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A Dose-Response Relationship

Peter F. Kokkinos, PhD; John C. Holland, PED; Puneet Narayan, MD; John A. Colleran, DO; Charles O. Dotson, PhD; Vasilios Papademetriou, MD, DSc

Arch Intern Med. 1995;155(4):415-420.

Abstract
Objective
To examine the association between miles run per week and high-density lipoprotein cholesterol levels in healthy middle-aged men.

Background
Regular exercise increases levels of high-density lipoprotein cholesterol. However, the exercise requirements for such increases are not well defined.

Methods
Healthy, nonsmoking men (n=2906; age, 43±4 years) completed a questionnaire on health habits and physical activities and a symptom-limited exercise test. They were then stratified on the basis of the number of miles run per week. Six groups, with mileages of 0, 5, 9, 12, 17, and 31 per week, were established.

Results
A gradual increase in high-density lipoprotein cholesterol level was observed with increased miles (0.008-mmol/L [0.308-mg/dL] increase in high-density lipoprotein cholesterol level per mile). Most of the changes were associated with distances of 7 to 14 miles per week. Levels of low-density lipoprotein cholesterol, triglycerides, and the ratio of total cholesterol to high-density lipoprotein cholesterol also improved with weekly mileage. The high-density lipoprotein cholesterol level correlated significantly with all exercise components, anthropometric measures, and alcohol consumption. Group comparisons disclosed significant differences (P<.05) in exercise time to exhaustion, miles run per week, body fat, body weight, and body mass index. Age and alcohol consumption were similar across groups.

Conclusions
These results indicate a dose-response relationship between miles run per week, high-density lipoprotein cholesterol level, and other lipoprotein-lipid levels. Most changes were noted in those who ran 7 to 14 miles per week at mild to moderate intensities. A mileage threshold for changes in high-density lipoprotein cholesterol level was not observed. However, when compared with those of the nonexercising group, high-density lipoprotein cholesterol levels attained statistical significance at 7 or more miles per week.

(Arch Intern Med. 1995;155:415-420)

Author Affiliations
From the Cardiology Division, Veterans Affairs Medical Center, (Drs Kokkinos, Narayan, and Papademitriou), the Cardiology Division, Georgetown University Medical Center (Drs Kokkinos, Colleran, and Papademitriou), and the Health/Fitness Directorate, National Defense University (Dr Holland), Washington, DC; and the Department of Kinesiology, University of Maryland, College Park (Dr Dotson).

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