Regular aerobic exercise increases high-density lipoprotein (HDL) cholesterol

HDL Forum Editor Professor Philip Barter highlights a meta-analysis by S Kodama and co-workers which confirms the benefit of regular aerobic exercise on raising high-density lipoprotein (HDL) cholesterol. These data re-enforce recommendations for increasing levels of activity as a cardioprotective strategy. The analysis was reported in Archives of Internal Medicine.

Kodama S, Tanaka S, Saito K et al. Effect of aerobic exercise training on serum levels of high-density lipoprotein cholesterol: a meta-analysis. Arch Intern Med 2007;167:999-1008.

There have been numerous studies linking HDL cholesterol to the level of aerobic exercise. In this meta-analysis, the researchers identified 25 randomized controlled studies that evaluated the effect of exercise training on HDL cholesterol levels from a comprehensive electronic search of the literature.

Among these studies, the mean change in HDL cholesterol was 2.53 mg/dL, which was statistically significant (p<0.001). HDL cholesterol levels only rose in subjects who expended at least 900 kcal or exercised for at least 120 minutes each week. For these subjects, every 10 minutes prolongation of exercise per session was associated with a 1.4 mg/dL increase in HDL cholesterol.

Further analysis showed that the increase in HDL cholesterol was greatest in subjects with body mass index <28 kg/m2 and total cholesterol levels at least 220 mg/dL (5.7 mmol/L).

The analysis also provided some insights into how much exercise is required. Current guidelines recommend around 30 minutes per day of moderate-intensity exercise. However, data from this analysis suggest that there may be substantial additional benefits of exercising longer than that currently recommended.