Discover the connection between muscle mass, lipids, and cardiovascular health with Dr. Richie Kirwan! 🏋️♂️🩺 Learn about the role of ApoB, the impact of resistance exercise on blood lipids, and practical strategies for improving heart health through muscle maintenance.
In part three of the Physical Activity Researcher Podcast, host Dr. Olli Tikkanen continues his conversation with Dr. Richie Kirwan, a lecturer in nutrition and exercise physiology at Liverpool John Moores University.
This episode dives into the relationship between muscle mass and lipoproteins, focusing on how resistance exercise impacts cholesterol and ApoB levels.
Dr. Kirwan explains the role of ApoB in lipid metabolism and its significance in cardiovascular health. He discusses the findings of recent research, including a Mendelian randomization study, which suggests that higher muscle mass and strength are associated with better lipoprotein profiles.
The episode also explores the potential mechanisms through which resistance exercise may influence cholesterol levels and cardiovascular risk.
Listeners will gain valuable insights into the practical implications of maintaining muscle mass and incorporating resistance training into their routines for improved cardiovascular health.
This episode is packed with scientific information relevant to researchers, health professionals, and anyone interested in the connections between muscle health, exercise, and chronic disease prevention.
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Explore our Wearables, Experience sampling method (ESM), Sleep, Heart rate variability (HRV), Sedentary Behavior and Physical Activity article collections for insights on related articles.
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This is the Physical Activity Researcher Podcast, a podcast for researchers of sedentary behavior, physical activity, and sports. Join for a relaxed dialogue about research design, practicalities, and well, anything related to research. Learn from your fellow researchers useful and relevant information that does not fit into formal content and limited space of scientific publications. And here is your host, researcher and entrepreneur Ollie Tickenham. Yeah, and then if we move to the muscle mass and lipids that you mentioned in the beginning, so could you explain a little bit the basics first? Sure, yeah, so if we look at the exercise research and blood lipids, if we just talk about cholesterol, the evidence isn't exactly very, very clear about what the effects of exercise are, there seems to be some small changes in cholesterol, but nothing major. But with resistance exercise, what we see is some studies have shown that there's a decrease in a molecule called ApoB. And for anybody who's not familiar with ApoB, if you've heard of LDL cholesterol, okay, and LDL stands for low-density lipoprotein, it's a low-density lipoprotein is a way of carrying cholesterol around our blood because cholesterol doesn't mix with water, our blood is mostly water, so we need to carry that somehow. And we do that in lipoproteins. And we hold lipoproteins together, or at least some of them, with a molecule of ApoB. So ApoB is just a protein that holds these lipoprotein molecules together. And it's found in LDL, it's found in very low density lipoproteins, or VLDLs as well, and intermediate density lipoproteins. And the beautiful thing about ApoB is that every lipoprotein molecule has just one molecule of ApoB. So if you can measure ApoB, it gives you a very, very good indicator of all of the what we call atherogenic lipoproteins. And by atherogenic, I mean it's a lipoprotein that can contribute to atherosclerosis or the buildup of plaque within our arteries. So ApoB is a... or ApoB is a really, really popular measure for looking at our risk of cardiovascular disease in the future, because the higher level your ApoB is, the greater risk you have of developing plaque in your arteries over time. And some studies have shown that resistance exercise seems to help to lower ApoB. And what our research group wants to do is wants to see what are some of the effects of muscle mass on all of these lipoproteins that we have in our body. And we did recently a Mendelian randomization study, okay, and for anyone who is not familiar, that's basically a... it's like a way of using population data to do a very, very large RCT. And we did a Mendelian randomization study that looked at the effect of higher levels or different levels of muscle mass and different levels of hand grip strength on a few different particles or lipid particles in our body. And what we found was that higher levels of muscle mass and higher levels of strength are associated with a better lipoprotein profile. So we have VLDL molecules, and if you have very, very large VLDL molecules, it's usually because somebody's in a poor metabolic health state. And what we saw is that more muscles and more strength was associated with smaller VLDL particles. And we also saw that it was associated with larger HDL particles or high-density lipoprotein. And most people will have heard of HDL, and they will call it erroneously the good cholesterol. It's not a term I particularly like to use at all. I don't like using good or bad cholesterol. I think it gives people a bad opinion of their lipids. But we see that you get these larger HDL cholesterol particles, which may be better, more associated with a better metabolic condition or metabolic state in the body. So that's our first evidence that muscle mass and strength have seemed to have a direct causal effect on changing these lipoprotein particles. We're planning some research to look at the direct effects on ApoB, but we do have some other evidence from other studies, not our research group, that shows the resistance exercise can actually have a direct effect on lowering ApoB by helping with recycling LDL particles in our body. So again, it's very, very early days for this area, but we have, let's say, some early research that indicate could be beneficial. We just need to do some more research now to see if that's genuinely the case and kind of to prove that. And about the ApoB, he said that the strength training or muscle mass would directly affect it, and that would affect the lipoproteins, or that ApoB is just kind of the measure that you use, and that maybe the muscle mass is directly affecting the lipoproteins, do you know the connection? So