Evidence summary (Updated 2022)
Blood cholesterol responses to exercise are mixed but may result in a small reduction in LDL cholesterol. Combined weight loss through dietary modification combined with exercise may be more effective than aerobic exercise training alone [1-3]
More recent evidence has strengthened evidence that shows exercise also improves inflammatory profile, helps to lower LDL cholesterol by a small amount and can prevent deterioration in LDL and total cholesterol profile. [4]
Quality of evidence
Grade A – High Quality
Strength of recommendation
Grade 1 – Strong recommendation
Conclusion
Existing evidence suggests that patients benefit from being more active, particularly in combination with dietary modification with resulting improved cholesterol profile.
References:
[1] Bruno RM, Penno G, Daniele G, Pucci L, Lucchesi D, Stea F, Landini L, Cartoni G, Taddei S, Ghiadoni L, Del Prato S. Type 2 diabetes mellitus worsens arterial stiffness in hypertensive patients through endothelial dysfunction. Diabetologia. 2012 Jun;55(6):1847-55.
[2] Pi-Sunyer X, Blackburn G, Brancati FL, Bray GA, Bright R, Clark JM, Curtis JM, Espeland MA, Foreyt JP, Graves K, Haffner SM, Harrison B, Hill JO, Horton ES, Jakicic J, Jeffery RW, Johnson KC, Kahn S, Kelley DE, Kitabchi AE, Knowler WC, Lewis CE, Maschak-Carey BJ, Montgomery B, Nathan DM, Patricio J, Peters A, Redmon JB, Reeves RS, Ryan DH, Safford M, Van Dorsten B, Wadden TA, Wagenknecht L, Wesche-Thobaben J, Wing RR, Yanovski SZ. Reduction in weight and cardiovascular disease risk factors in individuals with type 2 diabetes: one-year results of the look AHEAD trial. Look AHEAD Research Group Diabetes Care. 2007 Jun;30(6):1374-83.
[3] Wing RR. Long-term effects of a lifestyle intervention on weight and cardiovascular risk factors in individuals with type 2 diabetes mellitus: four-year results of the Look AHEAD trial. Arch Intern Med. 2010 Sep 27;170(17):1566-75.
[4] Magalhaes JP, Santos DA, Correia IR, Hetherington-Rauth M, Ribeiro R, Raposo JF, Matos A, Bicho MD, Sardinha LB: Impact of combined training with different exercise intensities on inflam- matory and lipid markers in type 2 diabetes; a secondary analysis from a 1-year randomised con- trolled trial. Cardiovasc Diabetol (2020) 19:169. https://doi.org/10.1186/s12933-020-01136-y