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What is the role of exercise in managing cholesterol levels?

The role of exercise in managing cholesterol levels is multifaceted and involves various physiological mechanisms. Regular physical activity can positively impact cholesterol levels through several interconnected processes:

  1. Increased HDL (Good) Cholesterol: Exercise has been shown to raise the levels of high-density lipoprotein (HDL) cholesterol, often referred to as "good" cholesterol. HDL cholesterol acts as a scavenger, picking up excess cholesterol from the bloodstream and transporting it to the liver for excretion. This helps reduce the overall cholesterol burden in the bloodstream and is associated with a lower risk of heart disease.

  2. Enhanced Lipoprotein Lipase Activity: Exercise stimulates the activity of lipoprotein lipase, an enzyme that plays a crucial role in lipid metabolism. Lipoprotein lipase breaks down triglycerides (a type of fat) in the bloodstream, reducing triglyceride levels, which can contribute to healthier lipid profiles.

  3. Reduced LDL (Bad) Cholesterol: While the direct effect of exercise on low-density lipoprotein (LDL) cholesterol may be modest compared to dietary changes, regular physical activity can still contribute to lower LDL cholesterol levels. This reduction is partly attributed to improved LDL receptor activity in the liver, which enhances the clearance of LDL cholesterol from the blood.

  4. Weight Management: Exercise helps control body weight and body fat percentage. Maintaining a healthy weight is associated with improved cholesterol profiles. Losing excess body fat, especially visceral fat (fat stored around the abdominal organs), can lead to reductions in LDL cholesterol and triglycerides.

  5. Anti-Inflammatory Effects: Chronic inflammation is associated with elevated cholesterol levels and an increased risk of cardiovascular disease. Exercise has anti-inflammatory properties and can reduce systemic inflammation, contributing to better overall heart health.

  6. Improved Insulin Sensitivity: Regular exercise enhances insulin sensitivity, making cells more responsive to insulin. Improved insulin sensitivity can lead to better control of blood sugar levels and lower triglyceride levels, which, in turn, can positively affect cholesterol levels.

  7. Enhanced Endothelial Function: Exercise improves the function of the endothelium, the inner lining of blood vessels. This can enhance vasodilation (widening of blood vessels), reducing blood pressure and promoting healthy blood flow.


  1. Palazón-Bru, A., Hernández-Lozano, D. & Gil-Guillén, V.F. Which Physical Exercise Interventions Increase HDL-Cholesterol Levels? A Systematic Review of Meta-analyses of Randomized Controlled Trials. Sports Med 51, 243–253 (2021).

  2. Wang, Y., Xu, D. Effects of aerobic exercise on lipids and lipoproteins. Lipids Health Dis 16, 132 (2017).

  3. Matsumoto, R., Tsunekawa, K., Shoho, Y. et al. Association between skeletal muscle mass and serum concentrations of lipoprotein lipase, GPIHBP1, and hepatic triglyceride lipase in young Japanese men. Lipids Health Dis 18, 84 (2019).

  4. Cerqueira É, Marinho DA, Neiva HP and Lourenço O (2020) Inflammatory Effects of High and Moderate Intensity Exercise—A Systematic Review. Front. Physiol. 10:1550. doi: 10.3389/fphys.2019.01550

  5. Lin Y, Fan R, Hao Z, Li J, Yang X, Zhang Y and Xia Y (2022) The Association Between Physical Activity and Insulin Level Under Different Levels of Lipid Indices and Serum Uric Acid. Front. Physiol. 13:809669. doi: 10.3389/fphys.2022.809669

  6. Gao, J., Pan, X., Li, G. et al. Physical Exercise Protects Against Endothelial Dysfunction in Cardiovascular and Metabolic Diseases. J. of Cardiovasc. Trans. Res. 15, 604–620 (2022).

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