Blood Lipid and Lipoprotein Adaptations to Exercise: A Quantitative Analysis
Abstract
Dose-response relationships between exercise training volume and blood lipid changes suggest that exercise can favourably alter blood lipids at low training volumes, although the effects may not be observable until certain exercise thresholds are met. The thresholds established from cross-sectional literature occur at training volumes of 24 to 32 km (15 to 20 miles) per week of brisk walking or jogging and elicit between 1200 to 2200 kcal/wk. This range of weekly energy expenditure is associated with 2 to 3 mg/dl increases in high-density lipoprotein-cholesterol (HDL-C) and triglyceride (TG) reductions of 8 to 20 mg/dl. Evidence from cross-sectional studies indicates that greater changes in HDL-C levels can be expected with additional increases in exercise training volume. HDL-C and TG changes are often observed after training regimens requiring energy expenditures similar to those characterised from cross-sectional data. Training programmes that elicit 1200 to 2200 kcal/wk in exercise are often effective at elevating HDL-C levels from 2 to 8 mg/dl, and lowering TG levels by 5 to 38 mg/dl. Exercise training seldom alters total cholesterol (TC) and low-density lipoprotein-cholesterol (LDL-C). However, this range of weekly exercise energy expenditure is also associated with TC and LDL-C reductions when they are reported. The frequency and extent to which most of these lipid changes are reported are similar in both genders, with the exception of TG. Thus, for most individuals, the positive effects of regular exercise are exerted on blood lipids at low training volumes and accrue so that noticeable differences frequently occur with weekly energy expenditures of 1200 to 2200 kcal/wk. It appears that weekly exercise caloric expenditures that meet or exceed the higher end of this range are more likely to produce the desired lipid changes. This amount of physical activity, performed at moderate intensities, is reasonable and attainable for most individuals and is within the American College of Sports Medicine's currently recommended range for healthy adults.
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Previous works were not systematic or included non-randomized trials, and limited pooled data analyses have been previously published.
“Previous works were not systematic [14] or included non-randomized trials [13, 15]; limited pooled data analyses have been previously published [16, 17].”
From The Effect of Exercise Training on Blood Lipids: A Systematic Review and Meta-analysis (2025) · cites this paper as [14]
Exercise energy expenditure is considered the primary determinant of change in serum lipid concentration.
“Exercise energy expenditure is considered as the primary determinant of change in serum lipid concentration [6].”
From The Effect of Exercise Training on Blood Lipids: A Systematic Review and Meta-analysis (2025) · cites this paper as [6]
Aerobic training and combined training produced significant total cholesterol reductions similar to those previously reported.
“AT and CT produced significant TC reductions similar to those previously reported [14].”
From The Effect of Exercise Training on Blood Lipids: A Systematic Review and Meta-analysis (2025) · cites this paper as [14]
An aerobic exercise training protocol of at least 180 min per week at > 40% VO2MAX or > 1200 kcal/week has a beneficial influence on lipids.
“Other studies have found that an AET protocol of at least 180 min per week at > 40% VO2MAX or > 1200 kcal/week has a beneficial influence on lipids [45, 46, 108, 109].”
From Estimating the Effect of Aerobic Exercise Training on Novel Lipid Biomarkers: A Systematic Review and Multivariate Meta-Analysis of Randomized Controlled Trials (2023) · cites this paper as [109]
The amount of daily physical activity, leisure time physical activity and physical fitness level are negatively correlated with mortality due to cerebrovascular disease and cancer, as well as all-cause mortality.
“The amount of daily physical activity, leisure time physical activity and physical fitness level have been found to be negatively correlated with morality due to cerebrovascular disease and cancer, as well as all-cause mortality in studies conducted worldwide596–606) and cohort studies in Japan577).”
From Japan Atherosclerosis Society (JAS) guidelines for prevention of atherosclerotic cardiovascular diseases 2017 (2018) · cites this paper as [605]
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- Authors
- Durstine, J. L., Grandjean, P. W., Davis, P. G., Ferguson, M. A., Alderson, N. L., & DuBose, K. D.
- Affiliations
- University of South Carolina (US)
- Auburn University (US)
- University of North Carolina at Greensboro (US)
- Venue
- Sports Medicine
- Published
- 2001
- Volume
- 31
- Issue
- 15
- Pages
- 1033-1062
- ISSN
- 0112-1642 (ISSN-L)
- OpenAlex
- W2167094654
- Cited by
- 588
- References
- 163
- Citations by year
- 2026: 9 · 2025: 15 · 2024: 21 · 2023: 20 · 2022: 14 · 2021: 20 · 2020: 29 · 2019: 19 · 2018: 23 · 2017: 16 · 2016: 21 · 2015: 44 · 2014: 31 · 2013: 31 · 2012: 40
- FWCI
- 34.13
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Sports Medicine (publishedVersion)
- PubMed (publishedVersion)
- Scholar Commons (University of South Carolina) (submittedVersion)
- Topics
- Health Sciences › Medicine › Complementary and alternative medicine › Cardiovascular and exercise physiology
- Health Sciences › Medicine › Physiology › Physical Activity and Health
- Health Sciences › Medicine › Surgery › Lipoproteins and Cardiovascular Health
- Keywords
- exercise training, serum lipids, lipoproteins, HDL cholesterol, triglycerides, LDL cholesterol, total cholesterol, exercise energy expenditure, training volume, dose-response relationship, exercise threshold, sex differences, physical activity guidelines
- MeSH terms
- Adult, Body Composition, Cholesterol, Cross-Sectional Studies, Energy Metabolism, Evaluation Studies as Topic, Exercise Therapy, Female, Humans, Hypercholesterolemia, Life Style, Lipids, Lipoproteins, Male, Physical Education and Training, Physical Endurance, Sex Factors, Time Factors, Triglycerides, Exercise
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