Working off your cholesterol

By Allen Smith

Overview
If you have been told by your doctor that you have high cholesterol, starting a regimen of prescription medications may not be your best approach. In fact, if your total cholesterol is moderately high--from 200 to 230 mg/dl--and your have no other risk factors for heart disease, there is a good chance that you will be able to see significant improvements in your cholesterol through diet and exercise alone.

Step 1
Have a complete physical examination by your physician--especially if you're over 40 years of age and/or have a family history of heart disease. During the examination, be sure that he measures your blood pressure, height, weight, performs a resting EKG and draws blood for a blood lipid profile. The blood lipid profile should include total cholesterol, low density lipoproteins (LDL), high density lipoprotein (HDL) and triglycerides.

Step 2
Discuss the results of your physical examination with your doctor. Ask him if there are any issues that could impact you beginning an exercise program. For instance, if you are overweight, you may want to choose low impact forms of exercise, such as cycling and swimming, that are easier on the joints than running. Focus on the LDL and the HDL levels of your blood lipid test. They are both important and work in concert with each other. If your exercise program is effective, your LDL levels should come down, while your HDL levels should go up. According to the American Heart Association, your LDL levels should be less than 140 mg/dl. Men's HDL levels should be at least 45 mg/dl. Women's should be 55 mg/dl or higher. The National Cholesterol Education Program (NCEP) has even more rigorous recommendations. NCEP states that all adults should implement therapeutic lifestyle changes (meaning a combination of diet and exercise) if their LDL is over 100 mg/dl.

Step 3
Reserve 30 minutes or more somewhere in your day for exercising. When you exercise isn't particularly important, as long as you can stick to it. If you are short on time, you may even wish to split it up into two sessions--one 15-minute session in the morning and one 15-minute session in the evening. Many people find that exercising in the morning is the best time. The air is clean, you get it out of the way and there are less things to interfere with it (like that sudden late meeting) than if you leave it until the end of the day.

Step 4
Choose an activity that you enjoy and that you can do all year-round in all types of weather. The best forms of exercise to lower cholesterol are those that use large muscle groups, can be sustained for moderate to long periods of time and elevate your heart rate. Good examples are walking, running, swimming, cycling, aqua aerobics and hiking. After you have established your aerobic exercise base, you can add light to moderate resistance training several times a week.

Step 5
Challenge yourself to make improvements in your performance. If you like to walk, set a course around the neighborhood that you have measured using your car's odometer. Each time you return from your walk, record how long it took you to complete the course, your resting heart rate before you began and your recovery heart rate 10 minutes after finishing exercise. Good indicators that your fitness level is improving is being able to walk faster, at a lower heart rate, with a quicker post-exercise heart rate reduction. After several weeks of regular exercise, you should also begin to see a dramatic loss in weight. If you are struggling with diabetes and high blood pressure, you should also begin to see improvements with these as well.

Step 6
Schedule another physical examination or blood lipid analysis with your doctor six months after you have been on your program. Discuss the results with him and look at ways to change your exercise program if you are not seeing the results you anticipated. You many also need to bring in a registered dietitian to help you with your diet. Diet and exercise work hand in hand when lowering cholesterol.

Tips and Warnings
* Recruit members of the family or friends to help you to adhere to your exercise program. If the weather turns bad, take your exercise program into the mall or choose another form. * Avoid fad diets and exercise programs. Restrict your daily exercise to a realistic routine.

Things You'll Need
* Blood lipid test
* Exercise clothing and shoes
* Digital stopwatch
* Exercise journal

References
Cholesterol statisticsMore about managing cholesterol with exerciseHow to reduce high cholesterol with exercise was originally published on LIVESTRONG.COM.

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