Fitness Q&A by Richard Weil

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?

Answer:

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.

Take care. Thank you for your question.


Last Editorial Review: 12/27/2006