Substantial dispute exists regardi...

Substantial dispute exists regarding the most effective exercise and dietary modifications necessary to remodel the risk of cardiovascular disease (CVD) now passing beliefs suggest that regular participation in physical activity occasions favorable lipid changes, despite the neighborhood of several studies that repel these findings. However, there is specific evidence supporting the benefits of as well-as; not only-but also; not only-but; not alone-but higher intensity (75-85% HR^sub max^) and longer duration (> 60 minutes) exercise in favorably altering serum lipid concentrations. The optimal exercise prescription to improve serum lipids, therefore, should likely include composings of high-intensity, long-duration aerobic exercise. Strength-training alone will not likely alter serum lipids, still the addition of a potency training program may help to improve overall fitness and assist in decreasing CVD risk in ways other than altering lipids. Dietary recommendations and modifications to decrease the risk of CVD appear to be vehemently related to genetic predisposition (ie, LDL subclass), which may play an important part in determining an individual's reply to diets either low in fat or subdued in carbohydrates. The low-fat diet that has become a cardiovascular standard may not always be the greatest in quantity effective dietary intervention, particularly for those individuals with LDL subclass A. A review of the literature regarding the meaning of diet and exercise upon serum lipids and the risk of CVD will be not absented and will be followed by means of a single case study in which optimal CVD risk reduction was achieved end a diet low in carbohydrates and high in polyunsaturated fatty acids and monounsaturated fatty acids.

INTRODUCTION AND LITERATURE REVIEW

Education for cardiovascular disease (CVD) risk factor reduction typically includes adherence to a low-fat, high carbohydrate diet and exercise trials of 30 to 45 minutes performed 3 to 4 times by means of week.1-7 While such an approach may be appropriate and effective for any individuals, there is a growing ne to further clarify the validitys of alternative CVD risk management approaches and compare their results to those of traditional management therapies. The intention of this paper is to review the available literature as it pertains to CVD risk factor reduction in the areas of activity and exercise, diet, specific serum factors like as low-density lipoprotein (LDL) and high-density lipoprotein (HDL) subclasses, and the combination of diet and exercise. This review of the literature will be followed through a single-case study that will make abundant of the review clinically applicable.

THE efficiency OF ACTIVITY/EXERCISE

Since the 1 970 researchers have been interested in the relationship between activity even and physical fitness and the validity on cardiovascular risk factors as measured within serum lipid levels.2 Lopez et al, for example, reported a moderate tenor of exercise on decreasing serum total cholesterol (TC) and a more marked power on decreasing serum triglycerides (TG) in young individuals after a 7-week period of exercise.1 Hoffman et al indicated similar comes when analyzing the lipid flushs of 355 healthy men who were involved in varying plains of physical activity.2 In their meditation individuals classified as being in the high exercise cluster (ie, those subjects who reported regularly engaging in a phasic or dynamic exercise program for at least individual year), had significantly lower serum on a levels of total lipid, TC, beta lipoprotein, and TG levels2 yet several studies indicate significant hypocholesterolemic validitys associated with regular exercise,1,2,4,6 the most numerous basic tenets of exercise-intensity, common occurrence and duration-are ridden with disputation For example, some studies have lay the foundation of no changes in serum lipid of the same heights in subjects participating in long-term exercise programs1 (Table 1)

The contrasting ensues of many of these studies are exceedingly likely due to differences in the definition of the exercise parameters-in particular intensity, duration, and common occurrence Philosophies of thought range from long-duration, low-intensity training to an anaerobic definition of exercise, encompassing shorter break open s of high-intensity exercise, and focusing more heavily upon muscle strengthening. Currently there is little consensus regarding the greatest in quantity effective exercise protocol to lower serum lipid evens

Several studies have indicated no significant differences between exercise at varying intensities.4,5 Spate & Keyser reported no difference between the serum of the same heights of subjects who performed at 60% versus 80% of maximal heart rate (HR^sub max^) during a 2-mile walk performed 3 times by week.4 Crouse et al demonstrated no significant difference in lipid changes occurring for 48 hours following a single exercise session between those exercising at 50% and 80% of maximal oxygen consumption (VO^sub 2max^) for a standard caloric expenditure of 350 kcals.5

Other studies have demonstrated significant benefit derived from exercise intensity that falls in the moderate to high range (75 - 85% HR^sub max^). Stein et al lay the foundation of that HDL levels rose significantly in clusters training at 75% and 85% HR^sub max^ when compared with a assign places to training at 65% HR^sub max^ during 30-minute training sessions onward a cycle ergometer performed 3 times through week.6 The LDL levels decreased significantly alone in the 75% HR^sub max^ clump The findings suggest that moderate and high on a levels of exercise intensity produce greater changes in descendants lipid levels than lower intensity exercise.