Cholesterol and some of the health issues associated with it (like cardiovascular disease and heart attacks) might seem like something you don’t need to worry about as a runner. After all, racking up the miles helps fry fat, keep your weight in check, and keep that ticker in tip-top shape—right?
While all that’s true, and being a runner can also help you maintain normal cholesterol levels, it doesn’t mean that you’re totally in the clear. Other factors may put you at risk for your numbers creeping up to an unhealthy level, often gradually over many years, while you’re none the wiser.
Here’s what everyone should know about cholesterol, how your running routine might affect your levels, and expert tips on how to keep these numbers in the sweet spot.
What is cholesterol anyway?
You’re likely fairly aware of the grams of fat and calories in the food you eat on a regular basis, but do you pay attention to how much cholesterol you’re eating?
Cholesterol is a waxy substance that’s also found in food, like the fatty part of meat and poultry, egg yolks, and full-fat dairy—and your body produces some of it as well. Just like fat, it’s not all bad: Your body needs some cholesterol to function. It gets broken down in the liver and intestines and is important for synthesizing estrogen, testosterone, progesterone, and vitamin D, says Kelly Pritchett, Ph.D., RD, an associate professor of nutrition and exercise science at Central Washington University.
But on the other hand, cholesterol levels that are too high can contribute to the progression of atherosclerosis, a disease of the arteries that can lead to other issues with your heart, explains Matthew Tomey, MD, a cardiologist at Mount Sinai Morningside in New York City. “Whereas heart attacks and strokes are sudden events, the atherosclerosis that leads to them is a slow process that begins in our teenage years and progresses over decades. The higher your cholesterol, the faster atherosclerosis progresses and the greater your risk of these major events,” Tomey says.
What’s the difference between “good” and “bad” cholesterol?
There are healthy and unhealthy types of fat, and the same goes for cholesterol. Cholesterol is found in several particles, called lipoproteins, that transport it through the blood. Those lipoproteins are classified as HDL or LDL.
Your liver makes HDL, or high-density lipoprotein cholesterol. It can pick up unwanted cholesterol from tissues, like the heart, and carry it back to the liver, which then processes it and flushes it from your body. “Because it takes substances that can block our arteries away from the heart, HDL is protective against heart disease,” explains Pritchett.
Then there’s LDL, or low-density lipoprotein, which makes up the majority of the cholesterol in your body. It’s the bad guy, transporting cholesterol to the heart and tissues and potentially causing plaque buildup in the arteries, which ups your risk for heart disease.
What are normal cholesterol levels?
Runners love spouting off their stats—and your LDL and HDL levels should be a number you remember right along with your latest PR. Checking for cholesterol is fairly simple and requires just a blood draw, but most people don’t know their levels.
Many people have never had them checked at all, even though the CDC recommends people over 20 to get it done every five years (even more often depending on your family history and other risk factors). On a basic level, you’ll ideally have less than 100 mg/dl of LDL, more than 40 mg/dl of HDL, and less than 200 mg/dl of total cholesterol in your body. The CDC also mentions normal levels of triglycerides (a type of fat in blood) should be lower than 150mg/dl.
There’s no one specific cutoff that puts you into the danger zone of “high” cholesterol, says Pritchett—there are several ranges from above optimal to borderline high to very high—so you should fully discuss your findings with your doctor. And if they determine that your levels are too elevated, it’s important to work to bring them down, considering the negative effects it can have on your heart health.
How can you lower cholesterol?
The good news: As a runner, you’re already doing something that’s generally great for your cardiovascular health and specifically proven to help with your cholesterol too. Several studies have shown that regular aerobic exercise in just a few months can not only lower your LDL significantly, but also bump up your HDL. To reap the benefits, aim for about 40 minutes of aerobic activity three to four times a week.
Of course, you can’t outrun a bad diet. “While exercise helps improve your HDL cholesterol, which we want because it’s protective, diet’s an equally important part of the equation,” says Pritchett. As a general rule, she recommends a diet low in saturated and trans fat, and refined sugars, and high in omega-3 fatty acids, nuts, whole grains, fruits, and vegetables to help lower your LDL cholesterol.
But keep in mind, “there’s no single best diet for everyone, and diet isn’t the only factor,” says Tomey. Genetics also play a key role. “For some individuals with genetic risk, cholesterol levels can remain dangerously high in spite of a ‘perfect’ diet.”
There are lots of other factors that can up your risk, too, like if you smoke or drink too much alcohol, have lupus or diabetes, or have taken certain meds for other conditions such as acne.
Eating well and staying active are the first steps to keeping your cholesterol in check, says Tomey. “But if your levels remain high despite your best efforts, medications are highly effective in lowering cholesterol levels and reducing risk of heart attack and stroke.”
Your best bet: Talk with your doctor about the ideal eating and exercise plan for you, plus the potential of meds or any other steps you should take to keep your normal cholesterol levels right where they should be.
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