The Impact of Aerobic Exercise on HDL Quantity and Quality: A Narrative Review

Abstract

High-density lipoproteins comprise roughly 25–30% of the circulating proteins involved in the transport of lipids in circulation. These particles differ in size and lipid composition. Recent evidence suggests that the quality of HDL particles (which depends on shape, size and the composition of proteins and lipids determining HDL functionality) may be more important than their quantity. The functionality of HDL is mirrored by its cholesterol efflux activity, as well as its antioxidant (including the protection of LDL against oxidation), anti-inflammatory and antithrombotic properties. The results of many studies and meta-analyses imply the beneficial impact of aerobic exercise on HDL-C levels. Physical activity was found to be usually associated with an increase in HDL cholesterol and a decrease in LDL cholesterol and triglycerides. Exercise, apart from inducing quantitative alterations in serum lipids, exerts a beneficial impact on HDL particle maturation, composition and functionality. The Physical Activity Guidelines Advisory Committee Report underlined the importance of establishing a program recommending exercises that enable attainment of maximal advantage at the lowest level of risk. The aim of this manuscript is to review the impact of different types of aerobic exercise (various intensities and durations) on the level and quality of HDL.

Effects of physical activity on the levels of remnant cholesterol: A population‐based study

“…or insufficient activity were linked to higher odds ratios for aberrant TG and HDL-C. 9,17,18 Apart from causing quantitative changes in blood lipids, exercise improves the quality of HDL particles. 19 Studies have reported that both acute and chronic aerobic exercise can increase plasma HDL-C levels in a dose-response manner. 19 Several high-quality meta-analyses have also indicated that exercise can raise HDL-C levels, with exercise volume exerting a greater impact on the HDL-C response compared to exercise intensity.…”

“…Research reported that high levels of exercise were connected with lower triglyceride levels and higher HDL‐C levels, whereas inactivity or insufficient activity were linked to higher odds ratios for aberrant TG and HDL‐C 9,17,18 . Apart from causing quantitative changes in blood lipids, exercise improves the quality of HDL particles 19 . Studies have reported that both acute and chronic aerobic exercise can increase plasma HDL‐C levels in a dose–response manner 19 .…”

Twelve-Week Safety and Potential Lipid Control Efficacy of Coffee Cherry Pulp Juice Concentrate in Healthy Volunteers

“…Therefore, the significance between groups is more likely to be caused by the slight increase in HDL in the study group and the slight decrease in HDL in the control group. The decrease in HDL in the placebo group after stopping the intervention may be due to other factors, such as reduced physical activity [ 34 ]. Although we asked all participants to maintain their routine exercises throughout the study, there could be some changes in their physical movement from their jobs or housework.…”

“…Though epidemiological studies found an inverse association between HDL levels and cardiovascular risk [ 36 ], a recent meta-analysis showed no improvement in cardiovascular outcomes after elevating HDL-C levels [ 37 ]. Recent evidence suggests that the quality of HDL is more important than quantity [ 34 , 35 ]. For triglycerides, it is worth noting that the increased average level of TG observed in the study group on week 14 was still within the normal range (lower than 150 mg/dL).…”

Sweet swell of burning fat: emerging role of high-density lipoprotein in energy homeostasis

“…Importantly, the improvement in the antioxidant status was observed despite elevated oxidative stress induced by the exercise [48]. There is evidence that aerobic exercise can increase HDL capacity to promote cholesterol efflux as well as its antioxidative and anti-inflammatory activities [42,49 ▪ ]. Moreover, another study reported that daily exercise enhanced antioxidative activity of HDL in middle-aged women [50 ▪ ].…”