Does exercising lower cholesterol

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Can Exercise Help Control Cholesterol? Find Out

Are you one of the 102 million American adults who have high cholesterol? There’s a pretty good chance you or someone you care about has high cholesterol.

About 41 percent of us have a total cholesterol level above 200 mg/dL, which is considered above healthy levels. More than 35 million adults with high cholesterol have a level of 240 mg/dL or higher. That puts them at high risk for heart disease.

Do you have high cholesterol you’d like to reduce for your health (and your longevity)? One effective approach is simple: Exercise.

Positive Effects of Exercise

Taking up a regular fitness activity can have a positive effect on your triglycerides and HDL. Triglycerides are a type of fat in your blood that your body uses for energy. At higher levels, they can contribute to coronary artery disease. HDL is your good cholesterol.

Exercise doesn’t do much to improve your LDL (bad cholesterol). Your best bet for reducing your LDL is a low-cholesterol diet and losing weight.

Before you start an exercise program, check with your health care provider to make sure.

What Exercise Is Recommended?

The good news is that a number of different physical activities can help you control your cholesterol. The main thing is to do your chosen activities regularly.

  • Aerobics — Try running, walking briskly, hiking or cycling (spinning or regular outdoor bike). How about swimming, dancing, kickboxing or an elliptical or a step machine?
  • Free weights or a weight machine — Circuit training is effective.

How Much Exercise Should You Get?

  • Don’t overdo it to start. Try 15 to 20 minutes at a time to start.
  • Work up to about 30 minutes of activity five or six days a week.

During your activity, you should aim for a moderate to somewhat hard effort. You should still be able to carry on a conversation without being too out of breath. If you can still sing, you should increase your effort.

A reminder: Stay hydrated when you exercise. Even when it’s cool during your workout, you still need to drink.

Added Benefits

Along with the cholesterol reducing benefits, exercise can help lower your blood pressure. It can help reduce your risk for stroke and heart attack.

If you have concerns about your cholesterol, visit with your health care provider. Along with exercise, a prescription medication may be recommended to control high cholesterol.

If you need a doctor, you can find one online and make an appointment. The best time to start controlling high cholesterol is now!

How to lower your cholesterol without drugs

You can begin to reduce your “bad” LDL cholesterol naturally by making a few simple changes in your diet.

Image:Thinkstock

You don’t have to follow an all-or-nothing approach. It’s really a matter of common sense.
—Kathy McManus,
director, Department of Nutrition, Brigham and Women’s Hospital

Updated: October 23, 2018Published: September, 2014

If your cholesterol is creeping upward, your doctor has probably told you that diet and exercise—the traditional cornerstones of heart health—could help to bring it down. And if you’d prefer to make just one change at a time to lower your cholesterol naturally, you might want to begin with your diet. A major analysis of several controlled trials involving hundreds of men and women found that dietary changes reduced LDL and total cholesterol while exercise alone had no effect on either. (However, adding aerobic exercise did enhance the lipid-lowering effects of a heart-healthy diet.)

The people in the studies followed a variety of diets, from Mediterranean to low-fat to low-calorie. However, the most effective diets substituted foods with the power to lower cholesterol for those that boost cholesterol. According to Kathy McManus, director of the Department of Nutrition at Brigham and Women’s Hospital, eating with your LDL in mind doesn’t have to be an exercise in self-deprivation. While you may have to say goodbye to a few snacks and fast foods, you can replace them with others that are equally satisfying. “You don’t have to follow an all-or-nothing approach. It’s really a matter of common sense,” she says. She suggests a few ways to start getting your cholesterol under control and keep it normal.

1. Weed out trans fats and saturated fats

There is so much evidence implicating trans fats in heart disease. “The first thing we do when I’m counseling patients is to go over all the sources of trans fats in their diet and make substitutions,” McManus says.

Trans fats are created by adding hydrogen to a liquid fat to help it solidify. Food manufacturers started using trans fats because they extend the shelf life of packaged baked goods. Fast-food purveyors took to them because they can be reused again and again. Although public pressure has forced the food industry to phase out trans fats, they haven’t disappeared entirely. To avoid eating them inadvertently, scrutinize the labels on food packages before you put them in your shopping cart. If you see “partially hydrogenated” in the list of ingredients, pass that product by. If trans fats aren’t banned from restaurants in your area, ask if the cook uses partially hydrogenated oil before you order.

Saturated fats and dietary cholesterol, which are derived primarily from animal products, aren’t exactly heart-healthy, but it’s all right to eat them in small amounts. McManus says that because eggs are such a good source of nutrients, it’s okay to have as many as four yolks a week and whites as often as you like. She also gives a nod to red meat, shrimp, lobster, high-fat cheeses, butter, and organ meats—but only to small portions of each one every couple of weeks or so.

2. Eat more polyunsaturated and monounsaturated fats

Both polyunsaturated and monounsaturated fatty acids help lower LDL. Most plant-derived oils, including canola, safflower, sunflower, olive, grapeseed, and peanut oils, contain both. Fatty fish (such as salmon, tuna, trout, herring, and mackerel), seeds, nuts, avocados and soybeans are also great sources.

3. Go crazy with colorful fruits and vegetables

Fruits and vegetables have scads of ingredients that lower cholesterol—including fiber, cholesterol-blocking molecules called sterols and stanols, and eye-appealing pigments. The heart-healthy list spans the color spectrum—leafy greens, yellow squashes, carrots, tomatoes, strawberries, plums, blueberries. As a rule, the richer the hue, the better the food is for you.

