Much attention concerning the treatment of high cholesterol in our present society tends to focus on the taking of medicine and the avoidance of poison. When I refer to medicine, I don't just mean prescription drugs like statins or fibric acids, but rather I am referring to any substance that we take in order to treat an illness. Therefore, the foods we choose to eat such as fruits, vegetables, fiber, unsaturated fats, and fish, for example, would also count as medicines. On the flip side, we also spend a tremendous amount of thought and effort on avoiding the ingestion of poisons in our daily lives such as trans fat and animal based fats. In short, we seem to be quite orally fixated when it comes to treating high cholesterol in that we are obsessed over what to put or not put into our mouths. The pharmaceutical industry also seems to share this oral fixation in that they continue to spend billions of dollars to develop cholesterol lowering pills that we can pop and then forget about till the next morning.

Unfortunately, lost amongst this smorgasbord of pills, capsules, bran muffins, and vegetable oil spreads resides a therapy that has been proven to improve cholesterol ever since the beginning of humankind. It's free, can be administered virtually anywhere, and not only has been shown to improve cholesterol but also reduce the risk of a heart attack, cancer, diabetes, high blood pressure, gallstones, depression, loss of mental ability, and overall death. That primordial therapy is called exercise.

It has been estimated that 12% of all deaths in our country may be related to physical inactivity. Numerous population studies have shown that those people who exercise on a regular basis have a lower incidence of developing heart disease as well as a better chance of surviving a heart attack when compared to sedentary people. Furthermore, a cardiac rehabilitation exercise program for those who have survived a heart attack may lower the risk of death by 25%. Some studies even suggest that exercise alone can reverse the development of atherosclerosis.

When I mention improved cholesterol, we often think that means lowering of total cholesterol, LDL, and triglycerides and increasing HDL. However, exercise may not necessarily cause that dramatic of a change in your standard cholesterol blood test. I know some people who after months of intense and regular exercise feel much healthier yet are disheartened when they see that their most recent blood test shows minimal to no change in their total cholesterol and LDL levels and only minor increases in HDL. Does this mean that exercise can only minimally improve cholesterol? If you only look at the numbers of the standard cholesterol test, you may easily get that impression and become discouraged. However, rest assure, exercise is helping you in more ways than one.

The standard cholesterol profile test typically measures global HDL, total cholesterol, and calculates LDL. However, there are several subtypes or sizes of LDL and HDL. In short, smaller LDL and another type of LDL called very low density LDL (VLDL) are bad in that they promote more heart disease development. Smaller HDL also does not seem to be as helpful as larger ones. So with regards to these lipoproteins, bigger is better. Even though exercise may not change the LDL reading on a standard blood test, it can markedly change the different subtypes of LDL by increasing overall LDL and HDL size and lowering the amount of VLDL. All of these are positive effects in preventing heart disease which may not be reflected at all when measured on a standard cholesterol blood test.