Does Exercise Lower Cholesterol?

Exercise is famous for all the ways it helps your body. So, it’s no surprise if you’re wondering whether a brisk walk or long bike ride can lower your cholesterol, too.

Clinical cardiac exercise physiologist and Director of Cardiac Rehabilitation, Erik Van Iterson, PhD, shares some great news. “Yes, regular exercise can help improve your cholesterol numbers,” he says. “But it doesn’t stop there. Combining exercise with heart-healthy eating and other changes makes the greatest impact.”

Dr. Van Iterson describes how exercise works its magic and which types to try.

How exercise can lower cholesterol

Exercise doesn’t directly lower your LDL (“bad”) cholesterol. Instead, it alters how your body processes, transports and clears these types of cholesterol particles. For example, regular exercise:

• Modifies LDL particle size and density
• Alters enzyme activity
• Helps your skeletal muscle do a better job of using fatty acids for energy
• Promotes HDL (“good”) cholesterol maturation, meaning you have more of these helpful particles circulating in your blood

Together, all these actions result in a lower LDL level over time.

To understand why a higher HDL level is a good thing, it helps to know that LDL and HDL aren’t actually different types of cholesterol. They’re different types of particles that carry cholesterol in your blood:

• LDL particles deposit cholesterol in your arteries, adding to plaque buildup. They’re like dump trucks that spill out debris where they shouldn’t.
• HDL particles remove excess cholesterol and carry it to your liver for disposal. They’re like the cleanup crew that comes to carry away all the debris.

Ideally, to help support low LDL levels, you want your HDL crew to be high in number and good at what they do. Exercise helps with both.

When you’re breaking a sweat at the gym, you’re boosting the number of HDL particles in your blood. It’s a bit like hiring more members for the cleanup crew. But the benefits go beyond that. Regular exercise can even modify enzyme activity in the liver — and this, in turn, can enhance your liver’s ability to clear LDL from your bloodstream.

“We’re learning more about the role that exercise plays in improving the function of HDL particles and modifying enzyme activity,” Dr. Van Iterson shares. “In other words, it helps your HDLs and liver do a better job of cleaning out the bad cholesterol from the blood flowing through your arteries and reducing inflammation. Over time, this can translate to a lower LDL level and other health benefits.”

Best exercises to try

When it comes to lowering your cholesterol, moderate-intensity cardio (aerobic-based) exercise is all you need. That means you’re reaching your target heart rate intensity (about 55% to 70% of your max heart rate) but still able to hold a light conversation. Gradually work your way up to at least 150 minutes per week — and spread those minutes out over at least three days.

“Start slow and progressively build up. Take your time,” Dr. Van Iterson advises. “You don’t need to push the pace or intensity to get the cholesterol-lowering wheels in motion.”

There are lots of different cardio exercises that you can do at a moderate intensity. Here are some that Dr. Van Iterson recommends:

• Brisk walking: Start with easy walks around the block. As you get more comfortable, walk a little farther and faster than last month.
• Jogging or running: When your walks start to feel too easy, it might be time to break into a gentle jog. “The goal isn’t to win a race — it’s to support your heart health,” Dr. Van Iterson clarifies. “Don’t put pressure on yourself. Set a pace that’s right for you. It’s also OK if you decide jogging or running isn’t for you. Just continue your regular walking routine for your cardio exercise.”
• Cycling: Pushing those pedals can burn just as many calories as jogging, but it can be easier on your knees, ankles, hips and back. If you have limited lower-body mobility, see if your local gym has an arm bike. It’s cycling for your arms, and it can still get your heart pumping. “You can also try a seated, semi-recumbent stepper, which may be useful if you have limited range of motion in your knees,” Dr. Van Iterson notes.
• Elliptical training: Gentler than a jog, an elliptical workout can make you feel like you’re running without all the pounding. This can be great if you’re recovering from an injury or want some variety in the colder months.
• Swimming or water aerobics: Water workouts are gentler on your body and can also help you relax. Check out local rec center options and consider joining a class, where you can meet others with similar movement goals. Just make sure you can access the pool year-round so you can be consistent regardless of the weather.

Do you enjoy strength and resistance training or recreational sports? Or are you simply craving some variety in your routine? There are many different activities that can complement your cardio exercise to help lower your cholesterol levels. Here are some examples:

• Strength training: There are tons of exercises to choose from, including some with no equipment.
• Barre workouts: You don’t have to be a ballerina to try barre. It’s designed for everyone. Barre draws on elements of ballet, yoga and Pilates to improve your strength and flexibility.
• Anything that you love: Whether it’s pickleball, salsa dancing or softball, find an activity that makes you smile or feel alive. You’re doing your cholesterol a favor in the process!

“There’s no need to monitor your heart rate zone for these types of activities,” Dr. Van Iterson says. “But you should still aim to maintain a feeling of moderate intensity to allow for both an effective and enjoyable experience.”

Tips to maximize results and stay safe

Before you hit the ground running, Dr. Van Iterson advises keeping these things in mind.

• Consult your cardiologist. “Always check with your cardiologist or healthcare provider before starting an exercise program,” he cautions. “They’ll let you know how much exercise is safe for you based on your health history.”
• Eat heart-healthy foods. No matter how much you exercise, your cholesterol won’t budge unless you make some dietary changes, too. “A Mediterranean pattern of eating is the way to go for lower cholesterol and overall heart health,” Dr. Van Iterson explains.
• Be consistent. One or two workouts won’t lower your cholesterol. The key is making a plan and sticking with it long term. When deciding on your routine, ask yourself whether you think it’s something you could do multiple times a week for many years to come.
• Mark your calendar. Schedule your workouts to improve your chances of making them happen. “Keep in mind, though, that there’s no such thing as a perfect time of day to exercise,” Dr. Van Iterson notes. “The best time is whenever you can find time!”
• Stay hydrated. Drink water before you’re thirsty, as well as in preparation for your exercise — not just during and after your session. In hot or humid conditions, you may need to drink even more water to meet your body’s needs. (A not-so-fun fact: Dehydration can make your blood pressure drop dangerously low.)

Above all, listen to your body. Stop exercising immediately and seek medical attention if you experience:

• Chest pain or discomfort
• Trouble breathing (beyond feeling a bit winded)
• Dizziness or lightheadedness

Final thoughts

Lowering your cholesterol takes time and patience. You may start to see results after about 12 weeks of consistent exercise and dietary changes. But if your numbers still aren’t where you want them to be, talk to your healthcare provider about your options.

“Plenty of people need medication to lower their cholesterol,” Dr. Van Iterson says. “It’s not a failing on your part. You can run marathons and still have high cholesterol. Sometimes, your genes or underlying health conditions have a louder say in the matter.”

Even if you add meds into the mix, keep your workouts going strong. And keep your exercise habit even if you reach your cholesterol target levels. The reason? Exercise maintenance is effective heart disease prevention.

“The benefits to your heart, mind and whole body are clear,” he adds. “Getting into the exercise habit now — no matter what your cholesterol levels are — can pay off for your entire life.”