Exercise and High Cholesterol: What the Research Actually Shows
If your health professional has told you that your cholesterol is on the high end, they have probably recommended that you "get more exercise". But, what type of exercise? How does it affect cholesterol? In this post, I will be using the latest research to answer those questions.
Let’s start here: What is cholesterol?
Cholesterol is a fat-like substance found in our cells. It plays many roles, such as the synthesis of vitamin D, steroid hormones, and sex hormones. Cholesterol also facilitates the absorption of fat-soluble vitamins A, D, E, and K (Huff et al., 2023).
It travels through the bloodstream packaged inside particles called lipoproteins. You've probably heard of the two main types, Baker and Vonderschmidt (2026) define it as follows:
LDL cholesterol (low-density lipoprotein), which is often referred to as "bad" cholesterol, as it can lead to artery blockage, narrowing the vessels, and reducing blood flow.
HDL cholesterol (high-density lipoprotein) is often called "good" cholesterol, as it helps carry excess cholesterol away from the arteries and back to the liver, where it is processed and removed from the body.
Triglycerides are a type of fat also present in blood that the body uses to create energy. When levels of triglycerides and LDL are too high (hyperlipidemia) or HDL levels are too low (dyslipidemia), the arteries are at risk of narrowing and hardening, significantly raising the risk of heart attack and strokes (Huff et al., 2023).
So, what role does exercise actually play?
With the information above, we can derive the following conclusion: it is paramount to decrease triglycerides and LDL levels back to normal ranges, as well as increasing HDL levels.
A meta-analysis using 148 clinical trials and more than 8,600 participants aimed to establish how exercise training changes each triglycerides, LDL, and HDL levels (Smart et al., 2024). The results were as follows:
LDL cholesterol decreased.
HDL cholesterol increased.
Triglycerides levels decreased.
But, the important question is: what type of exercise?
| Type of exercise | Outcome | Reason why |
|---|---|---|
| Aerobic exercise | Increase in HDL | 1. Increases the activity of an enzyme called lipoprotein lipase, which helps break down fats in your blood and plays a role in forming HDL particles. 2. Improves the quality of HDL particles themselves. It makes them larger, more efficient at clearing cholesterol from your arteries |
| Strength training | Increase in HDL | Muscle contraction improves insulin sensitivity, which helps increase HDL levels and reduce LDL levels. |
| Combination of aerobic exercise and strength training | Reducing LDL and triglycerides | Most effective course of action. Reduces LDL levels as well as increasing HDL levels, by boosting the activity of enzymes involved in processing fats, and improving how your body clears used cholesterol particles from the bloodstream. |
The researchers also found a helpful pattern:
Consistency is key. Regular sessions over 12 weeks or longer, several times a week, produced better results than sporadic or short-term efforts.
Even a single session of moderate exercise can create a short-term boost in HDL. Building a sustainable, regular habit is what produces lasting change.
Exercise also leads to better blood pressure, improved mood, stronger muscles and bones, and better overall metabolic health.
How can you get started?
Figuring out the right mix of aerobic and strength training, and sticking with it long enough to see real changes in your numbers, is not easy to do alone. That's exactly what I help clients with at ROPE AU. If you'd like personalised guidance to get started safely and build a routine you can stick with, book a free 15-minute consultation or send me a message on WhatsApp, I'd love to help you get started.
References
Baker, K., & Vonderschmidt, A. (2026). Interpreting Lower HDL Cholesterol in Plant-Based Diets: Mechanisms and clinical implications. Advances in Nutrition, 17(9), 100708. https://doi.org/10.1016/j.advnut.2026.100708
Gibbs, B. B., Hivert, M., Jerome, G. J., Kraus, W. E., Rosenkranz, S. K., Schorr, E. N., Spartano, N. L., & Lobelo, F. (2021). Physical activity as a critical component of First-Line treatment for elevated blood pressure or cholesterol: Who, what, and how?: A scientific statement from the American Heart Association. Hypertension, 78(2), e26–e37. https://doi.org/10.1161/hyp.0000000000000196
Huff, T., Boyd, B., & Jialal, I. (2023, March 6). Physiology, cholesterol. StatPearls - NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK470561/
Smart, N. A., Downes, D., Van Der Touw, T., Hada, S., Dieberg, G., Pearson, M. J., Wolden, M., King, N., & Goodman, S. P. J. (2024). The Effect of exercise training on blood lipids: A Systematic review and Meta-analysis. Sports Medicine, 55(1), 67–78. https://doi.org/10.1007/s40279-024-02115-z
