
C ER

bic exercise protocol and another with strength exer- ers.51 Dockworkers who performed hard physical la-
bor, such as lifting and loading of heavy loads, had a
Y

cises in which they earned a total estimated energy

expenditure of 5.1 MJ in PL, a decrease of 12% and lower mortality rate for coronary heart disease when
18% respectively, the total of elementary AUC of the compared to dockers that did not perform strenuous
IN

plasma PL.48 The measured values calculated from
the total AUC of PL concentrations in this study was
found low Burns et al.40 compared to that observed
for Zafeiridis et al.27 (-0.53 and -0.65 for the low and
M
physical tasks. In another study about the effect of
strength training on cardiovascular responses 32 of
individuals that perform 30 minutes of strength exer-
cises per week were 23% lower risk to developing of

high volume strength training, respectively). Despite
the estimated energy, energy expenditure was much
higher.
The evidence on this topic is still confused, since
there is only one study that disagrees with these re-
sults. Petitt et al.39 observed a reduction in the PL
concentrations after single session of strength exer-
or other proprietary information of the Publisher.
coronary heart disease than individuals that did not
perform any weight training. However, the benefits
of strength exercise on risk factors to developing of
cardiac diseases are not well established.51
The CVD share a common pathophysiology in-
volving atherosclerosis and thrombosis.2, 20, 32 Dis-
orders in the lipoprotein metabolism during post-

cises, energy expenditure estimated at 1.7 MJ and
calculated an effect size for this study -0.78, very
close to observed in the study.27 The main results of
the aforementioned studies are presented in Table
I.39-65
prandial period can promote atherosclerosis due to
accumulation of LDL-c and VLDL remnants in the
plasma after catabolism of these lipoproteins, which
increases susceptibility to oxidation of these parti-
cles.