4. Avoid refined sugars and grains

Whole grains are another good source of fiber. Instead of refined flour and white rice, try whole-wheat flour and brown or wild rice. Old-fashioned oatmeal is also a good choice, but not the quick-cooking versions, which have had much of the fiber processed out.

And don’t substitute sugar for fat. “It’s one of the worst choices you can make,” McManus warns. Food manufacturers may boost the sugar content of low-fat salad dressings and sauces to add flavor. If you see sugar, corn syrup, or any word ending in “ose” near the top of the list of ingredients, choose a higher-fat version without trans fats instead.

5. Remember to count your calories

All fats, whether good or bad, have nine calories per gram—about 100 calories a tablespoon. While you switch to a heart-healthy diet you may need to keep tabs on your calorie intake for a while.

For more information, check out “11 foods that lower cholesterol.”

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As a service to our readers, Harvard Health Publishing provides access to our library of archived content. Please note the date of last review on all articles. No content on this site, regardless of date, should ever be used as a substitute for direct medical advice from your doctor or other qualified clinician.

Lowering Your High Cholesterol: 6 Exercises That Will Pay Off

When you were first diagnosed with high cholesterol, your doctor may have talked to you about exercise. Besides improving your diet, exercising is one of the most effective lifestyle changes you can make to help bring your numbers down naturally.

Your first thought may have been, “I hate running.” Or maybe you like running, but you’ve been sidelined lately because of an injury. Or maybe you don’t mind jogging, but you hate the treadmill.

Running isn’t the only way to turn your health around. There’s no doubt that it’s an effective aerobic exercise, but several other good choices are available that can help counteract the negative affects high cholesterol has on your health.

Why exercise is effective at lowering cholesterol

Cholesterol is one of the fatty substances we have circulating in our blood. If we have too much, it can stick to the inside walls of our arteries, narrowing them and increasing risk of cardiovascular disease.

It’s not only the amount of cholesterol in the blood that affects our risk, though. Other factors play a part. One of these is the type of protein that carries the cholesterol through the body. Low-density lipoprotein (LDL) cholesterol is more likely to cause problems. High-density lipoprotein (HDL) cholesterol protects the body from cholesterol buildup.

Exercise helps increase levels of HDL good cholesterol. Researchers reported on this in Lipids in Health and Disease. Physically active women had significantly higher levels of HDL cholesterol than sedentary women. Another study published in Arteriosclerosis, Thrombosis, and Vascular Biology found similar results. In men with belly fat, regular endurance exercise increased HDL good cholesterol levels.

Exercise may even change the nature of our cholesterol. In 2002, researchers from Duke University Medical Center found that exercise improved the number and size of the particles carrying cholesterol through the body. Those who exercised more had larger, “fluffier” particles that were less likely to clog arteries.

Exercise can help you lower cholesterol numbers even if you’re overweight. In the Journal of Obesity, researchers reported that overweight and obese adults who walked, jogged, and cycled while eating a cholesterol-lowering diet improved total cholesterol, LDL cholesterol, and triglyceride levels.

Best exercises for lowering cholesterol

Some research has indicated that it may be that “how much” you exercise is more important than what kind of exercise you do. That means it’s worth it to incorporate more activity into your day however you can. Take a walk during your lunch hour, choose the stairs, stand up to take phone calls, or store a jump rope at your desk.

In addition, try to incorporate at least 30 minutes of structured exercise into each day. Any exercise is better than none, but the following six types have shown in studies to be effective at reducing cholesterol levels.

1. Go for a nice run or jog

If your joints are in good shape and you enjoy jogging, you’re in luck, as this is a great exercise for lowering cholesterol and for managing your weight. Don’t think you have to race, though. An easy jog for a few miles may be better for lowering cholesterol than a fast sprint around the block.

In a 2013 study published in the Archives of Internal Medicine, researchers reported that long-distance runners showed significantly better improvements in HDL cholesterol levels than short-distance runners (less than 10 miles a week). They also saw better improvements in their blood pressure.

2. Take a brisk walk

Whether walking is as good as running for cardiovascular health has long been the subject of debate. Especially as we get older, walking can often be a much better exercise in terms of protecting joint health.

Researchers reported good news on this in 2013 in the journal Arteriosclerosis, Thrombosis, and Vascular Biology. They compared tens of thousands of runners to an equal number of walkers. Results showed that the amount of exercise was what mattered, not the type.

People who exerted the same level of energy when exercising experienced similar benefits, whether they walked or ran. Benefits included reduced risk of high cholesterol and high blood pressure.

It takes longer to walk off calories than to run them off. If you burn 300 calories either way, though, you’ve spent about the same amount of energy. You are likely to experience similar benefits. Lead author of the study above, Paul Williams, stated that walking 4.3 miles at a brisk pace would take about the same amount of energy as running three miles.

3. Bike to work or just for fun

Cycling expends about the same energy as jogging, but it’s easier on your joints. That’s an important thing for many people as they age. Hips and knees are vulnerable to arthritis, and we all do need to watch out for them. If you’re starting to feel some pain in these joints, it may be best to choose cycling over running.

If it’s possible to bike to work, try it. Studies have shown some positive benefits. Scientists reported in the Journal of the American Heart Association that people who biked to work were less likely to develop high cholesterol than those who didn’t.

