Effects of alternate day fasting and exercise on cholesterol metabolism in overweight or obese adults : a randomized controlled trial

Abstract

Background: The objective of this randomized controlled trial was to investigate the effect of ADF and exercise on serum sterol signatures, surrogate markers of cholesterol absorption and biosynthesis. Methods: Overweight or obese subjects were randomly assigned to 4 groups: 1) ADF and exercise (E-ADF); 2) ADF; 3) exercise; 4) control. Thirty one completers who measured serum sterol signatures using gas chromatography -mass spectrometry were enrolled in this exploratory analysis. Results: After intervention, most of serum sterol signatures corresponding for cholesterol metabolism showed significant differences between groups (p-value <0.05 by ANCOVA), while there were no differences in plant sterols, markers of cholesterol absorption. Desmosterol, cholesteryl esters, and oxysterols decreased significantly in the exercise group. Furthermore, changes in the metabolic ratios of desmosterol and 7-DHC to cholesterol, which reflect cholesterol biosynthesis, were negatively correlated only with changes in physical activity levels (r = -0.411; p-value =0.030, and r = -0.540; p-value =0.003, respectively). Conclusion: These findings may indicate that exercise with or without ADF improves cholesterol metabolism as measured by serum sterol signatures, and increased physical activity has a greater effect on cholesterol biosynthesis than weight reduction or calorie restriction.