Summary:
In sedentary postmenopausal women (mean age 56.7 ± 4 years) following a high-fat meal, both high-intensity interval training (HIIT) and moderate-intensity interval training (MIIT) performed the day before the meal significantly reduced postprandial triglyceride levels with no significant differences between exercise intensities compared to no exercise (rest condition) prior to the high-fat meal, though HIIT was associated with higher perceived exertion and heart rate than MIIT, suggesting MIIT may offer similar metabolic benefits with better tolerability.
| PICO | Description |
|---|---|
| Population | Sedentary postmenopausal women aged approximately 56.7 ± 4 years, representing a population at elevated cardiovascular risk due to estrogen deficiency and metabolic changes. |
| Intervention | High-intensity interval training (HIIT) or moderate-intensity interval training (MIIT) performed the day before consuming a standardized high-fat meal challenge. |
| Comparison | No exercise (REST condition) prior to the high-fat meal, representing the typical sedentary state. |
| Outcome | Both HIIT and MIIT significantly reduced postprandial triglyceride levels compared to REST, with no significant differences in total cholesterol, HDL, or LDL. MIIT produced lower perceived exertion and mean heart rate than HIIT while achieving equivalent triglyceride reduction. |
Clinical Context
Postmenopausal women experience accelerated cardiovascular risk, with estrogen deficiency contributing to unfavorable changes in lipid metabolism, body composition, and vascular function. Postprandial lipemia—the transient elevation in triglycerides following fat-containing meals—is increasingly recognized as an independent cardiovascular risk factor. Most individuals spend the majority of their waking hours in the postprandial state, making the magnitude and duration of triglyceride elevation after meals a meaningful contributor to atherosclerotic risk.
Exercise is known to attenuate postprandial lipemia through multiple mechanisms, including increased lipoprotein lipase activity that accelerates triglyceride clearance. However, the optimal exercise intensity for this benefit remains unclear, particularly in postmenopausal women who may have lower exercise tolerance and higher perceived barriers to vigorous activity. Understanding whether moderate-intensity exercise provides equivalent postprandial lipemia reduction as high-intensity exercise has practical implications for exercise prescription.
This study directly compared HIIT and MIIT for their effects on postprandial triglyceride responses in sedentary postmenopausal women. By using a crossover design where each participant served as her own control, the study minimized inter-individual variability and enabled robust within-subject comparisons. The timing of exercise (day before the meal) reflects practical scenarios where exercise may precede rather than follow dietary indiscretions.
Clinical Pearls
1. Both Intensities Effective for Triglyceride Reduction: The lack of significant difference between HIIT and MIIT for postprandial triglyceride reduction is clinically important. Postmenopausal women who cannot or prefer not to perform high-intensity exercise can achieve equivalent lipid benefits with moderate-intensity intervals.
2. Exercise Effects Persist to the Next Day: The exercise sessions were performed the day before the high-fat meal, yet still reduced postprandial lipemia. This suggests that exercise doesn’t need to occur immediately before or after a meal to confer benefit—maintaining regular exercise provides ongoing metabolic protection against dietary lipid loads.
3. MIIT Better Tolerated Than HIIT: Lower perceived exertion and heart rate with MIIT suggests better tolerability for this sedentary postmenopausal population. Given equivalent triglyceride benefits, MIIT may be the more practical recommendation for patients who find high-intensity exercise aversive or difficult.
4. Triglyceride-Specific Effect: The absence of significant effects on total cholesterol, HDL, and LDL confirms that the acute exercise benefit specifically targets triglyceride metabolism, likely through enhanced lipoprotein lipase activity. Chronic exercise adaptations would be needed to modify cholesterol parameters.
Practical Application
For postmenopausal women seeking to reduce cardiovascular risk through exercise, emphasize that moderate-intensity interval training provides comparable postprandial triglyceride benefits to high-intensity exercise. This finding may improve exercise adherence in patients intimidated by or unable to perform HIIT. Frame exercise as metabolic protection that buffers against dietary lipid challenges.
Counsel patients that regular exercise provides ongoing protection against postprandial lipemia—they don’t need to exercise immediately before or after every meal. Maintaining consistent exercise habits creates a metabolic environment more resistant to dietary triglyceride spikes.
When prescribing interval training for sedentary postmenopausal women, consider starting with moderate-intensity intervals (MIIT) rather than HIIT. As fitness improves and patients become comfortable with interval formats, intensity can be progressed if desired, though equivalent lipid benefits may not require this progression.
Broader Evidence Context
This study contributes to the broader literature on exercise and postprandial lipemia, which has generally supported exercise benefits but with variable findings regarding intensity effects. Some studies have suggested dose-response relationships favoring higher intensity or greater energy expenditure, while others (including this study) find equivalent benefits across intensities. Study population, exercise timing, and meal composition all influence results.
The focus on postmenopausal women addresses an important knowledge gap, as much postprandial lipemia research has been conducted in younger men. Given the elevated cardiovascular risk in postmenopausal women and their potential barriers to high-intensity exercise, evidence supporting moderate-intensity alternatives has particular clinical relevance.
Study Limitations
Small sample size limits statistical power and generalizability. Single acute exercise sessions may not represent chronic training adaptations. The standardized high-fat meal may not reflect real-world dietary patterns. Only sedentary women were studied; results may differ in active individuals. Long-term cardiovascular outcomes were not assessed.
Bottom Line
Both high-intensity and moderate-intensity interval training performed the day before a high-fat meal equally reduce postprandial triglycerides in sedentary postmenopausal women, with moderate-intensity exercise offering better tolerability and equivalent metabolic benefits.
Source: Teixeira, Bruno Costa, et al. “Effects of high- and moderate-intensity interval training on postprandial lipemia in postmenopausal women after a high-fat meal.” J Bodyw Mov Ther. Read article
