Effects of 1 year of exercise training versus combined exercise training and weight loss on body composition, low-grade inflammation and lipids in overweight patients with coronary artery disease: a randomized trial
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Abstract Background Dyslipidaemia and low-grade inflammation are central in atherogenesis and linked to overweight and physical inactivity. Lifestyle changes are important in secondary prevention of coronary artery disease (CAD). We compared the effects of combined weight loss and interval training with interval training alone on physical fitness, body composition, dyslipidaemia and low-grade inflammation in overweight, sedentary participants with CAD. Methods Seventy CAD patients, BMI 28–40 kg/m2 and age 45–75 years were randomised to (1) 12 weeks’ aerobic interval training (AIT) at 90% of peak heart rate three times/week followed by 40 weeks’ AIT twice weekly or (2) a low energy diet (LED) (800–1000 kcal/day) for 8–10 weeks followed by 40 weeks’ weight maintenance including AIT twice weekly and a high-protein/low-glycaemic load diet. Effects of the intervention were evaluated by physical fitness, body weight and composition. Dyslipidaemia was described using both biochemical analysis of lipid concentrations and lipoprotein particle subclass distribution determined by density profiling. Low-grade inflammation was determined by C-reactive protein, soluble urokinase-type plasminogen activator receptor and tumour necrosis factor α. Effects on continuous outcomes were tested by mixed-models analysis. Results Twenty-six (74%) AIT and 29 (83%) LED + AIT participants completed the study. At baseline subject included 43 (78%) men; subjects averages were: age 63 years (6.2), body weight 95.9 kg (12.2) and VO2peak 20.7 mL O2/kg/min (4.9). Forty-six (84%) had pre-diabetes (i.e. impaired fasting glucose and/or impaired glucose tolerance). LED + AIT reduced body weight by 7.2 kg (− 8.4; − 6.1) and waist circumference by 6.6 cm (− 7.7; − 5.5) compared to 1.7 kg (− 0.7; − 2.6) and 3.3 cm (− 5.1; − 1.5) after AIT (within-group p < 0.001, between-group p < 0.001 and p = 0.018, respectively). Treatments caused similar changes in VO2peak and lowering of total cholesterol, triglycerides, non-HDL cholesterol and low-grade inflammation. A shift toward larger HDL particles was seen following LED + AIT while AIT elicited no change. Conclusions Both interventions were feasible. Both groups obtained improvements in VO2peak, serum-lipids and inflammation with superior weight loss and greater central fat loss following LED + AIT. Combined LED induced weight loss and exercise can be recommended to CAD patients. Trial registration NCT01724567, November 12, 2012, retrospectively registered (enrolment ended in April 2013).
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There are several trials on weight-loss interventions in patients with chronic physical or mental illnesses, e.g., rheumatoid arthritis, breast cancer, mental disorders, and cardiovascular diseases.
“There are several trials on weight-loss interventions in patients with chronic physical or mental illnesses, e.g., rheumatoid arthritis, breast cancer, mental disorders, and cardiovascular diseases (44–47).”
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- Authors
- Pedersen, L. R., Olsen, R. H., Anholm, C., Astrup, A., Eugen-Olsen, J., Fenger, M., Simonsen, L., Walzem, R. L., Haugaard, S. B., & Prescott, E.
- Affiliations
- University of Copenhagen (DK)
- Texas A&M University (US)
- Corresponding author
- Pedersen, Lene Rørholm
- ORCID
- Venue
- Cardiovascular Diabetology
- Published
- 2019-10-01
- Volume
- 18
- Issue
- 1
- Pages
- 127-127
- ISSN
- 1475-2840 (ISSN-L)
- PMC
- PMC6774219
- OpenAlex
- W2977550996
- Cited by
- 98
- References
- 63
- Citations by year
- 2026: 7 · 2025: 8 · 2024: 11 · 2023: 19 · 2022: 17 · 2021: 27 · 2020: 9
- FWCI
- 17.02
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- Cardiovascular Diabetology (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Research at the University of Copenhagen (University of Copenhagen) (publishedVersion, cc-by)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- Sundhed og Sygdom, Det Frie Forskningsråd (10-082982/FSS)
- Hjerteforeningen (10-04-R78-A278622613)
- The Faculty of Health and Medical Sciences (211-0730/10-3012)
- Else og Mogens Wedell Wedellsborgs Fond (1069)
- Beckett-Fonden
- Topics
- Health Sciences › Medicine › Complementary and alternative medicine › Cardiovascular and exercise physiology
- Health Sciences › Medicine › Physiology › Physical Activity and Health
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Keywords
- coronary artery disease, overweight, interval training, aerobic exercise, weight loss, hypocaloric diet, high-protein diet, body composition, waist circumference, dyslipidemia, low-grade inflammation, C-reactive protein, soluble urokinase plasminogen activator receptor, TNF-α, physical fitness
- MeSH terms
- Aged, C-Reactive Protein, Coronary Artery Disease, Denmark, Exercise Therapy, Female, Health Status, Humans, Inflammation, Lipids, Male, Middle Aged, Obesity, Oxygen Consumption, Physical Fitness, Time Factors, Tumor Necrosis Factor-alpha, Biomarkers, Weight Loss, Treatment Outcome, Inflammation Mediators, Caloric Restriction, Adiposity, Dyslipidemias, Receptors, Urokinase Plasminogen Activator
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