Evidence Summary

A systematic review in 2017 (596 participants), which looked at prospective randomised or controlled trials of exercise training lasting 12 weeks or more, found that in exercised adults there was a significant improvement in low-density lipoprotein cholesterol (LDL) (mean difference 0.21 mmol/L, 95% CI 0.33-0.08, p = 0.002) [1]. There were also significant improvements in LDL (MD: 0.31 mmol/L, 95% CI 0.55 to 0.06, p = 0.02) and triglycerides (MD: 0.21 mmol/L, 95% CI 0.42–0.0, p = 0.04) in exercised children. Results of a meta-analysis in 2019 (24 studies; 998 total participants with T1DM) also indicated that exercise training of no less than 4 weeks decreased total cholesterol, but no significant difference was found with respect to triglycerides, HDL-C or LDL-C [2].

In 2011, a randomized control trial (66 participants; 28 male, 38 female; aged 18-68) done in Canada concluded that a combination of aerobic and resistance exercise had significant favourable effects on HDL-C, triglycerides and total cholesterol/HDL-C ratio [3]. A systematic review (26 studies) in 2017 also showed that there was evidence of improvements in a number of health markers, including blood lipid profile, after exercise [4].

Quality of Evidence

B – Moderate

Strength of Recommendation

1 – Strong recommendation

Conclusion

Exercise and physical activity leads to significant improvements in LDL and triglycerides in both adults and children, and a decrease in total cholesterol. A combination of aerobic and resistance exercise leads to significant favourable effects on cholesterol and triglycerides.

References

[1] Ostman C, Jewiss D, King N, Smart NA. Clinical outcomes to exercise training in type 1 diabetes: A systematic review and meta-analysis. Diabetes Res Clin Pract. 2018 May;139:380-391. doi: 10.1016/j.diabres.2017.11.036. Epub 2017 Dec 6. PMID: 29223408.

[2] Wu N, Bredin SSD, Guan Y, Dickinson K, Kim DD, Chua Z, Kaufman K, Warburton DER. Cardiovascular Health Benefits of Exercise Training in Persons Living with Type 1 Diabetes: A Systematic Review and Meta-Analysis. Journal of Clinical Medicine. 2019; 8(2):253. https://doi.org/10.3390/jcm8020253

[3] Orals. (2011). Diabetes, 60(Supplement_1), A1–A104.

[4] Codella, R., Terruzzi, T. and Luzi, L. (2017). Why should people with type 1 diabetes exercise regularly? Acta Diabetologica, 54(7), pp. 615-630.