This article presents a meta-analysis that showed the effective duration of aerobic exercise to increase HDL or “good cholesterol.”
High-density lipoprotein (HDL) is often called good cholesterol. That’s because it causes cholesterol efflux.
Cholesterol efflux is when the oxidized LDL or “bad cholesterol” deposits in atherosclerosis are removed from the blood vessels and brought to the liver for metabolism.
Higher HDL levels are considered protective against cardiovascular diseases, which include coronary artery disease, strokes, hypertension, aortic dissections, and aortic aneurysms.
One way to increase HDL is to do aerobic exercises. But what is the minimum? Are ten minutes okay? Or do I have to run for one hour every day?
Aerobic Exercise
Let’s define what is aerobic exercise. Aerobic exercise is a physical activity that makes you use more oxygen, hence the word aerobic. Examples are walking, swimming, and running a long distance.
In contrast, anaerobic exercise is more strenuous, depletes oxygen supply, and makes the body switch to another lactic acid to produce ATP. You see this in weight-lifting sprints and high-intensity interval training.
Heart rate is one way to know if you are doing aerobic exercise. Working at 70% to 85% of your maximum heart rate puts you in the aerobic zone.
The American Heart Association chart below shows the target heart rate based on age if you want to do aerobic training.
Another way is to use this target heart rate calculator from active.com, where you can plug in your age.
Measuring the heart rate can be done in several ways. You can feel the radial nerve on your wrist, count the beats for 15 seconds and multiply by four.
The Zacurate Pro Series 500DL Fingertip Pulse Oximeter is a faster and more convenient way to know your heart rate.
If you want to know your heart rate in real time, the Polar H10 can do it. It is waterproof and connects to the blue tooth of your phone. It will also tell you the calories you spent and the time you exercised. That is what I use.
An inexpensive way is to use the Borg Rating of Perceived Exertion Scale. The CDC explains,
For example, a walker who wants to engage in moderate-intensity activity would aim for a Borg Scale level of “somewhat hard” (12-14).
If he describes his muscle fatigue and breathing as “very light” (9 on the Borg Scale), he would want to increase his intensity.
On the other hand, if he felt his exertion was “extremely hard” (19 on the Borg Scale), he would need to slow down his movements to achieve the moderate-intensity range.
The Meta-Analysis
With that long intro, let’s go to the article’s meat.
The study was made by the Department of Lifestyle Medicine and Nutritional Sciences at Ochamizu University in Japan.
The meta-analysis included 25 studies with a total of 1,404 subjects. The mean age range is 23-75 years. The average exercise intervention was 27.4 weeks, and the average aerobic exercise intensity was 64.8% of the maximal aerobic capacity.
They found,
Minimal weekly exercise volume for increasing HDL-C level was estimated to be 900 kcal of energy expenditure per week or 120 minutes of exercise per week.
The effect of aerobic training resulted in a 2.53-mg/dL (0.065-mmol/L) elevation of net HDL-C change.
The significance of a 2.53 increase in HDL could translate to a decrease in cardiovascular risk by about 5.1% in men and 7.6% in women.
Another finding is that every 10-minute prolongation of exercise per session was associated with an approximately 1.4-mg/dL (0.036-mmol/L) increase in HDL-C level.
So if you know your HDL values based on your lipid profile, which is below the recommended, you can estimate how much aerobic exercise you need to achieve your target.
HDL targets from Medline Plus
| Group | Healthy HDL Level |
|---|---|
| Age 19 or younger | More than 45mg/dl |
| Men aged 20 or older | More than 40mg/dl |
| Women aged 20 or older | More than 50mg/dl |
The other finding is that the HDL increase is independent of the frequency and intensity of the exercise.
As long as 120 minutes per week is achieved, it does not matter if the exercise is done in any frequency, whether it is twice a week, at 60 minutes each, or three times a week at 40 minutes each period.
In a previous post, Walk After Meals to Prevent Sky High Blood Sugars, I presented a study showing that a 15-20 minute walk after a meal can help lower the after-meal blood sugar increase or post-prandial hyperglycemia (PPH).
PPH indicates prediabetes and puts a person at risk for cardiovascular disease.
Brisk walking 20 minutes after the heaviest meal once a day for 20 minutes daily can add up to 140 minutes at the end of the week. Two goals are achieved simultaneously: lower blood sugar and higher HDL.
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Reference:
Kodama S, Tanaka S, Saito K, Shu M, Sone Y, Onitake F, Suzuki E, Shimano H, Yamamoto S, Kondo K, Ohashi Y, Yamada N, Sone H. Effect of aerobic exercise training on serum levels of high-density lipoprotein cholesterol: a meta-analysis. Arch Intern Med. 2007 May 28;167(10):999-1008. doi: 10.1001/archinte.167.10.999. PMID: 17533202.
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