those the lipoproteins are held together by ApoB, it is a core component of those lipoproteins. And what we see is that, so to give an example, one study has shown that resistance exercise can decrease a molecule in the blood, and the molecule is called PCSK9. And some people may have heard of this molecule before, because a new class of, let's say, anti-cholesterol drug is now called PCSK9 inhibitors, and they are exceptionally effective in helping us to lower cholesterol levels. And they work because PCSK9 is a molecule that actually causes us to, or sure, it slows down the recycling of the LDL molecules, sorry, it increases the breakdown of LDL molecules and the recycling of them. So we have less, sorry, LDL receptors on our cells. So if we have more PCSK9, we have lower levels of LDL receptors on our cells, and specifically on our liver cells. If we have lower levels of those LDL receptors on our liver cells, that means that less LDL from our blood is recycled by the liver. So if you have lower levels of PCSK9, you actually have higher levels of LDL receptors on your liver, which means that you're taking more LDL out of circulation and recycling it. And that means that over time, lower levels of LDL, lower levels of ApoB, and then hopefully a lower risk of cardiovascular disease in the future. So that's one of the potential mechanisms, and that's actually a particularly, a particular interest of ours is to see what are the real effects of PCSK9 and what are the metabolic pathways involved in relation to resistance exercise. And if you think muscle mass is usually linked to activity, so do you think this is, it relates more to the muscle mass itself, or is muscle mass kind of a proxy for a person being active? So do you think the muscle mass itself is the factor, or is it kind of proxy for activity? And again, this is something that we simply don't know, and we need to find out with research in the future. So one potential way that we want to look at this is to do studies and physically active individuals, but do studies where we're looking at individuals who are doing more aerobic endurance type activity, and those who are actually building muscle mass, and to see if there's a change in those PCSK9, well, specifically for that example, in those PCSK9 levels in relation to muscle mass, or is it just an activity-related thing? At the moment, we don't think it's exclusively related to activity, just because if you do, like I mentioned earlier, endurance exercise doesn't seem to have a very profound effect on LDL cholesterol levels. So we think it may be related to a level of muscle mass that somebody can build, or at least the level of muscle mass they can build in relation to their height. Yeah, and this is kind of the early state. Can we say anything kind of practical related to cardiovascular risk, what are the kind of practical implications of this? Of muscle mass, I would say the only practical thing that I would say to people is be active. You know, we have plenty of evidence in terms of the benefits of cardiovascular exercise, endurance exercise. We have plenty of evidence that muscle mass itself seems to be protective as well, so be active, maintain muscle. We want to see, obviously, we want to get into the nuts and bolts of the research and see how is muscle mass having this effect on our cardiac health, on our cardiometabolic health. We don't know that for a fact right now, but we do know that all of the population-level data that we have right now would suggest that higher levels of activity, higher levels of muscle mass, are associated with better health, so we can push people in that direction now for the moment at least. This podcast is sponsored by Phibian. Phibian is an accurate sitting and physical activity tracking device and analysis platform. It is a great tool for projects that aim for behavior change in sedentary behavior and incidental physical activity. Phibian provides easy to understand PDF and web browser reports for participants. Other features include comparisons to recommendations, linking results to health risks, achievement cards and interactive goal setting tool. In addition, Phibian provides an API that allows for easy integration to other systems and applications. Learn more about Phibian at phibian.com/research. Phibian from researchers to researchers. And it may be displaced to the kind of bigger narrative or a trend that we have studied a lot aerobic exercise and there has been recommendations for it a long time and only lately the strength training has kind of come to the physical activity recommendations and more and more studies are being done and it seems that strength training is as important as aerobic exercise which just haven't studied it enough. I also had discussions with researchers who are studying like children's cognitive development, cognitive skills and and so on and also there it was that we just have more study from studies from aerobic exercise but the strength training is as beneficial which is don't have many studies so I think this all links to the kind of saying that when we just do enough studies of strength training it seems to be super important maybe as important or even more important than than strength training. Do you see this being being true? Yeah, I often kind of get asked which do I think is better cardiovascular or strength training and I say that's a hard one to answer. First off I say to people is when I started my PhD I mostly only strength trained. I didn't really do a lot of cardiovascular exercise at all but as I learned more throughout my my PhD especially related to the effects of cardio of the O2 max on cardiovascular risk I started incorporating a lot more cardiovascular exercise and I would very much say that you will get most the most benefit from doing a combination of both in your life. When I carried out my first study from my my PhD I was I had a meeting with a group of exercise physiologists at a hospital where I was going to be recruiting my patient and they very very much focus on cardiovascular exercise aerobic exercise with their patients and when I mentioned that I was going to be using resistance exercise they immediate their response was so are you going to be telling our patients that they should be doing just resistance exercise and they shouldn't be doing any cardiovascular exercise at all that it's better and and my response is no no