A second study published in Circulation found that cycling reduces risk of heart disease. A group of adults between the ages of 50–65 who regularly spent time biking had 11–18 fewer heart attacks over the period of 20 years than those who didn’t.

4. Take a few laps at the pool

Swimming is probably the most joint-saving aerobic exercise you can do. In a 2010 study, researchers compared swimming with walking in women aged 50 to 70 years. They found that swimming improved body weight, body fat distribution, and LDL cholesterol levels better than walking did.

Researchers also looked at the beneficial effects of swimming in men in the International Journal of Aquatic Research and Education. They found that swimmers had 53 percent, 50 percent, and 49 percent lower risk of dying from any cause than did men who were sedentary, walkers, or runners, respectively.

5. Lift a few weights

So far, we’ve been talking mostly about aerobic exercise. It is the type of exercise most commonly recommended for reducing risk of heart disease.

Some research suggests, though, that resistance training is also extremely beneficial for those with high cholesterol. The journal Atherosclerosis published a study showing that those who participated in resistance training were able to clear LDL from their bloodstream faster than those who didn’t.

Resistance training can also help you protect cardiovascular health. In BMC Public Health, scientists reported that combining resistance and aerobic exercise helped people lose more weight and fat than either of these alone. The combination also created increased cardiovascular fitness.

Don’t think you’re too old to try weight lifting. It helps people of any age. The Journals of Gerontology published a study on women aged 70–87 years. Those who participated in a resistance-training program for about 11 weeks had significantly lower LDL cholesterol and total cholesterol levels compared with those who didn’t.

6. Strike a few yoga poses

After all this talk about aerobic exercise and lifting weights, it may seem odd that yoga would show up on the list. After all, yoga is mostly stretching, right?

Studies show, however, that yoga may reduce risk of heart disease. In some cases, it may directly affect cholesterol levels.

Researchers reported in the Indian Heart Journal that a three-month yoga program helped reduce total cholesterol and LDL cholesterol. It also improved HDL cholesterol levels in diabetics. The participants practiced for about one hour a day.

In a large study review published in the European Journal of Preventive Cardiology, those who regularly practiced yoga showed significant improvement in LDL cholesterol, HDL cholesterol, and blood pressure over those who didn’t exercise.

Most any exercise will do — If you do it often

All of these exercises are helpful for reducing cholesterol and protecting you from cardiovascular disease. You can choose which is best for you based on your overall health, joint health, and lifestyle.

There are other options, as well. If you play tennis or dance regularly, you’re likely to be expending about the same energy as someone who walks briskly or runs. The important thing is to get in at least 30 minutes of moderate-intensity exercise daily, with resistance training two times a week. Then add in more throughout your day when you can. Wherever you are, get up and move!

Cholesterol Guide: Exercise Tips

Will exercise help my cholesterol levels?

There are three main cholesterol levels doctors monitor: triglycerides, HDL and LDL.

Exercise has the greatest effect on triglycerides by lowering them, and on HDL, the good cholesterol, by increasing it.

Exercise does not have much impact on LDL, the “bad” cholesterol unless combined with dietary changes and weight loss.

Check with your doctor before starting an exercise program. Do not engage in any activity that causes chest pain, excessive shortness of breath, dizziness or lightheadedness. Stop immediately if you experience any of these symptoms.

How do I start on a cholesterol-lowering aerobic exercise program?

The American Heart Association and the American College of Sports Medicine recommend that people exercise most days of the week in an aerobic fashion. This type of exercise is repetitive in nature and uses multiple muscle groups. Examples of aerobic exercises include cycling, swimming, walking, elliptical machines and step machines.

  • Start slowly. If you are new to an exercise program, start with a short amount of time, and slowly increase. Start low, and go slow! You could start out with 15 to 20 minutes, or in some cases even less.
  • Try to build up over time so that the exercise lasts at least 30 minutes, even if you have to split this up into several smaller activities throughout the day. Do not forget to include a warm-up and a cool-down consisting of about 5 minutes each. These periods are in addition to your 30 minutes.
  • The optimal goal is to achieve approximately 200 minutes per week of exercise. This can be accomplished by doing 30 minutes of exercise 7 days per week or doing 40 minutes of exercise 5 days per week.
  • The exercise should feel moderate to somewhat heavy so that you can still carry on a conversation without being too breathless. However, you should feel breathless enough to not be able to sing comfortably.

What general tips should I know about cholesterol-lowering aerobic exercise?

  • Stay well-hydrated during exercise by drinking water when you are thirsty, and remember that in hot or humid conditions you may need to drink even more water to maintain hydration.
  • Wear comfortable clothes with sneakers or flat shoes with laces. Wear shoes with good support so that you can reduce the risk of orthopedic problems.
  • Make exercise a regular part of your healthy lifestyle, and try to exercise at the same time of day so it becomes a habit.
  • Use caution when exercising right after meals, when it is very hot or humid, or if you do not feel up to exercising.
  • Ask family and friends to join you to help keep you motivated. This also can help them to start or continue on a road to a healthy lifestyle.
  • Note your activities on a calendar or in a record book. Record the type of exercise, distance/amount of time, and how you felt during the activity. This will help you keep track of your progress – and serve as motivation to keep going!
  • Use a variety of exercise to keep up your interest. Try things such as yoga, tai chi, Pilates or kickboxing. Join an exercise group, health club or the YMCA. Many churches and senior centers also offer exercise programs.
  • Look for chances to be more active during the day. Some examples would be walking the mall before shopping, parking your car farther away from your destination than necessary, choosing a flight of stairs over an escalator, or taking 10 to15 minute walking breaks while watching TV or sitting for some other activity.

