The relationships of vigorous exercise, alcohol, and adiposity to low and high high-density lipoprotein-cholesterol levels

While vigorous exercise, alcohol, and weight loss are all known to increase high-density lipoprotein-cholesterol (HDL-C), it is not known whether these interventions increase low HDL as effectively as has been demonstrated for normal HDL. This report tests the hypothesis that there may be differences in the calculated response of men and women with low versus high HDL-C to exercise, alcohol, and weight loss across the spectrum of HDL-C levels. Physican-supplied medical data from 7,288 men and 2,326 women were divided into deciles of self-reported vigorous exercise, alcohol intake, body mass index (BMI), or body circumferences. Within each decile we determined the percentiles of the HDL distributions and average running distance, alcohol intake, BMI, or body circumference. Simple least-squares regression analysis was then used to estimate the slope for kth HDL percentile (k = 5%, 6%,...,95%) versus running distance, alcohol intake, BMI, or body circumference across cleciles. Bootstrap resampling was used to estimate standard errors and statistical significance for the regression lines. In both sexes, the increase in HDL-C per unit alcohol intake was at least twice as great at the 95th as at the 5th percentile of the HDL distribution. There was also a significant graded increase from the 5th to the 95th HDL percentile for the slopes relating HDL to exercise (km run) and alcohol intake. Men's HDL-C declined in association with fatness (BMI, waist, and chest circumference) more sharply at the 95th than at the 5th percentile of the HDL distribution. The results of this study suggest that the effects of physical activity, alcohol, and weight reduction on HDL-C levels may be, to a large extent, dependent on the initial level with the greatest improvement achieved in subjects with high HDL and the least improvement in those having low HDL-C levels. (C) 2004 Elsevier Inc. All rights reserved.