Plasma lipid and lipoprotein levels in obese post-menopausal women: effects of a short-term low-protein diet and exercise.

Obesity is associated with an increased prevalence of cardiovascular and cerebrovascular disease, probably mediated by the induction of an atherogenic lipid profile. Since few data are available concerning plasma lipid levels and the effects of short-term dieting on these parameters in obese postmenopausal women, we studied plasma lipid and lipoprotein levels in such women and also the effects on these levels of a short-term hypocaloric low-fat diet combined with a moderately intense physical exercise programme. Plasma triglycerides and low-density-lipoprotein cholesterol (LDL-C) levels were significantly higher, whereas high-density-lipoprotein cholesterol (HDL-C) and apoprotein A1 (ApoA1) levels, as well as the HDL-C/LDL-C and ApoA1/ApoB ratios, were significantly lower in moderately to severely obese women (Body Mass Index greater than 30, n = 26) than in non-obese post-menopausal controls. A short-term (4 week) protein-sparing modified fast diet, providing 400 calories (1675 J), resulted in a mean weight loss of 7.7 +/- 2.8 (S.D.) kg. While plasma cholesterol, LDL-C and ApoB levels decreased by approximately 25% and reached the levels recorded in normal controls, ApoA2 decreased by 20%. HDL-C and HDL2-C levels remained unchanged and as a consequence the HDL-C/LDL-C and the ApoA1/Apob ratios increased, indicating a shift towards a less atherogenic lipid profile. No correlation was observed between weight loss and changes in lipid or lipoprotein levels. It was concluded that a hypocaloric, low-fat diet combined with our physical exercise programme, resulted in the normalization of plasma lipids within 4 weeks.