A Review of the Literature on “The Effects of Exercise, Diet and Resistance Training on Lipoprotein Particle Subfractions”

Cardiovascular disease is the number one cause of death in the United States, and accounts for one-third of all deaths worldwide. 1 In the United States, 43.9% of the adult population is projected to have some form of Cardiovascular Disease, CVD, by the year 2030. 2 The increasing trend of cardiovascular mortality is ever increasing especially for low and middle-income countries. 3 Some common risk factors that drive this trend include tobacco smoking, lack of physical activity, and unhealthy diet. 4 Fortunately, some of the risk factors for CVD can be clinically assessed and treated medically through blood lipid profiles. Previously, this has been done through lipoprotein-cholesterol (LDL-C) reduction, however, a closer look at the LDL subclasses or particle size distribution has revealed that it may be the size and not the number of lipoprotein particles that are a more powerful predictor of CVD. 5. It appears that small, less dense particles have a greater susceptibility to oxidation and permeability to the endothelial wall in the coronary vessels. 2 Furthermore, small, dense LDL particles also circulate longer in the blood stream and are likely to undergo numerous atherogenic modifications such as desialylation, glycation, and oxidation, increasing their atherogenicity. 6 Similar findings have been found with HDL particle sizes where small HDL particles have been associated with increased CVD risk. Conversely, the concentration of large HDL particles has been shown to be negatively correlated with CVD risk, however, the size of the HDL particle and its cardioprotective functions has not been clearly established in the literature and the mechanisms need further study. 7,8 Therefore, the purpose of this review is to discuss the effect of exercise (both aerobic & resistance training) and diet on HDL and LDL particle size.