If there is a break in your exercise due to illness or other factors, remember that your body adapts to whatever level of exertion is put on it. You might have to restart at a slightly slower level than before the break.

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How to lower cholesterol with the right diet and exercise regimens

You can lower cholesterol by eating foods with healthier fats — like avocados — and exercising regularly. NatashaPhoto/iStock

  • The best way to lower cholesterol is with a heart-healthy diet and regular exercise.
  • Foods that can lower cholesterol include nuts, avocados, whole grains, fruits, vegetables, and healthy oils.
  • It generally takes at least three months to lower cholesterol and you will still need to maintain a healthy lifestyle afterward for any change to be effective.
  • This article was reviewed by Jason R. McKnight, MD, MS, a family medicine physician and clinical assistant professor at Texas A&M College of Medicine.
  • Visit Insider’s homepage for more stories.

If you’re one of the 95 million US adults with a total cholesterol level higher than 200 mg/dL, you might be wondering what measures you can take to lower your cholesterol.

Medication isn’t right for everybody, and making changes to your lifestyle, such as eating a heart-healthy diet and getting regular exercise, may be more important for you. Here’s what you need to know.

The best ways to lower cholesterol

According to Steven Reisman, MD, a cardiologist and director of the New York Cardiac Diagnostic Center, the best way to lower cholesterol is with lifestyle modification through diet and exercise.

Reducing saturated and trans fats, while introducing soluble fiber and healthier fats, is key to adopting a heart-healthy diet. As far as exercise, aim for at least 30 minutes of aerobic activity five times each week — walking, biking, jogging, or exercise classes should work.

If you’re a smoker, giving up the habit can also get your numbers under control. That’s because smoking lowers HDL, which is considered good cholesterol. You’ll want higher levels of HDL to remove LDL from the arteries, which is considered bad cholesterol.

Foods to eat to lower cholesterol

To lower LDL cholesterol, Reisman says to reduce your consumption of saturated fats, such as red meat and full-fat dairy products. You’ll also want to minimize trans fat and partially hydrogenated oil in your diet, especially fried foods.

The next step is to eat foods that are considered heart-healthy. “Foods with monounsaturated fats are beneficial because they can decrease bad cholesterol (LDL) and increase good cholesterol (HDL),” says Reisman. Foods with monounsaturated fats include:

  • Avocados
  • Nuts like almonds, cashews, and pecans
  • Cooking with canola, olive, or peanut oil

Including polyunsaturated fats may also reduce the risk of heart disease and help lower your LDL cholesterol, says Reisman. Look for foods that contain an important type of polyunsaturated fat — omega-3 fatty acids. These include:

  • Walnuts
  • Sunflower seeds
  • Fish like salmon, herring, and tuna

Finally, Reisman says soluble fiber can also reduce LDL cholesterol. Some of the best foods to eat for added soluble fiber are:

  • Whole grains and oats
  • Beans and lentils
  • Apples, pears, and peas

How long it takes to reduce cholesterol levels

Sasan Massachi, MD, a primary care physician specializing in internal medicine, says that patients are typically advised to adopt a lifestyle modification program for three months, focusing on a healthier diet and regular exercise. This is followed up with cholesterol tests after three months to gauge results.

“If patients reduce their cholesterol adequately and are not in any danger of cardiovascular diseases, and they commit to maintaining a healthy diet and exercise regimen, we have them follow up in three to six months for additional cholesterol tests,” he says.

Overall, how quickly you can reduce cholesterol will depend on your total cholesterol level, your family history, any pre-existing health conditions like diabetes, and the type of diet and exercise program.

If your levels are already closer to a healthy range, and you don’t have any pre-existing conditions, it may take less time.

When a doctor will recommend medication

“For some patients who don’t respond well to lifestyle changes, it is necessary to take medication,” says Massachi. This may include those with a family history of high cholesterol and those who also have cardiovascular diseases or diabetes.

In these cases, Massachi says taking cholesterol medication can lower your cholesterol levels, and also help manage other pre-existing conditions. You should talk with your doctor if you think this might be the right option for you.

Related stories about heart health:

  • A cardiologist is begging patients to avoid the high-fat keto diet because their cholesterol levels could skyrocket
  • Eating 2 apples a day may lower cholesterol, helping ward off heart attacks and strokes
  • An avocado a day could lower your ‘bad’ cholesterol levels and reduce your risk of heart disease
  • Burnout may lead to an irregular heartbeat decades later, according to a first-of-its kind new study
  • 7 of the most dangerous things that put you at risk of a heart attack
  • A cardiologist revealed the truth behind red wine’s health benefits

A high-fat meal may not be quite as bad for your body if you exercise shortly afterward, a small study from Japan suggests.

The results show that walking and doing light resistance training one hour after eating a high-fat meal reduces the boost in triglycerides, fats in the blood, normally seen after consuming this type of food. What’s more, exercising after eating did a better job of reducing elevations in triglyceride levels than exercising before a meal.

High levels of triglycerides can increase the risk of heart disease.

