Vol.5, No.8, 1236-1240 (2013) Health
http://dx.doi.org/10.4236/health.2013.58167
Aerobic exercise program on blood lipids in women
between 40 and 55 years old
Judith M. Rodríguez-Villalobos*, María de Jesús Muñoz-Daw, Rosa P. Hernández,
Martha Ornelas
Faculty of Physical Education and Sport Sciences, Chihuahua Autonomous University, Chihuahua, México;
*Corresponding Author:
Received 24 May 2013; revised 25 June 2013; accepted 16 July 2013
Copyright © 2013 Judith M. Rodríguez-Villalobos et al. This is an open access article distributed under the Creative Commons At-
tribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is prop-
erly cited.
ABSTRACT
Objective: Evaluate the effect of a physical ac-
tivity program on the blood lipid profile in wo-
men between 40 and 55 years old. Methods: 7
female participants from the city of Chihuahua,
Chihuahua, Mexico, on a program of moderate-
intensity physical activity lasting 4 months, eva-
luated before and af ter the implementation of the
program in the variables of total cholesterol,
triglycerides, LDL and HDL, as well as the athe-
rogenic index and cardiov ascular risk. Dat a were
analyzed with Student t test for related samples
with a significance level of 0.05. Results: Total
cholesterol levels and LDL in samples collected
after physical exercise program decreased sig-
nificantly compared to those collected before
the implementation of the exercise program,
while statistically, HDL and triglycerides did not
show significant changes. The atherogenic in-
dex and cardiovascular risk showed positive
trends, thus favoring that moderate intensity
aerobic exercise decreased cardiovascular risk
in women reaching the perimenopause period.
Keywords: Lipids; Menopause; Exercise; Therapy
1. INTRODUCTION
Cardiovascular diseases are the main causes of death in
women. Epidemiological studies show that menopause is
associated with the prevalence of cardiovascular diseases
[1]. In Mexican women, the average age of menopause
occurrence is 49 years, due to the loss of ovarian follicu-
lar activity [2].
The hormonal deprivation produces changes in the
lipid profile, increasing the quantity of total cholesterol
(TC), low density lipoprotein (LCL-C) [1,2] and de-
crease of high density lipoprotein (HDL-C) [3]. This mo-
dification in blood lipids is a risk factor in the contrac-
tion of atherosclerosis and other chronic degenerative
diseases; this was observed more frequently in the post-
menopausal period, causing deterioration in the quality
of life and increase of morbidity and mortality [2,4-6].
The lipid problem has been increasing in our country,
mainly in women who are older than 40 and to 69 years
old, presenting higher values than men of the same age
[7].
The most common treatments for women during this
period are hormonal and/or drug therapy, however, the
use of hormones as a monotherapy has not been evident
in these conditions [4]. New studies involve a multidis-
ciplinary approach in which the measures are directed to
reduce the risk factors for cardiovascular diseases in-
cluding obesity, abnormal blood lipids, hypertension, dia-
betes, smoking, sedentary lifestyle, genetic background
effects, stress and estrogen deficiency [1].
Physical activity is acquiring more and more impor-
tance in being incorporated as part of an integral treat-
ment. Benefits have been found in several studies, espe-
cially in lipids and other cardiovascular risk factors in
women in perimenopause stage [8-11]. Among the pub-
lished involvements there are still variations in the man-
ner of applying the physical activity. On one hand, the
level of intensity of the exercise has been given consid-
erable importance, finding different benefits in the body,
aerobic activity being the most recommended for the
reduction of lipids and strength exercises being recom-
mended for the management of osteoporosis [12-16].
Some studies concluded in favor of low-intensity exer-
cise [17], others focused on vigorous exercise [18]. On
the other hand, research such as Kraus argues that it is
not the intensity level but the amount of exercise that

J. M. Rodríguez-Villalobos et al. / Health 5 (2013) 1236-1240 1237
gets really beneficial results [19].
The present study proposes the implementation of a
program of moderate-intensity physical activity (indi-
vidually controlled), for an extended period of time, to
assess its effect on the lipid profile in women who are in
perimenopause stage. The study’s objective is to gener-
ate and verify effective strategies to supplement existing
treatment processes in the area of Chihuahua, Mexico.
2. METHODS
2.1. Design
Intervention study is with the same group as control.
The individuals were evaluated in lipid profile at the be-
ginning and the end of their physical activity program,
which 4 lasted months.
2.2. Subjects
7 volunteer women who responded to a campaign by
radio and press and who met the following inclusion cri-
teria: age between 40 and 55 years old, without diabetes,
with medical authorization to exercise and complete sat-
isfactorily at least 80% of the sessions of the program.
They attended an informative meeting and at the same
meeting signed a letter of voluntary participation and
answered the questionnaire Par-Q & You [20]. Partici-
pants were instructed to maintain their normal activities
in their daily lives. The research committee of the Fac-
ulty of Physical Education and Sport Sciences at the
Autonomous University of Chihuahua approved the re-
search.
