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Your best option? Don’t choose just one.

Reviewed by Dietitian Katey Davidson, M.Sc.FN, RD, CPT

Key Points

• Combined aerobic and strength training may offer the best cholesterol benefits.
• Aim for at least 150 minutes of aerobic exercise and two strength sessions weekly.
• A heart-healthy diet, sleep and quitting smoking also support healthy cholesterol.

High cholesterol is one of those silent conditions that you may not know you have. It has no symptoms, yet living with high cholesterol increases your risk of heart disease and stroke.

While medication is a common treatment for high cholesterol, your lifestyle also has an impact on your numbers—and that includes exercise. “For all cardiovascular disease risk factors, lifestyle interventions are the first line of defense,” says Linda Pescatello, Ph.D, FACSM.

But is all exercise created equal when it comes to your cholesterol? Is aerobic exercise or strength training better? Turns out, it’s both.

Why Combination Exercise Helps Improve Cholesterol

When you’re looking to improve your cholesterol numbers, combined exercise—that is, a regular routine consisting of both aerobic and resistance exercise—is what you need.

“While there are a few studies that show aerobic training alone is beneficial, when we look at all of the 150-plus studies that have been published so far as a whole, then aerobic training will only lower the ‘bad’ LDL cholesterol, but has little effect on raising the ‘good’ HDL cholesterol,” says Neil Smart, Ph.D.an exercise physiologist and co-author of a meta-analysis on exercise and blood lipids in the journal Sports Medicine.

In that research, resistance training increased HDL cholesterol but had little impact on LDL cholesterol. “This means we need both aerobic training and resistant training to get best benefits in terms of LDL and HDL,” explains Smart. Raising HDL is key in this equation. HDL takes up cholesterol particles and ferries them to the liver where they can be excreted.

Although more research needs to be done on exact mechanisms, there’s an idea of what may be going on. Aerobic training may help lower LDL by increasing energy (calorie) expenditure and lipid (fat) utilization, with higher-intensity exercise potentially providing greater benefits. Resistance training may raise HDL in part through increases in muscle mass and energy expenditure. Overall, regular exercise can improve the way your body processes and clears lipids from the blood, which may support healthier cholesterol levels.

It’s important to point out that research Pescatello co-authored and published in the Journal of Sports Science and Medicine in 2026 found no statistically significant difference in blood lipids between aerobic and resistance training. This suggests that both cardio and strength training can be used as lifestyle strategies to manage cholesterol and overall cardiometabolic health, she says. “We concluded that combined aerobic and resistance training may be the best way to go for improvements in the total lipid profile,” says Pescatello.

Her point: Both should be included in your exercise program.

How to Get Started

Generally, the more exercise you do, the more benefit you’ll get, says Smart. For aerobic activity, he advises 2.5 to 3 hours (150 to 180 minutes) per week for 8 to 12 weeks to improve cholesterol levels.

However, he says this may change depending on intensity. For example, if you walk slowly or exercise at a low intensity, then you’ll need to bump that up to four hours per week, he says. Alternatively, if you’re doing high-intensity activity, the guidelines change to at least 75 minutes per week.

Along with this, aim for at least two days of strength training activity that targets all major muscle groups.

If you have any underlying medical conditions or injuries, get clearance from your health care provider first. If you’re new to exercise, it’s best to start slow and gradually build up. Remember, any increase in physical activity can help.

Other Strategies to Lower Cholesterol

• Know Your Numbers. Get your blood lipid levels checked, including total, LDL, HDL and triglycerides. Ideally, also get a one time measure of your lipoprotein-a to assess your overall heart disease risk. This helps you and your health care provider design a care plan based on your unique needs.
• Focus on a Heart-Healthy Diet. Prioritize whole, minimally processed foods, including fruits, vegetables, whole grains, legumes, nuts, seeds, unsaturated fats and lean proteins. Keep saturated fats to a minimum and avoid foods that contain trans fats.
• Don’t Smoke, or Quit If You Do. Any reduction in smoking will help your arteries, and that also goes for exposure to secondhand smoke.
• Prioritize Sleep. Seven to nine hours per night is the goal number to support healthy cholesterol and triglyceride levels.
• Maintain a Healthy Body Weight. Staying within a healthy body weight and body composition is linked with better cholesterol levels.

Our Expert Take

Instead of picking one or the other, the best approach to lowering cholesterol is to do combined exercise. Both aerobic and strength-training exercise play important roles in managing cholesterol and overall heart health.

Aim for at least 150 minutes of moderate-to-vigorous aerobic exercise per week, along with two days of strength training. As usual, a well-rounded routine wins again.