Regular exercise reduces triglyceride levels, but few studies had looked at the effect of exercise on triglyceride levels shortly after eating, the researchers said.

However, because the study was small, further research is needed to know whether the results apply to the general population, the researchers added. In fact, a study published in 1998 (also a small one), found the opposite — that exercising 10 to 12 hours before a high-fat meal was best at reducing triglyceride increases, although exercising afterward did show some benefit as well.

Stephen Ball, an associate professor of nutrition and exercise physiology at the University of Missouri, and an author of the 1998 study, said the best time to exercise is any time you can. And if you want to lose weight, you’ll have to exercise enough to burn more calories than you consume, Ball noted.

In the new study, researchers measured triglyceride levels in 10 men and women after they had eaten a fatty meal (about 38 percent fat). On two separate days, people exercised either one hour before or one hour after eating the meal. On a third day, people did not exercise after eating.

When people didn’t exercise, their triglyceride levels rose from 66 milligrams per deciliter (mg/dL) to 172 mg/dL two hours after eating. Normal fasting triglyceride levels are below 150 mg/dL.

When people exercised before dining, their triglyceride levels increased to 148 mg/dL within two hours after eating (a 25 percent reduction compared with triglyceride levels following no exercise). When people exercised after eating the meal, their triglyceride levels increased to 131 mg/dL (a 72 percent reduction compared with no exercise.)

Six hours after eating the high-fat meal, all participants’ triglyceride levels were the about the same, regardless of whether or not they had exercised. However, even temporary increases in triglyceride levels after eating a high-fat meal may increase cardiovascular disease risk, the researchers said.

Exercising after a fatty meal may accelerate the rate at which the body uses fat, thus reducing triglyceride levels, the researchers said.

“Maybe there is a reason that it is good to go for a walk after a big meal, like Thanksgiving,” said Dr. William Kraus, a professor of medicine at Duke University School of Medicine, who was not involved in the research.

The study, conducted by researchers at Kyoto Prefectural University, is published in the February issue of the journal Medicine & Science in Sports & Exercise.

Pass it on: Exercising one hour after eating a high-fat meal reduces elevations in triglyceride levels.

Follow Rachael Rettner on Twitter @RachaelRettner, or MyHealthNewsDaily @MyHealth_MHND. We’re also on Facebook & Google+.

Lifestyle Changes to Improve Your Cholesterol

Cholesterol is a waxy, fat-like substance in your body. Your body uses it to protect nerves, make cell tissues, and produce certain hormones. Your liver makes all of the cholesterol your body needs. But you also get cholesterol directly from food you eat. Common sources include eggs, meats, and dairy products. This can add too much cholesterol into your body. That can have negative effects on your health. Luckily, there are a number of lifestyle changes you can make to improve your cholesterol.

Path to improved health

There are 2 types of cholesterol:

  • Low-density lipoprotein (LDL). This delivers cholesterol to the body. This is called “bad” cholesterol. You want a low level of this type.
  • High-density lipoprotein (HDL). This removes cholesterol from the bloodstream. This is called “good” cholesterol. You want a high level of this type.

A high level of LDL is bad for your body. Likewise, a low level of HDL is bad for you. If your doctor says you need to improve your cholesterol, you’ll need to lower your LDL and increase your HDL. Medicines can help with this. But the simplest way to improve your cholesterol is through lifestyle changes.

What lifestyle changes can I make to help improve my cholesterol levels?

Exercise regularly.

Exercise can raise HDL cholesterol levels. It can also reduce levels of LDL cholesterol and triglycerides (a type of fat in your blood). Try to work out for 30 minutes, 4 to 6 times a week. Make sure you talk to your doctor before starting an exercise plan.

Lose weight if you are overweight.

Being overweight can raise your cholesterol levels. Losing weight, even just 5 or 10 pounds, can lower your total cholesterol, LDL cholesterol, and triglyceride levels.

If you smoke, quit.

Smoking lowers your HDL cholesterol. Even exposure to second-hand smoke can affect your HDL level. Talk to your doctor about developing a plan to help you stop smoking.

Eat a heart-healthy diet.

  • Eat plenty of fresh fruits and vegetables. Fruits and vegetables are naturally low in fat. They add flavor and variety to your diet. They are also the best source of fiber, vitamins, and minerals for your body. Aim for 5 cups of fruits and vegetables every day. This should not include potatoes, corn, or rice. These count as carbohydrates.
  • Pick “good” fats over “bad” fats. Fat is part of a healthy diet, but there are “bad” fats and “good” fats. “Bad” fats include saturated and trans fats. They are found in foods such as:
    • butter
    • coconut and palm oil
    • saturated or partially hydrogenated vegetable fats such as shortening and margarine
    • animal fats in meats
    • fats in whole milk dairy products.

Limit the amount of saturated fat in your diet. Avoid trans fat completely.

Unsaturated fat is the “good” fat. Most fats in fish, vegetables, grains, and tree nuts are unsaturated. Try to eat unsaturated fat in place of saturated fat. For example, use olive oil or canola oil when cooking instead of butter.