no no do you don't need to worry this isn't an either or situation we just for this particular study we just want to have a look at what are the effects of of resistance exercise I think a lot of people get a little bit defensive and become very very black and white when it comes to it some people really love resistance exercise some people really love aerobic exercise and I think you know marrying the two together is where we're going to get our our most benefit and obviously we do need a lot more research on the benefits of resistance exercise - yeah and and I think from public health perspective strength training is it may be easier to incorporate for your daily life like you can you can easily like be doing something else having a video call and training your calves doing calf raises or something not so easily doing aerobic exercise or you might be able to do strength training easily at home even without any equipment like some some of the moments so I think it's it's kind of easier and sometimes maybe it's easier to go for a walk but sometimes it's easier and I think if people understand that you can you can do some strength training basically anywhere like any anywhere I think it could make a big difference but people mind is that oh you need to go to gym to do do a strength training so I think this is something important try to change that people could do throughout the day just lifting something heavy or or doing something absolutely I like I will always be a fan of like encouraging people to go to the gym just because it's it's very easily quite easy to quantify and it's very very easy to progress but if you look at any of the guidelines well at least here in the UK you know our guidelines for strength strengthening exercises as they're called it can involve a lot of different types of physical activity it can include like working in your garden or you know just climbing up and down stairs regularly just to get those muscles working and what I say to people is when they are a little bit let's say intimidated by the gym is you most certainly don't need to start there and I would say if you don't do any resistance exercise you can start anywhere which is you know the most important thing to do is to start and for some particularly older adults you know that resistance exercise might be just standing up and down out of a chair by yourself you know a few times every day might be just climbing up a stairs and it can progress from there you know it can progress to resist the bands it can progress to you know doing bicep curls with a couple of cans of beans or something like that so there's lots and lots of ways to incorporate it into daily life yeah I fully appreciate and is there anything else you would like to add to this this discussion not too much the one thing I will say is like obviously I'm I'm big on you know people incorporating exercise in their daily life I'm big on people incorporating extra protein into their daily life but also a large aspect of my research is also focused around Mediterranean diet and how to let's say incorporate the high protein aspect in and I would say to people that so I my research is based on the Mediterranean diet I don't say to people that they need to follow a Mediterranean diet I just say to people like follow some of the aspects of a Mediterranean diet so for example in Norway Sweden and Finland there are the the guidelines for the Norse dietary pattern which is you know very very much focused on whole grains lots and lots of plants lean proteins some dairy products lots of the fish which is very very similar to the Mediterranean diet pattern as well and I think people get a little bit caught up on oh this is a Mediterranean diet or this is such and such a diet I think we focus on things that we need to get into the diet getting plenty of plants plenty of whole grains legumes some dairy some fish some lean meats you know anybody can accomplish a a very very healthy diet and it doesn't need to fit one particular template and that that's kind of what we tried to do here because obviously I'm based in the northwest of the UK in Liverpool and we did what we call a Mediterranean style diet which is where we got a lot of foods that people were familiar with here and we just made them more healthy by incorporating aspects of the Mediterranean diet more whole grains more fruit and vegetables things like that so yeah don't get too hung up on it yeah and you mentioned the protein intake I think often we are discussing how lots you need to eat protein when you are training what's the guideline for inactive people how much they would need to eat do you think inactive people are not eating enough protein what's that what's the kind of guideline for the inactive people and it's the kind of situation so it's a tough one to call because so I'm by training I'm a nutritionist so technically I should be like saying yeah nutrition is the solution to everything in this situation where we're talking about muscle mass I would say without a shadow of a doubt exercise is going to be far more superior to a to adding protein to somebody's diet and adding additional protein well we know for a fact adding additional protein to somebody's eyes who's not exercising is not going to have any effect on improving muscle mass it may have an effect on reducing muscle loss in the long term but I think it's it's a tough one to call so we do say that with older adults we're trying to really really encourage and a higher protein diet which is usually around 1.2 grams per kilogram of body weight so just just for simplicity for a hundred kilogram adults quite a big a big person that would be 120 grams of protein a day that is going to have the most benefit in somebody who's exercising and if somebody can't improve like if somebody has to do one or the other I would say exercise before adding protein you can do both most certainly do both and that's where most benefit comes from so sounds great it has been lesser discussing I think a lot of lot of new teams and I think our listeners we find what find a lot of a lot of interesting points from here so thank you Richie for taking the time for this podcast thank you so much for having me it's been a pleasure thanks for joining us this week on physical activity research through podcast if you like the show makes you never miss an episode by 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