Can exercise and diet successfully manage high cholesterol without the need for medication?

I don't like to say “without the need” because that's up to the doctor, but I certainly do see for some patients that exercise definitely improves the HDL's, and it can reduce the triglycerides. Vigorous exercise is more so important for improving the good cholesterol as well. But again it's about making sure that those exercises are suitable for the particular patient.

There is a lot of research to support that exercise and diet together, which is what we call healthy lifestyle changes, can very successfully manage high cholesterol as well as blood pressure. We generally recommend that people initially talk to their General Practitioner before making changes and then visit an Exercise Physiologist to help them design a suitable physical activity regime that can help.

  Clinically High cholesterol is named Hypercholesterolemia, which translates to Increased Cholesterol in the blood.

  Without generalising, numerous Australians will suffer from increased cholesterol. Unfortunately many of these individuals will also suffer from other, what are called co-morbidities, such as high Blood pressure and high blood glucose. 

  According to the World Health Organisation (WHO) and the top 10 leading causes of death we understand that the top causes include:

1). Ischaemic Heart Disease - 12.8%
2). Stroke and other cerebrovascular disease - 10.8%
9). Diabetes Mellitus - 2.2%

  Unforuntunately these can be caused by all aforementioned symptoms, especially high cholesterol. High Cholesterol and high blood pressure directly affect an increase of what is known as atherosclerosis, which is a build up of plaque inside the blood vessels where it attaches to the walls. This build up can create damaging of the blood vessel which can lead to further conditions; eg stroke and varying heart diseases. So back to the question, can Exercise and diet successfully manage high cholesterol without the need for medication?

  The way cholesterol medication works is by stabilising this atherosclerosis or plaque, which therefore decreases the liklihood of causing further health concerns. It will also decrease cholesterol production and reabsorption by the body. Can this be done naturally?

  With reference to exercise and the WHO top 10 leading causes of death, a 40 year study was concluded by the Dallas centre in Texas that explained 150 minutes of moderate-intensity exercise per week, actually decreases the liklihood of these top 10 causes by 50%. 

  I strongly believe that if there was one single medication that would decrease the liklihood of all of these conditions by 50% then it would definately be prescribed. Luckily this medication does exist, its EXERCISE. It just isn't prescribed like it should be.
  Specific guidlines are obviously needed for chronic conditions such as high cholesterol, in which an Exercise Physiologist can provide a thourough assessment followed by an individualised exercise and lifestyle program. They will provide education on your condition and also provide behavioural changes to improve your current condition. Like any health problem, professional advice is needed to improve an individuals condition and quality of life.

  With reference to other factors, re: Diet I believe a professional Dietician will have the best scope of knowledge to provide a detailed answer on this, however many studies have proven the increased positive effects of both regular exercise and improved diet, with reference to chronic health conditions.

Hello!

I would like to add to the fantastic responses above that yes both diet and exercise can help to manage high cholesterol and I have seen clients that have been able to weane off medication by making suitable changes. HOWEVER like Angela has posted, always consult your General Practitioner before ceasing any medication. 

High cholesterol has a number of risk factors not just diet and (lack of) physical activity. You also have to factor in family genetics, smoking, alcohol and stress.

In terms of Dietary Advice for lowering Cholesterol I will try and keep it simple.

Your overall goals should be to aim for a healthy weight (for most adults that is a BMI of <25) and reduce your waist measurement. In addition by exercising for at least 30 minutes a day of moderate activity on most days of the week, would be a good point to start for (I find pedometers great for tracking steps - aim for >10,000 a day!)

Dietary Guidelines

1. Reduce Saturated Fats - any visible fat on meat, skin on poultry, full fat dairy products, pastry and T/A items, processed meats (eg sausages), coconut oil and palm oil.

2. Include 2-3 serves of oily fish a week (150g is sufficient which is hand size). Australian and Atlantic salmon (fresh or canned), blue-eye trevalla, gemfish and canned sardines or salmon are the best choices. If you dislike fish, I would recommend taking 3-6 grams of fish oil capsules per day. 

3. Try to include Legumes and pulses in at least two meals a week - excellent source of protein and soluble fibre.

4. Aim for the 2 Fruit / 5 Veg a day. (1 serve = approx 1/2 cup ;)

5. Add some nuts to your diet. 30-50 grams of raw, unroasted, unsalted nuts everyday is a great snack idea. Almonds are my personal fav!

6. Try to limit sugary, fatty and salty snack foods. You can still enjoy these in moderation however it is best to limit them.

7. Include sources of soluble fibre such as chia seeds, apple, oats, barley, psyllium husks and rice bran. All proven to help reduce total blood cholesterol. You should aim for around 30 grams of fibre a day.

8. If you choose to drink, limit to one-two standard drink(s) a day with a couple of alcohol free days during the week.

9. Choose foods and drinks with added plant sterols in them (check the product label to see if they are added). Plant sterols help to lower your total cholesterol. The Heart Foundation recommends 2-3 grams of plant sterols each day. They are added to certain margarines such as Logicol, ProActiv and a milk & yoghurt called Pura Heart-Active. 

10. Choose low salt foods and avoid adding salt to foods instead use herbs and spices.


It takes at least six weeks to see some change in your Cholesterol levels so request a new blood test around this time. Best of luck!

Aidan Ma
Accredited Practising Dietitian
DNA Dietitians

Absolutely! In my case, I was eating quite poorly at the time my cholesterol was found to be high. I was eating things like red duck curry, and steak and chips. After changing my diet to limit saturated fats, increase vegetable intake, and of course increasing exercise, my cholesterol level came down to normal within 6 months.

However, some people have a genetic reason for having high cholesterol, and may not be able to reduce cholesterol levels to normal via diet and exercise alone. For many reasons, attention to a healthy diet and regular exercise should continue, as these have multiple health benefits beyond reducing cholesterol.