Response of HDL, LDL, and TG indices to barberry extract and aerobic exercise in obese men

Subject Areas : biochemistry

Farah Nameni ¹ , Saba Barzegar ²

1 - Associate Professor, Department of Exercise Physiology, Varamin-Pishva Branch, Islamic Azad University, Varamin, Iran
2 - MSc, Department of Exercise Physiology, Central Tehran Branch, Islamic Azad University, Tehran, Iran

Received: 2025-06-13 Accepted : 2025-08-07 Published : 2025-08-31

Keywords: Aerobic exercise, betel nut extract, lipid profile, obesity, herbal supplement,

Abstract :

Introduction: Obesity is associated with impaired blood lipid profiles use of non-pharmacological approaches, such as regular exercise and the consumption of herbal supplements, can be effective in improving blood lipid status. This study aimed to investigate the effects of regular aerobic exercise and the consumption of a hydroalcoholic extract of Pistacia atlantica individually and in combination with HDL, LDL, and triglyceride levels in obese men.

 

Materials and Methods: This study was conducted as a randomized controlled clinical trial involving 48 obese men (aged 20-30 years, body mass index: 30 - 35 kg/m²). Participants were randomly divided into four groups: aerobic exercise with consumption of Pistacia extract, aerobic exercise with a placebo, consumption of Pistacia extract without exercise, and a control group without intervention. The exercise intervention included aerobic exercise for 8 weeks, 5 sessions per week, for 60 to 75 minutes per session, with an intensity of 55 to 70% of maximum heart rate. The groups receiving the extract of the bulrush received 1000 mg of hydroalcoholic extract of the bulrush in capsules daily. Blood samples were collected to measure the values ​​of HDL-C, LDL-C, and TG before with ELISA method.

 

Results:  The results of the analyses showed that after 8 weeks of intervention, the exercise and bulrush groups showed a significant increase in mean HDL levels and a significant decrease in LDL and TG compared to the baseline and other groups. The aerobic exercise group alone also significantly improved HDL and TG, and LDL-C. Consumption of betel nut extract without physical activity also caused a slight decrease in TG and LDL-C. But it had no significant effect on HDL-C. In the control group, no significant changes were observed in lipid indices (P<0.05).

 

Conclusion: The findings of this study indicate that regular aerobic exercise, especially when combined with betel nut extract, can have positive and synergistic effects on improving lipid profiles, especially in increasing HDL-C and reducing LDL-C and triglycerides in obese men. These results indicate the role of betel nut extract supplementation as an effective plant-based strategy alongside exercise in managing cardiovascular risk factors in obese individuals.

References:

1. Balasundaram P, Daley SF. Public Health Considerations Regarding Obesity. [Updated 2025 Feb 15]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-.
2. Jiab W, Liu F. Obesity: causes, consequences, treatments, and challenges. J Mol Cell Biol. 2021;13(7):463–5. doi: 10.1093/jmcb/mjab056.
3. Powell-Wiley TM, Poirier P, Burke LE, Després JP, et al. Obesity and Cardiovascular Disease: A Scientific Statement from the American Heart Association. Circulation. 2021;143(21):e984–e1010. doi: 10.1161/CIR.0000000000000973.
4. Franczyk B, Gluba-Brzózka A, Ciałkowska-Rysz A, Ławiński J, Rysz J. The Impact of Aerobic Exercise on HDL Quantity and Quality: A Narrative Review. Int J Mol Sci. 2023;24(5):4653. doi: 10.3390/ijms24054653.
5. Gonfa YH, Tessema FB, Bachheti A, et al. Anti-inflammatory activity of phytochemicals from medicinal plants and their nanoparticles: A review. Current Research in Biotechnology. 2023;6:100152. doi: 10.1016/j.crbiot.2023.100152.
6. Tan J, Krasilshchikov O, Kuan G, Hashim HA, Aldhahi MI, Al-Mhanna SB, et al. The Effects of Combining Aerobic and Heavy Resistance Training on Body Composition, Muscle Hypertrophy, and Exercise Satisfaction in Physically Active Adults. Healthcare (Basel). 2023;11(17):2443. doi: 10.3390/healthcare11172443.
7. Han Y, Sun Q, Chen W, Gao Y, Ye J, Chen Y, et al. New advances of adiponectin in regulating obesity and related metabolic syndromes. Journal of Pharmaceutical Analysis. 2024;14(5):100913. doi: 10.1016/j.jpha.2023.12.003.
8. Yanai H, Yoshida H. Beneficial Effects of Adiponectin on Glucose and Lipid Metabolism and Atherosclerotic Progression: Mechanisms and Perspectives. Int J Mol Sci. 2019;20(5):1190. doi: 10.3390/ijms20051190.
9. Raiman L, Amarnani R, Abdur-Rahman M, Marshall A, Mani-Babu S. The role of physical activity in obesity: let's actively manage obesity. Clin Med (Lond). 2023;23(4):311–7. doi: 10.7861/clinmed.2023-0152.
10. Mohammadi Karizno F, Saghebjoo M, Foadoddini M, Sarir H. The role of aerobic training and Pistacia atlantica extract on the levels of protein carbonyl, heat shock protein 70, and glycogen in the liver tissue of diabetic rats. J Birjand Univ Med Sci. 2014;21(1):35–47.
11. Sun T, Tadmor Y, Li L. Pathways for Carotenoid Biosynthesis, Degradation, and Storage. In: Rodríguez-Concepción M, Welsch R, editors. Plant and Food Carotenoids. Methods in Molecular Biology, vol 2083. New York, NY: Humana; 2020. doi: 10.1007/978-1-4939-9952-1_1.
12. Swift DL, Johannsen NM, Lavie CJ, Earnest CP, Church TS. The Role of Exercise and Physical Activity in Weight Loss and Maintenance. Prog Cardiovasc Dis. 2014 Jan-Feb;56(4):441-7. doi: 10.1016/j.pcad.2013.09.012.
13. Akbarpourbani M, Mehrabizadeh A. The effect of aerobic exercise and Spirulina supplementation on some cardiovascular risk factors in overweight women with type 2 diabetes. Sports Biosciences (Movement). 2019;12(2):207–22.
14. Hoseini R, Hoseini Z. The effect of aerobic training and turmeric supplementation on cardiovascular risk factors in overweight women. Yafte. 2019;20(4):85–96.
15. Sheikh-ol-Eslami Vatani D, Firouzmanesh S. The effect of a single dose of caffeine supplementation on lipolysis following maximal endurance exercise in trained women. Journal of Sport and Biokinetics. 2016;8(16):33–44.
16. Kalita P, Ahmed AB, Sen S, Chakraborty R. A comprehensive review on polysaccharides with hypolipidemic activity: Occurrence, chemistry and molecular mechanism. Int J Biol Macromol. 2022;206:681–98. doi: 10.1016/j.ijbiomac.2022.02.189.
17. Al-Fatlawi A, Pouroqar MJ, Mohammad Ibrahim B. The effect of a selected period of intense resistance training on serum levels of amentin 1, cystatin C and fasting glucose in overweight and obese prediabetic men. Exercise and Biokinetics. 2023;15(30):121–32. doi: 10.22034/sbs.2024.428803.1074.
18. Shirzad J, Tofighi A, Toloei Azar J, Khadem Ansari MH. Response of serum irisin, Follistatin, and myostatin to eight weeks of resistance, aerobic, and combined training in obese men. 2020;(4):23–41.
19. Zhang Y, Cai P, Cheng G, Zhang Y. A Brief Review of Phenolic Compounds Identified from Plants: Their Extraction, Analysis, and Biological Activity. Nat Prod Commun. 2022;17(1). doi: 10.1177/1934578X211069721.
20. Srivastava RAK. A Review of Progress on Targeting LDL Receptor-Dependent and -Independent Pathways for the Treatment of Hypercholesterolemia, a Major Risk Factor of ASCVD. Cells. 2023;12(12):1648. doi: 10.3390/cells12121648.
21. Sellami M, Almuraikhy S, Naja K, et al. Eight weeks of aerobic exercise, but not four, improves insulin sensitivity and cardiovascular performance in young women. Sci Rep. 2025;15. doi: 10.1038/s41598-025-86306-2.
22. Muscella A, Stefàno E, Lunetti P, Capobianco L, Marsigliante S. The Regulation of Fat Metabolism During Aerobic Exercise. Biomolecules. 2020;10(12):1699. doi: 10.3390/biom10121699.
23. Dakal TC, Xiao F, Bhusal CK, et al. Lipids dysregulation in diseases: core concepts, targets and treatment strategies. Lipids Health Dis. 2025;24:61. doi: 10.1186/s12944-024-02425-1.
24. Almuraikhy S, Doudin A, Domling A, Althani AAJF, Elrayess MA. Molecular regulators of exercise-mediated insulin sensitivity in non-obese individuals. J Cell Mol Med. 2024;28(1):e18015. doi: 10.1111/jcmm.18015.