Cholesterol is a term often taken to mean something which is bad or harmful; however, our bodies do need cholesterol in order to be able to function properly. Cholesterol is an essential component in the production of certain hormones, digestive fluids and vitamin D.
There are two types of cholesterol: low- and high-density lipoproteins. As we’ve written previously, lipoproteins are particles which carry cholesterol around the body. Low density lipoproteins, or LDLs, carry cholesterol out to where it is needed; high density lipoproteins, or HDL, carry it back to the liver if it isn’t needed.
High cholesterol is present when the number of LDLs is high, and the number of HDLs is low. This means that cholesterol gets stranded in the bloodstream, and begins to leave deposits (plaques) on the walls of blood vessels; a process is called atherosclerosis. Someone who has persistently high cholesterol for a prolonged period is therefore more likely to develop a build up of plaque on their artery walls, and experience heart and circulation problems as a result.
Each year, National Cholesterol Month runs throughout October to help raise awareness of high cholesterol and related conditions; as well as the diet and lifestyle measures which can help to lower cholesterol and keep it at a healthy level.
To mark the occasion, we wanted to take a closer look in particular at how exercise can be help lower high cholesterol. So, we got in touch with the team at Heart UK; where Baldeesh Rai, a dietetic advisor for the cholesterol charity, very kindly answered our questions.
How can exercise help to lower high cholesterol?
Most people will be aware that regular exercise can benefit health in a number of ways. But how exactly does it help us to keep our cholesterol in check?
‘Regular exercise is thought to increase the size of the LDL.’ Baldeesh tells us. ‘Some of these particles are small and dense, others are big and “fluffy”. The fluffier particles are less likely to clog the arteries.’
Another less direct way that regular exercise can benefit cholesterol is by helping us to maintain a healthy weight.
‘Being overweight can increase the amount of low density lipoprotein (LDL) in your blood, the kind of lipoprotein linked to heart disease.’ Baldeesh explains. ‘One way exercise can help lower cholesterol is by helping you lose or maintain weight.’
What exercises should I do?
Ideally a full exercise regime should include aerobic activity, resistance training and flexibility; and this is also true for people looking to improve their cholesterol.
‘Moderate to intense aerobic exercise that raises the heart rate for 20 to 30 minutes at a time, at least five times a week, can improve your cholesterol profile by increasing your HDL levels (the so-called “good” cholesterol).’ Baldeesh explains.
So, what do we mean by aerobic exercise?
‘Aerobic exercise causes your heart and lungs to work harder to supply more oxygen to your muscles. This type of exercise helps improve your stamina, strengthen your heart and keep it on top form so it can work efficiently, pumping blood to every part of your body.’
‘Aerobic activities also burn calories, helping you to control your weight.’
‘For most people, aerobic exercise means light to moderate intensity which should gently increase your breathing and heart rate.’
‘Adults should aim for at least 150 minutes of moderate intensity aerobic activity each week. For instance, this could be 30 minutes a day, five days a week. Each bout of activity needs to be at least 10 minutes. For the best results you should also do activities that will strengthen your muscles at least twice a week.’
You can incorporate aerobic activity into your lifestyle through a number of means; and you don’t necessarily need to join a gym in order to reach these physical activity targets. There are numerous aerobic activities you can take part in to improve your cholesterol levels.
Baldeesh suggests: brisk walking (on a flat surface), slow jogging, cycling, swimming, gardening, hiking or gentle dancing as moderate aerobic workouts; and brisk walking uphill, running, spinning classes, sports such as football or tennis, or dancing classes such as Zumba or salsa as high intensity aerobic workouts.
Should I also include strength or flexibility exercises?
In short, yes. If you want to improve your cholesterol levels through physical activity it is still important to incorporate a mixture of resistance and flexibility exercises, in addition to cardiovascular activity.
As Baldeesh explains: ‘Resistance training, also called strength training, can strengthen and tone your muscles, as well as improve bone strength and help with good posture and balance.’
‘Building muscle will help to boost your metabolism, so that you naturally burn more energy when at rest as well as when you are active. For example weight training can raise your metabolism for up to 38 hours after you finish; in comparison to pure cardio workouts, when calorie burning stops shortly after you do.’
Resistance training is especially important as we get older, as Baldeesh explains:
‘Muscle mass drops sharply as we reach our fifties through a process called sarcopenia, and lifting weights can help to stem these losses. Examples include: carrying shopping, weight and floor training at the gym (such as push-ups, lunges, bicep curls, lifting weights). Flexibility exercises (such as stretching, pilates, yoga and tai chi) are equally important. As they help to stretch and lengthen your muscles.’
How much of a difference can exercise make to cholesterol levels?
If a cholesterol test reveals that you have high cholesterol your doctor may suggest that you start a course of medication. However, alongside any prescribed treatment, there are lifestyle changes you can make to help get your cholesterol levels back on track; and taking up exercise can make a real difference.
‘Becoming more physically active through regular aerobic exercise can increase HDL cholesterol by about 5% within two months,’ Baldeesh tells us, ‘and can improve LDL cholesterol and lower triglycerides too.’
‘If you have raised triglycerides (another type of blood fat),150 minutes per week of moderate activity over several weeks could lower them by as much as 20-30%.’
‘Evidence suggests that duration of exercise, rather than the intensity, is the more important factor in raising HDL cholesterol, but both duration and intensity have been shown to be beneficial.’
Is it still possible for someone who exercises regularly to have high cholesterol?
While watching our weight is an integral part of staying healthy, it’s important to remember that people who have a BMI within the healthy range can still be at risk of raised cholesterol; as can people who exercise regularly.
As Baldeesh explains: ‘Exercise alone won’t guarantee a low cholesterol level. Genetics, weight, age, gender and diet all contribute to an individual’s cholesterol profile.’
It’s not possible to know whether you have high cholesterol, unless you have a blood test, as it does not always cause symptoms; and some people with certain risk factors will be advised to have their cholesterol levels checked regularly (Read more about getting your cholesterol checked.)
When you’re new to exercise
If you haven’t taken part in exercise for a long time, reintroducing it into your lifestyle might seem daunting.
Baldeesh provided some useful tips for taking those first steps to reestablishing a regular exercise routine.
‘If you have never exercised before or have not exercised for a long time speak to your GP before starting a new exercise programme. Once you’ve been given the go ahead follow these guidelines:
- Reduce the amount of time in sedentary activities such as sitting.
- Find activities you enjoy and build them into your daily routine.
- Start slowly and gradually build up to 150 minutes every week.
- Choose a form of exercise you can do for 10-20 minutes at a time. Aim for an activity of moderate intensity such as brisk walking, swimming or using an exercise machine at low intensity and build up to the 30 minute goal. (Remember, you can get your exercise in 10 minute increments, as long as it adds up to 30 minutes by the end of the day).
- If you feel chest pain or shortness of breath stop and rest.’
Heart UK is a cholesterol charity that offers expert support to anyone affected by raised cholesterol conditions. You can read more about National Cholesterol Month and how you can get involved on the Heart UK website.