  • Use healthier cooking methods. Baking, broiling, and roasting are the healthiest ways to prepare meat, poultry, and other foods. Trim any outside fat or skin before cooking. Lean cuts can be pan-broiled or stir-fried. Use either a nonstick pan or nonstick cooking spray instead of adding fats such as butter or margarine. When eating out, ask how food is prepared. You can request that your food be baked, broiled, or roasted, rather than fried.
  • Look for other sources of Meats are good sources of protein. But they contain a lot of cholesterol and saturated fats. Fish, beans, tree nuts, peas, and lentils also offer protein, but without the cholesterol and fats. They also contain fiber and other nutrients. Consider eating one “meatless” meal each week. Try substituting beans for meat in a favorite recipe, such as lasagna or chili. Snack on a handful of almonds or pecans. Soy is also an excellent source of protein. Good examples of soy include soymilk, edamame (green soy beans), tofu, and soy protein shakes.
  • Get more fiber in your diet. Add good sources of fiber to your meals. Examples include:
    • fruits and vegetables
    • whole grains (such as oat bran, whole and rolled oats, and barley)
    • legumes (such as beans and peas)
    • nuts and seeds (such as ground flax seed).

In addition to fiber, whole grains supply B vitamins and important nutrients not found in foods made with white flour.

  • Eat more fish. Fish is an excellent source of omega-3 fatty acids. These are “good” fats that are good for your heart. Wild-caught oily fish are the best sources of omega-3s. These include salmon, tuna, mackerel, and sardines. But all fish contain some amount of this beneficial fatty acid. Aim for 2 6-oz. servings every week.

Add supplements to your diet.

If changing your diet isn’t enough, certain supplements may help improve your cholesterol levels. Some examples include:

  • Plant sterols and stanols. Plant sterols and stanols can help keep your body from absorbing cholesterol. Sterols have been added to some foods, including margarines and spreads, orange juice, and yogurt. You can also find sterols and stanols in some dietary supplements.
  • Omega-3 fatty acids. If you have heart disease or high triglycerides, consider taking an omega-3 or fish oil supplement. Make sure the supplement has at least 1,000 mg of EPA and DHA. These are the specific omega-3 fatty acids found in fish.
  • Red yeast rice. A common seasoning in Asian countries, red yeast rice may help reduce the amount of cholesterol your body makes. It is available as a dietary supplement. The recommended dose of red yeast rice is 1,200 milligrams twice a day. Talk to your doctor before taking red yeast rice, especially if you take a cholesterol-lowering medicine called a statin.

Things to consider

Often, there are no symptoms telling you that you could have high cholesterol. If you have high cholesterol, your body may store the extra cholesterol in your arteries. This build-up is called plaque. Over time plaque can become hard and make your arteries narrow. Large deposits of plaque can completely block an artery. The plaque can also break open. This leads to formation of a blood clot that can block the flow of blood.

If an artery that leads to the heart becomes blocked, you could have a heart attack. If an artery that leads to the brain is blocked, you are at risk of having a stroke. Many times, people don’t find out they have high cholesterol until they’ve had one of these life-threatening events.

If you have high cholesterol, you are twice as likely to develop heart disease. This is why it is important to have your cholesterol levels checked, especially if you have a family history of heart disease.

Questions to ask your doctor

  • Am I at risk for heart disease?
  • How often should I get my cholesterol tested?
  • What are my cholesterol levels? What do they mean?
  • What lifestyle changes do I need to make to help improve my cholesterol levels and heart health?
  • Is there a chance that I’ll need cholesterol-lowering medicine?
  • What are the risks and benefits of taking this medicine?

Resources

National Institutes of Health: National Heart, Lung, and Blood Institute, Cholesterol

Centers for Disease Control and Prevention, Cholesterol

Ask the experts

My doctor just told me I have high cholesterol. He prescribed a statin drug for me, but I’m afraid of its side effects. I’m not overweight, and I already exercise a couple times a week. Will exercising more help to lower my cholesterol? If so, what type of exercise is best?

Doctor’s response

The research is mixed on the effect of exercise on cholesterol. Some studies show that exercise helps lower it, while others do not. When exercise does lower cholesterol, the effect may be what researchers consider statistically significant, but clinically, it may drop only a few percentage points and not enough to lower cholesterol into a healthy range. You might consider making a deal with your doctor where you agree to try three months of regular exercise and attention to your diet to lower your cholesterol, and if the change at three months isn’t enough to put the value in a healthy range, then you can discuss how to proceed with your physician. You should know that the side effects of statins are easy to monitor, not everyone gets side effects, and they are effective medications.

As for the type of exercise to lower cholesterol, most of the research involves aerobic exercise, so walking, jogging, biking, swimming, dancing, and all cardio machines at the gym count. How much aerobic exercise you need to do, or how hard it should be, is unknown, but I suggest a high dose of five or more days per week for at least 30 minutes at an intensity of approximately 65% to 75% of your maximum heart rate. Consistency is important if you try the three-month experiment, so plan carefully. I recommend that you set a weekly exercise plan at the beginning of each week and make the plan as realistic and specific as possible. Write down the days of the week, the time of day, the type of exercise, and the duration. Again, be as specific and realistic as possible to increase the probability of doing it. If and when you miss a day, get right back on track, and always set your weekly plan at the beginning of every week.

The good news is that even if your cholesterol doesn’t come down with three months of regular exercise, you’ll certainly get more fit, and research shows that other lipid risk factors for heart disease improve with regular exercise. For instance, triglycerides almost always drop with regular aerobic exercise, sometimes as much as 60 mg/dl, and HDL cholesterol, the “good” cholesterol, rises in some people when they exercise regularly (scientists believe that HDL cholesterol carries “bad” cholesterol away from arteries and to the liver where it’s removed from the body).