Vol. 55 - No. 9 THE JOURNAL OF SPORTS MEDICINE AND PHYSICAL FITNESS 1041
not permitted. It is not permitted to remove, cover, overlay, obscure, block, or change any copyright notices or terms of use which the Publisher may post on the Article. It is not permitted to frame or use framing techniques to enclose any trademark, logo,
means which may allow access to the Article. The use of all or any part of the Article for any Commercial Use is not permitted. The creation of derivative works from the Article is not permitted. The production of reprints for personal or commercial use is
This document is protected by international copyright laws. No additional reproduction is authorized. It is permitted for personal use to download and save only one file and print only one copy of this Article. It is not permitted to make additional copies
(either sporadically or systematically, either printed or electronic) of the Article for any purpose. It is not permitted to distribute the electronic copy of the article through online internet and/or intranet file sharing systems, electronic mailing or any other
SILVA CORREA STRENGTH EXERCISE AND TRAINING IN POSTPRANDIAL LIPAEMIA
Atherosclerosis is a disease not only characterized
by lipid accumulation, but also a chronic inflamma-
tory process.42 The C-reactive protein (CRP) is a
classic marker of the inflammatory process associat-
ed with atherosclerosis that can also play an etiolog-
ic role in atherogenesis. Epidemiological research 52
suggests that strength work is beneficial to health,
and it is possible that the energy expenditure induced
by this effort provides some cardioprotective effects.
Thus, there remains important to determine how
much strength exercise is beneficial to cardiovascu-
® A
lar health mainly for special populations.
T C
Effects of strength exercise and training in meno-
pause
H DI
Menopause is characterized by closure of the ovu-
latory menstrual cycle of woman, occurring at an av-
erage of 47-54 years of age.53 During the premeno-
IG E
pausal progress, the ovaries become resistant to the
actions of follicle-stimulating hormone (FSH), which
R M
generates an increase in the concentration of this
hormone.4 Several changes associated to menopause
have been described for this transitional period in-
cluding: 1) increased body mass index (BMI); 2) de-
P A
creased physical activity; 3) decreased bone mineral
density; 4) decreased basal metabolism; 5) increased
O V
ghrelin independent of BMI; and 6) increased leptin
in non-obese women follow by a greater oxidative
C ER
stress and increased inflammatory markers.9, 17, 54
Change in classical lipid parameters such as higher
Y
concentrations of triglycerides, low intensity lipo-
protein (LDL), higher density of particles and lower
IN
LDL lipoprotein high intensity (HDL) also are found
in the menopause, which generates a greater risk for
cardiovascular diseases and decreased muscle mass
(sarcopenia).15 The ovarian follicles depletion result-
M
ing in the inability to produce hormones such as es-
trogen added to the physiological changes that occur
in the premenopausal.55
Women as well as men show several risk factors
for CVD such as family history, poor dietary hab-
its, obesity, smoking, dyslipidemia, high levels of
homocysteine, fibrinogen, high, inactivity, diabetes
or other proprietary information of the Publisher.
and hypertension,15, 56 young women have a signifi-
cantly lower risk of developing CVD compared to
men the same age group.4 However, with advancing
age, especially after menopause, the risk approaches
that of men. This increased vulnerability is related
1042 THE JOURNAL OF SPORTS MEDICINE AND PHYSICAL FITNESS September 2015
to decreased levels of the hormone estrogen. These
hormones appear to protect women by promoting an
anti-atherogenic lipid profile with direct action on
the wall of blood vessels.15
During menopause, women lose much of the
cardioprotective effect induced by endogenous es-
tradiol showing a greater risk of developing CVD
than men.57 The possible effects of cyclic hormone
concentrations in lipid and carbohydrate metabolism
may confound studies of premenopausal women.9
Recently, the postmenopausal status has been
identified as an independent risk factor for metabolic
syndrome. The authors reported that, after control-
ling for age and BMI, postmenopausal women had
a higher prevalence of abdominal obesity, high
concentration of TAG, elevated fasting glucose and
hypertension during the 10-14 years following the
menopause,58 which provides an increased health
risk for metabolic syndrome and cardio metabolic
diseases such as type 2 diabetes and dyslipidemia.59
Aerobic exercise is commonly described as a
non-pharmacological strategy for prevention and
treatment of obesity and dyslipidemia, as strength
training, as a possible preventive intervention and
treatment of obesity and dyslipidemia is still uncer-
tain.15
Strength training results in inconsistent effects on
BMI, weight and percentage of body fat in obese
and type 2 diabetes.60 Likewise, strength training has
been shown effective in reducing serum concentra-
tions of TC, TAG and LDL-C as well as increased
concentrations of HDL-C.4, 5, 7-9 Therefore, many au-
thors reported no changes on plasma concentrations
of lipids and lipoproteins after different periods of
strength training (e.g., 8-20 weeks).21, 53, 61, 62
The inconsistencies and conflicts of the literature
on the above findings may be due to types of strength
training (e.g., circuit machines, free weights or elas-
tic bands), total training volume and intensity and
the characteristics of participants.
Few studies have investigated the effects of
strength training in the lipids and lipoproteins con-
centrations in postmenopausal women. The study of
Fahlman et al.63 analyzed the plasma lipoprotein re-
sponse in older postmenopausal women aged 70-87
years and overweight subjects that were randomly
assigned to two groups of exercise: aerobic (three
days/week, 20-50 minutes, with 70% heart rate re-
serve) and another power (3 days/week, 1-3 sets, 8
not permitted. It is not permitted to remove, cover, overlay, obscure, block, or change any copyright notices or terms of use which the Publisher may post on the Article. It is not permitted to frame or use framing techniques to enclose any trademark, logo,
means which may allow access to the Article. The use of all or any part of the Article for any Commercial Use is not permitted. The creation of derivative works from the Article is not permitted. The production of reprints for personal or commercial use is
This document is protected by international copyright laws. No additional reproduction is authorized. It is permitted for personal use to download and save only one file and print only one copy of this Article. It is not permitted to make additional copies