2.3. Variables
Independent variables: exercise program
The exercise program lasted a total of 66 sessions over
4 months, 4 times a week and 3 levels of intensity were
used, gradually increasing at each level. They started the
first 16 sessions at 40% of maximum heart rate, then
increased to 50% the following 16 sessions, and the last
sessions were programmed at 60%. The intensity at
which they should perform physical activity was deter-
mined based on their heart rate reserve calculated by the
Karvonen method [21], for this calculation we used the
age and resting heart rate of the subject taken with the
heart rate monitor after 10 minutes of remaining without
any physical effort, the equation was used as follows:
220 minus age, the heart rate at rest is then subtracted
from the result, and thus obtaining the so-called heart
rate reserve; this number is multiplied by the degree or
intensity that is going to be worked (40%, 50% or 60%),
and to the result of this multiplication, finally we add the
resting heart rate, and thus we obtain a heart rate at
which the person must maintain during a minimum of 20
minutes for each session, with variations of no more than
5 beats above and below it. Their beats per minute were
controlled using telemetric Polar heart rate monitors.
Dependent variable:
The variables observed were: lipid profile (total cho-
lesterol, triglycerides, low density lipoprotein, high den-
sity lipoprotein), the atherogenic index [22] (calculated
by dividing the total cholesterol by high density lipopro-
tein) and the cardiovascular risk index [23] (composed of
five components: age, total cholesterol, HDL-C, smoking
and blood pressure). Variables were also measured to
describe the general characteristics of the participants,
which were: estradiol level, hemoglobin, weight and
body mass index (BMI).
2.4. Procedure
In the beginning, participants were asked to provide a
medical authorization document to affirm that they could
exercise and were also asked to independently undertake
a blood test to determine the level of estradiol which was
issued by a certified laboratory, for women who still had
menstrual cycle, the sample was taken in the twenty-first
day of the menstrual cycle.
In the initial assessment overall variables were meas-
ured: body weight and height. A blood sample from the
antecubital vein was taken while fasting to determine the
lipid and hemoglobin profile; with the results of all these
assessments a file was made.
We proceeded to the implementation of the program in
which each session consisted of a warm up, between 10
and 15 min which included basic gymnastic exercises to
warm up the joints and stretch the muscles, the core con-
sisted of aerobic exercises for 30 to 40 min ranging from
in motion gymnastic moves, to floor exercises, and rou-
tines, with and without hand held weights, which did not
exceed 1 kg; the relaxation in the closing session lasted
between 5 and 10 min with relaxed breathing and stretch-
ing exercises. Heart rate was monitored every 5 minutes
making sure that in the core of each session people
maintained their heart rate according to the programmed
intensity.
At the end of four months, the lipid profile measure-
ments were performed again.
2.5. Instruments
The instrument used for the measurement of body
weight was a Torino brand scale and for the height it was
a standing stadimeter fixed to the wall, using for both the
technique of the International Society for the Advance-
ment of kinanthropometry. With these values were cal-
culated the BMI (weight /height2).
For the assessment of the blood sample, syringes or
vacuum extraction system were used in the measurement

J. M. Rodríguez-Villalobos et al. / Health 5 (2013) 1236-1240
1238
of the lipid profile. Blood was transferred to EDTA tubes
and before a refrigeration of 2 hours the plasma was
separated by centrifuging the tubes at 2500 rpm in a
clinical centrifuge (IEC C300). The quantifying of the
blood lipids was done by an automated analyzer (BTS-
370 Bio system plus) with reagents of Bio system and
enzyme-spectrophotometric techniques. HDL-C was meas-
ured before precipitation of Apo lipoprotein B (VLDL-C
and LDL-C) with phosphotungstate and magnesium ions
and before precipitating LDL-C with Polyvinyl sulfate
and subtracting the value of the supernatant cholesterol
of the total cholesterol.
The atherogenic index was obtained by dividing the
total cholesterol by the HDL-C. The Framingham scale
was applied to determine the cardiovascular risk index
which is divided into five sections which are age, total
cholesterol, HDL-C, smoking and blood pressure, the
sum of the scores on each of the sections of the scale, is
compared to the reference table, which results in the
percentage of possibility of having a heart attack within
10 years.
2.6. Data Analysis
Statistical analysis was performed using SPSS version
15.0, to calculate descriptive data of mean and standard
deviation for each variable. A comparison was perform-
ed between initial and final evaluations with t-test paired
samples with a significance level of 0.05.
3. RESULTS
We evaluated seven participants who met the inclusion
criteria including satisfactory completion of the physical
activity program with an attendance rate of over 80%.
At the time of starting the program, the average blood
estradiol was found to be 25.35 ± 35 pg/ml. One of the
values was above 100 pg / ml, another at 26 pg/ml and
the rest below; that is, 5 of the participants were in the
postmenopausal stage and two in menopause, the aver-
age age group was 48.14 ± 5.11 years, and had an aver-
age hemoglobin of 13.95 ± 1.72, the weight at the begin-
ning had a mean of 72.5 ± 10.04 kg and BMI was 28.42
± 2.99, without significant variation throughout the pro-
gram (Table 1).