Good luck with the three-month experiment if you decide to try it. But even if you don’t get the results you want and end up needing a statin, there are so many other benefits of regular exercise that it’s certainly worth the effort.

Exercise helps your heart

Regular exercise is an important way to lower your risk of heart disease. Exercising for 30 minutes or more on most days can help you lose weight, improve your cholesterol, and even lower your blood pressure by as many as five to seven points.

A sedentary lifestyle, where your job and your leisure activities involve little or no physical activity, doubles your risk of dying from heart disease. This is similar to the increased risk you’d have if you smoked, had high cholesterol, or had high blood pressure.

The good news

It’s easier than you might think to improve your health with exercise. You don’t have to jog for an hour a day. In fact, some studies have shown greater health benefits from light to moderate exercise simply because people are more likely to stick with it.

Your heart health improves with just 30 minutes of exercise on most days. Two 15-minute segments of exercise or three 10-minute segments still count as 30 minutes. Just make sure the activity is vigorous enough to raise your heart rate. Try the talk/sing test: If you can’t talk while you exercise, you’re working too hard. If you can sing, you need to work harder.

What happens with exercise

Just as exercise strengthens other muscles in your body, it helps your heart muscle become more efficient and better able to pump blood throughout your body. This means that the heart pushes out more blood with each beat, allowing it to beat slower and keep your blood pressure under control.

When you exercise regularly, your body’s tissue (including the heart) does a better job of pulling oxygen from your blood. This allows your heart to work better under stress and keeps you from getting winded during high-intensity activities.

Physical activity also allows better blood flow in the small blood vessels around your heart. Clogs in these arteries can lead to heart attacks. There’s also evidence that exercise helps your body make more branches and connections between these blood vessels, so there are other routes for your blood to travel if the usual path is blocked by narrow arteries or fatty deposits.

Exercise also increases your levels of HDL cholesterol, the “good” cholesterol that lowers heart disease risk by flushing the artery-clogging LDL or “bad” cholesterol out of your system.

Along with lowering your risk for heart disease, exercise:

  • Keeps your weight down.
  • Improves your mood.
  • Lowers your risk for some types of cancer.
  • Improves your balance.
  • Reduces your risk of osteoporosis by increasing your bone mass.
  • Gives you more energy.
  • Helps you sleep better.

Your doctor can help you design an exercise routine that’s right for you. Be sure to check with your doctor if you haven’t exercised in a long time or if you have a history of high blood pressure, heart disease, stroke, dizziness, or exercise-related pain.

Clinical review by Avra Cohen, RN
Kaiser Permanente
Reviewed 01/03/2019

How to Cut High Cholesterol and Heart Attack Risk With Exercise

If you’re not familiar with the moves, take a class or work with a professional trainer first to avoid injury and get the maximum benefit.

Once you’ve worked up to a stable exercise program, you should see improvements in your HDL cholesterol and triglyceride levels in about a month, says Dr. Eckel. But exercise alone won’t significantly drop your LDL cholesterol levels. For that, you also need to alter your diet; in particular, he advises avoiding saturated fat, the kind found in marbled red meat and full-fat dairy products.

Even though reducing your LDL is beneficial, research on whether it has an effect on overall longevity is still inconclusive. For now, eating a balanced, healthy diet that’s rich in vegetables, fruits, and whole grains — based on the Harvard Healthy Eating Plate or a Mediterranean diet — is the most reasonable approach.

How to Start an Exercise Habit to Lower Cholesterol

Don’t leap straight from your couch to the running track. “If you’ve been sedentary, particularly if you have risks for heart disease, get your doctor’s okay before you start exercising,” says Eckel, who is also an author of the 2013 AHA/ACC Guideline on Lifestyle Management to Reduce Cardiovascular Risk and the resulting online heart risk tool.

Then, just start. “That may sound ridiculous,” says Jordan, “but people get themselves all tied up waiting for the perfect time to begin an exercise program — ‘when this happens or that happens.’ There’s no perfect time. You just have to start.”

He believes that while the AHA frequency guidelines point to good outcomes for people who are trying to shift their cholesterol numbers, people who are just beginning to work out should aim for even more sessions: five or six days a week. “That’s what it takes to establish a new habit,” says Jordan. “In the beginning, frequency really counts.”

RELATED: 8 Foods to Help Lower Your Cholesterol

How to Keep Exercise Up to Get Cholesterol and Heart Disease Risk Down

Some great ways to stay motivated include:

  • Keeping your goals realistic. If you expect to lose a lot of weight through exercise, or you reach healthy cholesterol levels quickly, you could be setting yourself up for disappointment — and end up dropping out.
  • Making exercise social. Having the support of family or a friend helps you keep going. Numerous apps can also link you to other exercisers.
  • Being flexible. If you can’t make it to the gym or the weather is forcing you to stay in, work out in your living room.

Anna Rambo (left) and American Heart Association CEO Nancy Brown. (Anna Rambo photo by LauraBelle Photography)

As Anna Rambo and her husband moved around the country – setting up homes in four states, having a son in each – she knew there was something to take care of once life settled down.

The time came early last year.

She went to her family doctor for a physical and gave him the quick version of her medical history: Her mom had a stroke caused by high cholesterol, her sister has high cholesterol, and Anna herself was diagnosed with high cholesterol at age 8. Now in her late 30s, she’d never taken medicine, but she’d always followed a healthy diet and remained active.

