Effects of energy balance on postprandial triacylglycerol metabolism

Purpose of review: To present the effect of negative energy balance on postprandial triacylglycerol concentrations (pTAG), an independent risk factor for the development of cardiovascular disease. Recent findings: Aerobic exercise reduces pTAG; however, recent findings confirm that this effect is only evident with an accompanying energy deficit. Moreover, a recent study showed that acute diet-induced energy deficit also reduces pTAG. The extent of energy deficit required to significantly attenuate pTAG depends on the type of given meal, the type of deficit (aerobic/resistance exercise, diet, or combination of diet and exercise), and patients' health status. Apart from the acute effects, prolonged energy deficit leading to moderate weight loss attenuates pTAG, when it is combined with other known hypotriacylglycerolemic agents, such as carbohydrate restriction. Summary: For healthy population, it seems that it is up to patient's preference and ability which type of energy deficit will follow to attenuate pTAG; an energy deficit of approximately 30 kJ/kg of body mass is required; for resistance exercise a smaller deficit is probably sufficient. More studies are needed to investigate dose-response/plateau effects, the effects of energy deficit-energy surplus every other day, and the threshold of energy deficit-weight loss in diabetics and other high-risk populations. Finally, investigation of the underlying mechanisms may be clinicall helpful in individualizing the appropriate intervention.