In regards to the lipid profile, the initial average blood
cholesterol was 217.86 ± 27.8 mg/dl and after the pro-
gram, there appeared a mean difference of 35.57 ± 25.62
mg/dl, being a statistically significant change with a P
value less than 0.01. Triglycerides data showed no sig-
nificant differences, based on a mean value of 228.5 ±
168.78 mg/dl, the average difference was 57.18 ± 92.97
mg/dl (Table 2).
The LDL-C in the beginning was at an average of
172.0 ± 34.5 mg/dl and after 4 months of the program
there appeared significant differences with a P value less
than 0.02, with the mean difference of 28.24 ± 25.33
mg/dl. In HDL-C, we found no significant changes, with
the initial average of 35.5 ± 3.48 mg/dl and the mean
difference was −0.63 ± 6.56 mg/dl (Table 2).
The atherogenic index in the beginning was 6.2 ± 1.1
on average; the mean difference found was 1.04 ± 1.39
not being statistically significant. The cardiovascular risk
index calculated with the Framingham scale, in the be-
ginning, was on average 2.28 ± 2.36, the mean difference
in the end was 1.00 ± 1.82, with no significant differ-
ences between evaluations (Table 3).
Table 1. Descriptive data of mean and standard deviation for the general variables.
Variable N Mean Standar Deviation
Age (years) 7 48.14 5.11
Estradiol (pg/ml) 7 25.35 35.00
Hemoglobin (g/dl) 7 13.95 1.72
Weight (kg) 7 72.50 10.04
Body Mass Index (kg/m2) 7 28.42 2.99
Table 2. Starting Mean, mean differences and significance of lipid profile.
Variable Pre-Test (Mean ± SD) Mean of Differences (d ± SD) P
Total Cholesterol (mg/dl) 217.86 ± 27.84 35.58 ± 25.62 0.01
LDL-C (mg/dl) 172.10 ± 34.58 28.24 ± 25.34 0.03
HDL-C (mg/dl) 35.58 ± 3.48 −0.63 ± 6.57 0.81
Triglyicerids (mg/dl) 228.54 ± 168.78 57.18 ± 92.98 0.15

J. M. Rodríguez-Villalobos et al. / Health 5 (2013) 1236-1240 1239
Table 3. Starting Mean, mean differences and significance for atherogenic indices and cardiovascular risk.
Variable Pre-Test (MEAN ± SD) Mean of Differences (d ± SD) P
Atherogenic index 6.19 ± 1.14 35.58 ± 25.62 0.09
Cardiovascular risk index 2.29 ± 2.36 57.18 ± 92.98 0.19
4. DISCUSION
The participants reached a minimum of 80% atten-
dance, maintaining during the programmed sessions a
moderate intensity level, to obtain changes in the lipid
profile.
The average age of the group of women who partici-
pated in the physical activity program agrees with the
average Mexican woman marks of the official Mexican
standard for the treatment of menopause. According to
the estradiol blood values calculated in the study, 5 of
them are in post-menopausal stage, being the reference
point of less than 25 pg/ml.
The research focused on improving blood lipid levels,
it was observed after 4 months that the total cholesterol
reached 182.3 ± 23.3 mg/dl, a value that is within sug-
gested range according to the National Cholesterol Edu-
cation Program US [24]. Similarly, LDL-C, significantly
decreased, with a final value of 143.9 ± 26.4 mg/dl but is
still above the suggested range. The HDL-C, however,
remained constant and triglycerides did not change sig-
nificantly, which also occurred in the study of Janssen
(2002) [13], who applied aerobic exercise combined with
a diet and found no relationship between exercise, weight
loss, decreased body fat and HDL-C, triglycerides and
glucose.
On the other hand, the cardiovascular risks, deter-
mined by the Framingham scale showed a decrease of
10% in probabilities of getting a coronary problem with-
in 10 years [24]. The same happened with the athero-
genic index, which had a tendency to decrease although
not significantly. In both measurements, the cause ap-
pears to be that the HDL-C remained relatively constant
and well below the minimum required (>60 mg/dl ac-
cording to the NIH, 2002) [24].
The following considerations are: 1) The inclusion of
a representative sample of women located in both pre
and post-menopausal stage; 2) Following the diet me-
ticulously; 3) Adding anthropometric measurements to
estimate the distribution of body mass and weight since
BMI alone may not be a good estimator of lipid risk.
Consequently, it is suggested to include at least the
measuring of waist circumference, which reflects on the
lowering of visceral fat, and can relate most to the lipid
changes.
5. CONCLUSION
In this study, an aerobic exercise program of moderate
intensity appeared to give benefits on the lipid profile of
women in perimenopause who participated voluntarily in
the city of Chihuahua, Chihuahua, resulting in a signifi-
cant decrease in total cholesterol and LDL-C, but the
HDL-C and triglycerides were not changed significantly.
Considering the positive impact on the cardiovascular
risk index and atherogenic index, the program may give
rise to more widespread similar studies, and even pro-
mote its direct use in health centers as part of the strate-
gies for treatment of this cluster of the population.
6. ACKNOWLEDGEMENTS
This study was produced with material and financial resources of the
Faculty of Physical Education and Sport Sciences at the Autonomous
University of Chihuahua, Mexico.
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