I exercise for a half hour most days, eat well and am not overweight. But my doctor said I have elevated LDL (bad) cholesterol. How can that be, and what can I do to lower it?

I exercise for a half hour most days, eat well and am not overweight. But my doctor said I have elevated LDL (bad) cholesterol. How can that be, and what can I do to lower it?

Elizabeth Ricanati, M.D.

Elizabeth Ricanati, M.D.

Elizabeth Ricanati, M.D., is the founding medical director of Lifestyle 180, an innovative Cleveland Clinic program aimed at treating and... Read more

First off, it’s important to consider more than low-density lipoprotein (LDL) levels when assessing your cholesterol health. Total cholesterol measurements include high-density lipoproteins (HDLs), known as good cholesterol, as well as lousy LDL cholesterol and triglyceride levels. Having high HDLs (above 55 milligrams per deciliter) and a total cholesterol that’s in a normal range (200 mg/dl or below), or even slightly elevated, can offset some of the risk associated with elevated bad cholesterol. Same goes for triglycerides, which ideally should be under 150 mg/dl. Meanwhile, your total cholesterol number might look good, but the HDL could be low, which will work against you. Bottom line: Know your LDL, HDL and triglyceride numbers.


When looking at LDLs specifically, doctors consider levels between 130 and 159 mg/dl borderline high, and anything above 160 mg/dl as high. Your goal: an LDL of less than 100 mg/dl, which is ideal, or between 100 and 129, considered near optimal.


Getting back to your question, elevated LDL can be a result of a poor diet or lack of exercise. But often, as might be the case for you, there’s a familial connection, particularly in families with known heart disease. So even when eating and exercise habits are good, genetics can still work against you.


The good news is that there’s a lot you can do to lower your LDL, and in turn lessen your cardiovascular risk. Working closely with your physician, you can target the two most common approaches for lowering cholesterol: lifestyle modifications (in this case, exercise, good nutrition and stress management) and, if necessary, medication. A few guidelines:


Exercise: All adults should get a minimum of 30 minutes of physical activity five days per week. But more is better, especially when you’re trying to lower cholesterol. So a few times per week, consider increasing the length of your workouts to 45 minutes or an hour and upping their intensity.


Nutrition: Although you’re not overweight, your diet may not be as good as it can be. You may want to work with a dietitian who can teach you how to avoid saturated fats and trans fats, two substances that can raise your cholesterol. You can also learn how to incorporate yummy foods that naturally lower cholesterol, including steel-cut oatmeal, blueberries and walnuts.


Stress: Try to lower your stress level by spending five minutes a day focusing on the sound of your breath. While relaxation exercises don’t have a direct effect on lowering cholesterol, they can put you in a better mind-set, which then makes it easier to choose the right foods and stick with your exercise routine.


If diet and exercise changes still aren’t enough, prescription medications can help lower cholesterol levels. Medications often include statins, which work by inhibiting cholesterol production. If you are pregnant, trying to become pregnant or breast-feeding, you should not use these drugs. Learn more wellness solutions for high cholesterol at 360-5.com.