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Aims: To determine if the combination of exercise and statin could normalize postprandial triglyceridaemia (PPTG) in hypercholesteraemic individuals. Methods: Eight hypercholesteraemic (blood cholesterol 182 ± 38 mg dL−1; low‐density lipoprotein–cholesterol [LDL‐c] 102 ± 32 mg dL−1) overweight (body mass index 30 ± 4 kg m−2) individuals with metabolic syndrome (MetS) were compared to a group of 8 metabolically healthy (MetH) controls (blood cholesterol 149 ± 23 mg dL−1; LDL‐c 77 ± 23 mg dL−1, and body mass index 23 ± 2 kg m−2). Each group underwent 2 PPTG tests, either 14 hours after a bout of intense exercise or without previous exercise. Additionally, MetS individuals were tested 96 hours after withdrawal of their habitual statin medication to study medication effects. Results: A bout of exercise before the test meal did not reduce PPTG in MetS (P =.347), but reduced PPTG by 46% in MetH (413 ± 267 to 224 ± 142 mg dL−1 for 5 h incremental area under the curve; P =.02). In both trials (i.e., either after a bout of intense exercise or without previous exercise), statin withdrawal in MetS greatly increased PPTG (average 65%; P <.01), mean LDL‐c (average 25%; P <.01), total cholesterol (average 16%; P <.01) and apolipoprotein (Apo) B48 (24%; P <.01), without interference from exercise. However, Apo B100 was not affected by statin withdrawal. Conclusion: Hypercholesteraemic MetS individuals (compared to MetH controls) fail to show an effect of exercise on reducing PPTG. However, chronic statin medication blunts the elevations in triglyceride after a fat meal (i.e., incremental area under the curve of PPTG) reducing their cardiovascular risk associated with their atherogenic dyslipidaemia. Statin decreases PPTG by reducing the secretion or accelerating the catabolism of intestinal Apo B48. [ABSTRACT FROM AUTHOR]

We studied the accuracy of graded exercise testing (GXT) to assess improvements in maximal oxygen uptake (V̇o2max) with exercise training in unfit individuals with metabolic syndrome (MetS). Forty-four adults with MetS (58 ± 7 yr, 36% women, BMI 31.8 ± 4.8 kg/m−2) underwent 4 mo of supervised high-intensity interval exercise training. V̇o2max was assessed using GXT, followed by a constant-load verification test (VerT) at 110% of the maximal work rate achieved during GXT. V̇o2 data from GXT and VerT were compared using repeated-measures ANOVA. The mean improvement in V̇o2max following exercise training was similar when using GXT only or VerT. However, before training, 18 subjects achieved a higher V̇o2max during the verification test that was (+159 mLO2/min) higher than the GXT (P < 0.001). After training, the underestimation of V̇o2max by GXT was reduced but still present (+64 mLO2/min). As a result, improvements in V̇o2max following exercise training as assessed using GXT only almost doubled the “real” increase in V̇o2max as measured by VerT in these 18 individuals. In the remaining 26 subjects, GXT scored below VerT only after training (+54 mLO2/min, P = 0.046). As a consequence, GXT underestimated the actual V̇o2max increases (−49 mLO2/min, P = 0.013) in these individuals. Assessment of changes in V̇o2max following exercise training using only GXT over- or underestimates V̇o2max gains in unfit individuals with MetS. Thus, a verification test may be required to 1) identify the highest V̇o2max during a maximal exercise test on a cycle ergometer and 2) accurately quantify the true changes in cardiorespiratory fitness following exercise training in unfit individuals with MetS. NEW & NOTEWORTHY It is unclear whether the traditional GXT is suitable to assess V̇o2max changes in unfit individuals with metabolic syndrome. Mean changes in V̇o2max following exercise training were similar using GXT or VerT. However, we showed that the GXT overestimated V̇o2max improvements in 41% and underestimated V̇o2max improvements in 59% of subjects. Our data suggest the need for a verification test to appropriately determine training-induced improvements in V̇o2max in unfit individuals with metabolic syndrome. [ABSTRACT FROM AUTHOR]

We studied the accuracy of graded exercise testing (GXT) to assess improvements in maximal oxygen uptake (V̇o 2max ) with exercise training in unfit individuals with metabolic syndrome (MetS). Forty-four adults with MetS (58 ± 7 yr, 36% women, BMI 31.8 ± 4.8 kg/m -2 ) underwent 4 mo of supervised high-intensity interval exercise training. V̇o 2max was assessed using GXT, followed by a constant-load verification test (VerT) at 110% of the maximal work rate achieved during GXT. V̇o 2 data from GXT and VerT were compared using repeated-measures ANOVA. The mean improvement in V̇o 2max following exercise training was similar when using GXT only or VerT. However, before training, 18 subjects achieved a higher V̇o 2max during the verification test that was (+159 mLO 2 /min) higher than the GXT ( P < 0.001). After training, the underestimation of V̇o 2max by GXT was reduced but still present (+64 mLO 2 /min). As a result, improvements in V̇o 2max following exercise training as assessed using GXT only almost doubled the "real" increase in V̇o 2max as measured by VerT in these 18 individuals. In the remaining 26 subjects, GXT scored below VerT only after training (+54 mLO 2 /min, P = 0.046). As a consequence, GXT underestimated the actual V̇o 2max increases (-49 mLO 2 /min, P = 0.013) in these individuals. Assessment of changes in V̇o 2max following exercise training using only GXT over- or underestimates V̇o 2max gains in unfit individuals with MetS. Thus, a verification test may be required to 1 ) identify the highest V̇o 2max during a maximal exercise test on a cycle ergometer and 2 ) accurately quantify the true changes in cardiorespiratory fitness following exercise training in unfit individuals with MetS. NEW & NOTEWORTHY It is unclear whether the traditional GXT is suitable to assess V̇o 2max changes in unfit individuals with metabolic syndrome. Mean changes in V̇o 2max following exercise training were similar using GXT or VerT. However, we showed that the GXT overestimated V̇o 2max improvements in 41% and underestimated V̇o 2max improvements in 59% of subjects. Our data suggest the need for a verification test to appropriately determine training-induced improvements in V̇o 2max in unfit individuals with metabolic syndrome.