OK, the doctor said. Let’s take your blood work and see what the tests show.

The result: “You have crazy-high numbers!” the doctor told her.

That’s not all he said. Anna was diagnosed with , a term she’d never heard and one you probably haven’t, either. But if you or a loved one have a family history of , it’s something you should know – especially if you have children.

Anna Rambo (right) with her sister, Elizabeth, and mother, Jennifer. The three share familial hypercholesterolemia, which led to Jennifer’s stroke. (Photo courtesy of Anna Rambo)

Spoiler alert for the rest of Anna’s story: Two of her boys have FH; her baby is too young to be tested.

“When I was growing up, they just told me to watch my diet and exercise,” she said. “But now, for my kids’ generation, there is hope. We know there is treatment available.”

FH is a condition marked by high levels of . While everyone’s cholesterol levels tend to rise with age, LDL levels for FH patients start high from birth.
High cholesterol is fearsome because it can lead to a buildup of plaque in arteries. Like gunk in a pipe, too much can cause a blockage. In a body, those kinds of blockages can lead to a heart attack or stroke. Other serious issues are in play, too.

Left untreated, one in two men with FH will have a heart attack before they turn 50; 30 percent of untreated women will have a heart attack by their 60th birthday. One in every 250 people have FH – and more than 90 percent of Americans don’t know it.

indeed starts with diet and exercise; not smoking helps, too. Doctors also may prescribe cholesterol-lowering medicines known as statins(link opens in new window).

What’s considered FH-caliber high LDL? Above 190.

Anna was in the 300s when her doctor called on St. Patrick’s Day in 2017. She’s now under 120 and trying to dip below 100.

Cholesterol barged into Anna’s life during her childhood in Baytown, Texas. Her mom’s high cholesterol was serious enough that Anna and her two older sisters were taken a half-hour west to Houston for testing at a top-notch medical center.

Sure enough, Anna and one of her sisters had “ridiculously high numbers for that age.” Yet back then, in the late 1980s, the advice was, essentially, “Keep an eye on it.”

“We just kind of lived life like everything was normal,” Anna said. “I had the mindset of, `I’ll deal with it later.’”

A decade later, her mom, a teacher, was in her third-grade classroom when she didn’t feel right. The school nurse recommended she go to the hospital. She was having a stroke.

She suffered no long-term consequences, but doctors have monitored her cholesterol more aggressively. It’s worked, too, as she’s had no more cardiovascular scares. Aided further by a new class of medicines known as PCSK9 inhibitors, Anna’s mom’s LDL numbers are in the 80s. (Ditto for Anna’s sister, who also takes statins.)

When her mom suffered the stroke, Anna was in college. She rushed to the hospital and spent several days alongside her mom. Hearing that high cholesterol was the culprit caused Anna to … well, actually, not do anything.

“I really thought, ‘That can’t happen to me,’” she said. “I’m going to take control, running and eating right. And I did. I ran marathons and half-marathons. I was a vegetarian for a while.”

At 22, she married Philip, a budding neuropsychologist. Their first son, Neil, arrived while in graduate school in Oklahoma. Caleb was born in Connecticut, Miles in Montana and Owen in Kansas.

Along the way, Anna saw plenty of OB-GYNs, but none checked her cholesterol. Not that it mattered; women who are pregnant or trying to get pregnant are advised against taking statins. Anna knew this, which is part of the reason she delayed getting tested.

When she finally made that fateful visit to her family doctor last year, Anna hoped that diet and exercise had kept her numbers in check. Still, she braced for harsh results.

Getting those harsh results was one thing. Learning that she had FH could’ve made it worse. But Anna found it freeing.

“It was comforting to know there was a name for it, that it was something I could research,” she said. “Everything kind of clicked once I got that diagnosis.”

She soon discovered the . Three months later, she attended an event in Washington, D.C. That’s when she learned her kids had a 50-50 chance of having FH. And that – unlike when she was young – treatment could begin at age 10.

Anna Rambo’s sons: Neil (left), holding Owen, and Miles (center) have high cholesterol. Caleb (right) does not, and Owen will be tested next month. (Photo by Brittany Deere Photography)

After so many years of being in the dark about her own case, Anna felt there was no time to waste with her children. So she and Philip had the cholesterol levels checked for Neil, Caleb and Miles.

Genetic testing is available for FH, and is becoming more common, but today most people are diagnosed based on their LDL cholesterol and family history.
Neil, who is 9, and Miles, who is 4, have FH. Caleb, who is 7, doesn’t. Owen will have his cholesterol tested after he turns 2 next month.

Neil and Miles see a pediatric endocrinologist twice a year, plus a dietitian. Both are likely to take medication once they’re old enough, with Neil only months from being eligible.

Anna remains involved with the FH Foundation and has become active in my organization, the American Heart Association. She wants others to learn about the condition and to feel as empowered as she is. This is a great time, as FH Awareness Day is Sept. 24.

Anna’s passion comes from a deep place. After all, FH runs in families, and she not only has FH, she’s also the daughter, sister and mother of people with FH.

“You may know that heart disease runs in your family and that you have high cholesterol, but maybe you haven’t put it together,” she said. “This is a genetic condition that needs treatment. Diagnosis is going to save lives. And it’s as simple as a blood test and knowing your family history.”

A version of this column also appeared on .

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