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Managing Cholesterol with Exercise

The National Cholesterol Education Program (NCEP ATP III, 2001) states that a sound diet, weight loss and physical activity are the cornerstones of therapy for many individuals with cholesterol disorders. (Cholesterol lowering drug therapy is reserved for those who have the very highest lipid levels or for those who have diabetes or coronary disease.)

For many people with cholesterol disorders the first choice of therapy is dietary modification. In general, reducing high-glycemic carbohydrates reduces triglycerides, and reducing saturated and trans-fat foods decreases LDL-cholesterol. If LDL-cholesterol (the “bad” cholesterol) is high enough, dietary therapy is often supplemented with cholesterol-lowering drug therapy. Exercise is of tremendous benefit when used in combination with either of these two forms of therapy. For those who maintain a frequent and sufficient level of exercise, it is possible that their physician will reduce their cholesterol-lowering medications and in some cases stop it altogether.

Here are the guidelines that outline a systematic approach for favorably altering cholesterol levels with regular exercise:

If you have a less than desirable cholesterol level, or your doctor has indicated you have a cholesterol disorder, have your physician establish your cardiovascular health status before engaging in a vigorous exercise program. Your physician may elect to perform additional blood tests and/or a treadmill stress test on you first.

Choose dynamic forms of exercise that tend to last at least 20 – 30 minutes and are performed at moderate intensities. Moderate exercise intensities would be an approximate effort of four to seven, on a scale of one to ten with ten being near maximal exercise.

In general, for exercise to significantly lower cholesterol levels, a relatively high volume of exercise is recommended, equivalent to three to four hours per week for the average unfit person performing moderate-intensity walking, swimming, walk-jogging or cycling. In 12 to 16 weeks this volume of exercise can reduce total cholesterol by 10 to 20 percent.

This volume of weekly exercise is approximately the same volume of physical activity required to lose weight. As a result, fat weight loss tends to be associated with increases in HDL-cholesterol and reductions in total cholesterol and LDL-cholesterol levels, especially fat loss around the waist and abdomen.

A sample program would be to start with walking 20 minutes per day, four days a week. Over six to eight weeks, graduate this program to one hour, six to seven days a week of walking over hilly (variable) terrain or walk-jogging over relatively flat ground. An alternative would be to walk 50 to 60 minutes three days a week and take an aerobics class three days a week and perhaps two to three sets of singles tennis on the seventh day.

It is important to know that lower volumes of weekly exercise can still produce many other benefits, such as improved fitness and overall health, reduced blood pressure and increased psychological well-being.