(either sporadically or systematically, either printed or electronic) of the Article for any purpose. It is not permitted to distribute the electronic copy of the article through online internet and/or intranet file sharing systems, electronic mailing or any other
STRENGTH EXERCISE AND TRAINING IN POSTPRANDIAL LIPAEMIA SILVA CORREA
exercises, eight repetitions maximum) for 10 weeks.
The aerobic training showed a significant increase in
serum concentrations of TC and HDL-c with a con-
comitant reduction of LDL-C and TAG. The strength
training group also increased HDL-C concentrations
and reduced TC, LDL-C and TAG, despite these val-
ues are more significant in percentage terms for the
aerobic group. In contrast, Elliott et al.53 examined
the effects of strength training (for 8 weeks, 3 days/
week, 3 sets of 6 exercises to 80% of 10-RM) in the
concentrations of circulating lipids and lipoproteins,
® A
as well as evaluated muscle strength in postmeno-
pausal women. Despite significant increases in mus-
T C
cle strength and changes in serum lipids and lipopro-
teins found in the post-workout, this work presents
some interventions, including the use of hormone re-
H DI
placement therapy by the subjects as well as chang-
es in plasma volume after training, that possibly
contribute to these inconsistent findings.. In recent
IG E
work,15 postmenopausal women without hormone
replacement therapy shown a significant reduction of
R M
TC and LDL-c blood concentrations after 12 weeks
of strength training, although not have found differ-
ence in BMI and body composition when compared
to rest group.
P A
Similarly to strength training, the effects of a sin-
gle bout of resistance exercise on lipids and lipopro-
O V
teins have inconsistent results. In healthy men has
been reported significant reductions of TAG concen-
C ER
trations (20%) and an increase in HDL-c (11%) and
HDL3-C (12%) 24 hours following a single session
Y
of strength exercises at high volume and moderate
intensity (7 exercises with intensity between 08-12
IN
RM).64 In contrast, Hill et al.26 observed an increase
in HDL-C immediately after a single session of high-
intensity strength exercises (3 sets, 8 exercises and
RM 10), although the changes found may have been
M
due to changes in plasma volume after session, since
the plasma volume adjustments were not performed
in this investigation.
Recently, our Correa et al.65 published an acute
study: thirty-nine healthy unconditioned postmeno-
pausal women 59.5±4.8 years of age were assigned
to a LVRE (N.=12), HVRE (N.=14), and control
or other proprietary information of the Publisher.
group (CG, N.=13). Experimental groups performed
one RES involving eight exercises. The HVRE group
performed three sets with a maximum of 15 repeti-
tions, and the LVRE group performed one set with
a maximum of 15 repetitions. Approximately 16 h
Vol. 55 - No. 9 THE JOURNAL OF SPORTS MEDICINE AND PHYSICAL FITNESS 1043
after a RES, all of the groups were given an oral fat
tolerance test (OFTT). During the RES, we evalu-
ated the energy expenditure (EE) of the resistance
session and excess postexercise oxygen consump-
tion (EPOC); following the RES and the OFTT,
we evaluated lipid profiles (total cholesterol, HDL,
LDL, and triglycerides). While the study groups did
not demonstrate significant differences in lipid pro-
files, the total energy expenditure (EE+EPOC) of the
session exercise treatments was significantly higher
for HVRE than for LVRE (0.60±0.12 and 0.31±0.11
MJ, respectively, P<0.001). Apparently, different
levels of resistance exercise do not lower basal trig-
lyceride concentration and postprandial lipid profile
parameters at approximately 16 h following resist-
ance exercise in untrained postmenopausal women.
In another study Correa et al.,66 chronic study,
thirty-six healthy and untrained postmenopausal
women age, 58.9±5.8 years participated in resist-
ance training 3× per week for 11 weeks (HVRT=12;
LVRT=13; and control group=11). Energy expendi-
ture total (EE+EPOC; 6.12±1.21 MJ vs. 2.26±0.85
MJ), resting fat oxidation (5.52±1.69 g h−1 vs.
4.11±1.12 g h−1); triacylglycerol (TAG) 0, 1, 2,
4; and 5 h after OFTT, TAG area under the curve
(AUC) (5.79±0.42 vs. 7.78±0.68), and incremental
AUC (-46.21±14.42% vs. 7.78±4.68%) were all sig-
nificantly different post-training for HVRT versus
LVRT, respectively (P<0.05), the results of this in-
vestigation suggest that HVRT reduces PPL in post-
menopausal women.
Conclusions
This review supports the hypothesis that resistance
exercise has a direct relationship with changes in
postprandial lipaemia associated with cardiovascular
disease. However, there are few studies that looked
at the effects of this intervention on changes in fast-
ing lipid profile or after high-fat meal. The strength
proves more effective than aerobic exercise in reduc-
ing concentrations of PL by enabling greater resting
energy expenditure without necessarily correlate
with changes in body composition. Indeed, strength
training appears as a crucial tool in improving lip-
id parameters associated with greater efficiency of
energy demand, and thus can be considered an im-
portant non-pharmacological strategy to reduce risk
not permitted. It is not permitted to remove, cover, overlay, obscure, block, or change any copyright notices or terms of use which the Publisher may post on the Article. It is not permitted to frame or use framing techniques to enclose any trademark, logo,
means which may allow access to the Article. The use of all or any part of the Article for any Commercial Use is not permitted. The creation of derivative works from the Article is not permitted. The production of reprints for personal or commercial use is
This document is protected by international copyright laws. No additional reproduction is authorized. It is permitted for personal use to download and save only one file and print only one copy of this Article. It is not permitted to make additional copies
(either sporadically or systematically, either printed or electronic) of the Article for any purpose. It is not permitted to distribute the electronic copy of the article through online internet and/or intranet file sharing systems, electronic mailing or any other
SILVA CORREA STRENGTH EXERCISE AND TRAINING IN POSTPRANDIAL LIPAEMIA
factors to developing of CVD, showing greater ef-
fect on risk groups such as postmenopausal women.
The strength training is a non-pharmacologically ef-
fective strategy for the prevention of cardiovascular
diseases that are associated with the phenomenon
of PPL and may provide other health benefits than
those traditionally associated with this type of exer-
cise in postmenopausal women.
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Conflicts of interest.—The authors certify that there is no conflict of
interest with any financial organization regarding the material discussed
in the manuscript.
Received on July 16, 2013.
Accepted for publication on February 12, 2014.