Cholesterol for lifters: LDL, HDL and what moves them

What each number on a cholesterol test means, how much training and diet really move them, and when to get checked.

Being fit and strong does not guarantee healthy cholesterol. High cholesterol does not usually cause symptoms, and the only way to know is a blood test ^[1]. This guide explains the numbers on a lipid test, what training and food can realistically change, and how often to check.

The numbers on a lipid test

A full lipid profile measures total cholesterol, HDL cholesterol and triglycerides, and from these the lab calculates non-HDL and LDL cholesterol ^[3]. In the UK you usually do not need to fast for it ^{[2, 3]}.

• LDL cholesterol. Often called "bad" cholesterol. High levels can lead to heart disease and stroke ^[10].
• HDL cholesterol. Often called "good" cholesterol. Higher HDL is linked with a lower risk of heart disease and stroke ^[2].
• Non-HDL cholesterol. Total cholesterol minus HDL, and the NHS also calls it "bad" cholesterol ^[2]. NICE uses it to judge how well cholesterol-lowering treatment is working in people without heart disease ^[3].
• Triglycerides. A type of blood fat. High levels can contribute to cholesterol build-up ^[10], and they are often driven by alcohol, sugar and excess weight ^[5].

The NHS gives these general healthy levels for adults ^[2]:

These are general markers, not targets for everyone. Your doctor looks at your overall risk, including your age, other health conditions and your risk of heart disease ^[2]. US labs report in mg/dL rather than mmol/L, so check the units before comparing with UK figures.

What exercise does

Training helps, but the effect is modest. A 2025 meta-analysis of 148 randomised trials (8,673 people) found exercise lowered LDL by about 7 mg/dL, lowered triglycerides by about 8 mg/dL and raised HDL by about 2 mg/dL on average ^[6]. Aerobic, resistance and combined training all improved lipids, with combined training looking best overall. Improvements were roughly 3.5 to 11.7% across the different measures ^[6].

So lifting is good for your lipids, and adding some cardio is likely better. NHS advice is at least 150 minutes of moderate-intensity exercise a week ^[4], and NICE recommends both aerobic and muscle-strengthening activity for people at higher risk ^[3]. See cardio and lifting.

What diet does

Food usually moves cholesterol more than training does.

• Saturated fat. NICE advises keeping total fat to 30% or less of energy and saturated fat to 7% or less for people at higher risk ^[3]. In practice: eat less fatty meat, sausages, pies, butter, lard and ghee, and more oily fish, nuts and seeds ^[4]. A high-calorie bulk built on fatty meat and butter can push LDL up.
• Triglycerides. Alcohol is a common cause of high triglycerides. Sugar, refined carbohydrates and excess weight also raise them, and even modest weight loss of 5 to 10% can lower them a lot ^[5].
• Alcohol. The NHS advises not regularly drinking more than 14 units a week, with several drink-free days ^[4].
• Smoking. Stopping helps cholesterol and lowers heart risk in many other ways ^[4].

If you have a history of disordered eating, work with a professional on diet changes rather than tracking numbers closely.

Medicines that can lower HDL

Some medicines change your lipid profile. The prescribing information for nandrolone states that anabolic steroids have been reported to raise LDL and lower HDL, that these changes are linked with a higher risk of atherosclerosis, and that lipids should be checked periodically ^[7]. Testosterone product labels also say the lipid profile can change and should be monitored periodically, especially after starting treatment ^[8].

If you are prescribed testosterone or have been given nandrolone, ask your doctor how often to check your lipids and what to do if they change. Do not change any medicine without talking to them.

How often to test

• UK. Adults aged 40 to 74 who have not already been diagnosed with conditions such as heart disease or diabetes are invited for an NHS Health Check every five years, which includes cholesterol and blood pressure ^[9].
• Sooner or more often if your doctor advises it: for example a family history of early heart disease or inherited high cholesterol (familial hypercholesterolaemia), which can affect young people ^[1], or a medicine whose label recommends lipid monitoring ^{[7, 8]}.
• After a change. If you make a big change to diet or training, a repeat test after a few months shows whether it worked. Your GP can advise on timing.

When to see a doctor

See your GP if you have not had a cholesterol test and have risk factors, if a result is outside the healthy levels above, or if close relatives had heart disease or stroke young. Chest pain, especially during exertion, needs urgent medical help, not a blood test.

Tracking it in ETS

ETS lets you log blood test results and chart each marker over time, with alert ranges so a drifting LDL or falling HDL stands out. Weigh-ins with a trend line and your Body tab calorie and macro targets show how a bulk or cut lines up with your results. Logged medications sit alongside, which makes a GP appointment easier.

Sources

1. NHS. High cholesterol. NHS website. NHS: high cholesterol
2. NHS. High cholesterol: cholesterol levels. NHS website. NHS: cholesterol levels
3. National Institute for Health and Care Excellence. Cardiovascular disease: risk assessment and reduction, including lipid modification (NG238). NICE, 2023. NICE NG238
4. NHS. High cholesterol: how to lower your cholesterol. NHS website. NHS: how to lower your cholesterol
5. Cambridge University Hospitals NHS Foundation Trust. Dietary advice for management of high triglycerides. CUH. CUH patient information
6. Smart NA, Downes D, van der Touw T, et al. The effect of exercise training on blood lipids: a systematic review and meta-analysis. Sports Medicine, 2025. PubMed
7. Watson Laboratories. Nandrolone decanoate injection: prescribing information. DailyMed, US National Library of Medicine, 2007. DailyMed
8. US Food and Drug Administration. AndroGel 1% (testosterone gel) prescribing information. FDA, 2025. FDA label (PDF)
9. Public Health England. NHS Health Check: aged 40 to 74? (patient leaflet). PHE, 2015. NHS Health Check leaflet
10. American Heart Association. What is cholesterol? (patient information sheet). AHA. AHA: what is cholesterol (PDF)

More on health for lifters

Last reviewed 7 October 2026. General information, not medical advice. Found a mistake? Email [email protected].