Cardio vs. Strength Training: How Each Impacts Cholesterol Differently

When it comes to improving cholesterol levels, both cardio and strength training offer benefits, but they work in different ways, according to recent research and clinical guidance. While aerobic exercise has long been promoted as the go-to for heart health, emerging evidence suggests that resistance training may play a more significant role in certain lipid improvements than previously recognized.

A 2023 meta-analysis published in the British Journal of Sports Medicine reviewed 35 randomized controlled trials involving over 2,000 adults and found that while both aerobic and resistance exercise reduced LDL cholesterol — often called “bad” cholesterol — resistance training showed a slightly greater effect on lowering triglycerides and increasing HDL cholesterol, the “good” form that helps remove LDL from the bloodstream.

Dr. Erin Michos, associate director of preventive cardiology at the Johns Hopkins Ciccarone Center for the Prevention of Heart Disease, explained that strength training influences cholesterol metabolism through mechanisms distinct from endurance activities. “Lifting weights increases muscle mass, which enhances insulin sensitivity and improves how the body processes fats,” she said. “This can lead to better lipid profiles over time, especially in people with metabolic syndrome or prediabetes.”

In contrast, aerobic exercise such as brisk walking, running, or cycling primarily improves cardiovascular endurance and tends to lower LDL cholesterol more consistently through increased calorie expenditure and enhanced liver clearance of lipids. The American Heart Association notes that moderate-intensity aerobic activity for at least 150 minutes per week can reduce LDL by 5 to 10 percent in sedentary individuals.

However, the most effective approach may combine both modalities. A 2022 study in JAMA Network Open followed overweight adults with elevated cholesterol for 12 weeks and found that those who combined resistance training three times per week with moderate aerobic exercise twice weekly achieved the greatest improvements in total cholesterol, LDL, and HDL levels — outperforming groups that did only one type of exercise.

Experts emphasize that consistency matters more than intensity for long-term cholesterol management. “You don’t need to lift heavy weights or run marathons,” said Dr. Michos. “Even bodyweight exercises like squats, push-ups, and resistance bands, done regularly, can make a meaningful difference when paired with activities that elevate your heart rate.”

Diet remains a foundational factor. No exercise regimen can fully offset the effects of a diet high in saturated fats, trans fats, and refined carbohydrates. The most significant improvements in cholesterol occur when physical activity is combined with dietary changes such as increasing fiber intake, choosing unsaturated fats, and limiting processed foods.

For individuals unable to engage in high-impact cardio due to joint issues or mobility limitations, strength training offers a viable alternative for improving metabolic health. Similarly, those who find resistance training intimidating can begin with low-impact aerobic activities like swimming or cycling and gradually incorporate strength elements.

Before starting any new exercise program, especially for those with existing heart conditions, high blood pressure, or uncontrolled cholesterol, consulting a healthcare provider is recommended. A clinician can help tailor a safe and effective plan based on individual risk factors and fitness levels.

the best exercise for lowering cholesterol is the one that can be sustained over time. Rather than choosing between weights and cardio, integrating both into a routine offers the most comprehensive benefits for lipid profiles, cardiovascular fitness, and long-term heart health.