Quick Facts

• Combined cardio and weight training reduces cholesterol more effectively than cardio alone, according to a 2024 meta-analysis of 148 studies
• Resistance training alone only improves HDL cholesterol, while cardio improves all cholesterol markers
• 30-60 minutes of weight training per week provides maximum cardiovascular benefits when added to regular cardio

The fitness world’s biggest cholesterol myth just got busted. Cardio alone is not the best way to lower cholesterol.

A massive 2024 meta-analysis published in Sports Medicine examined 148 randomized controlled trials involving 8,673 participants. The researchers found that combining aerobic exercise with resistance training produces superior cholesterol improvements compared to cardio-only programs.

The numbers tell the story. Exercise training decreased total cholesterol by 5.90 mg/dL, increased HDL cholesterol by 2.11 mg/dL, decreased LDL cholesterol by 7.22 mg/dL, and reduced triglycerides by 8.01 mg/dL across all study participants.

Cardio Still Rules for Overall Heart Health

Dr. Melissa Tracy, cardiologist and medical director of cardiac rehabilitation at Rush University Medical Center, explains the science. “Exercise absolutely lowers cholesterol, as it makes us a more effective machine,” she said.

Cardio dominated the cholesterol-lowering game. Aerobic training significantly reduced total cholesterol, LDL, triglycerides, and VLDL while raising HDL. Resistance training only significantly improved HDL cholesterol.

A landmark 2024 Iowa State University study published in the European Heart Journal tracked 406 adults. The research found that cardiovascular disease risk improved in cardio-alone and combined training groups. The strength-training-only group saw no cardiovascular risk reduction.

The Resistance Training Revolution

Doctors are changing their tune about weight training. Dr. Patrick McBride from the University of Wisconsin admits the medical community was wrong. “Doctors used to believe it was only aerobic, endurance exercise that improved levels, but it turned out that we were wrong,” he said.

The 2023 American Heart Association scientific statement confirms resistance training produces “a favorable, although modest, effect on total cholesterol, triglycerides, and high-density lipoprotein cholesterol.”

The sweet spot for resistance training is 30-60 minutes per week. Clinical trials show two sessions per week provide enough stimulus for cholesterol benefits.

How Much Exercise You Need

The cardio prescription remains clear. At least 150 minutes of aerobic exercise per week reduces total cholesterol, LDL cholesterol and triglycerides while increasing HDL cholesterol.

Intensity matters less than consistency. High-intensity exercise proves no more effective than moderate-intensity exercise for lowering cholesterol. Every additional weekly aerobic session reduced total cholesterol by 7.68 mg/dL in the meta-analysis.

A 2024 British Heart Foundation study explains why exercise works. The more active you are, the more saturated fat your muscles use for energy. Less circulating saturated fat means lower cholesterol levels.

The New Exercise Prescription

The research suggests resistance exercise should be “considered as an addition to aerobic exercise, rather than a substitute” for cardiovascular risk management.

Dr. Leslie Cho, a cardiologist at Cleveland Clinic, calls exercise “a great place to start if you’re trying to lower bad cholesterol.” The latest evidence shows that place should include both the treadmill and the weight room.

Read more: Is Cardio Really Best for Lowering Cholesterol? Doctors Say Not So Fast.