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Evidence Summary
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Aerobic exercise can increase levels of HDL “good” cholesterol in middle-aged and older adults
Liang L, Peng F, Wang L, et al. Effects of exercise on high-density lipoprotein levels in middle-aged and older individuals: A systematic review and meta-analysis Medicine. 2025; 104: e41493.
Review question
What is the effect of exercise on high-density lipoprotein (HDL) cholesterol in middle-aged and older adults compared to no exercise?
Background
The buildup of plaque in the arteries leads to cardiovascular diseases, a main cause of death globally. An excess of low-density lipoprotein (LDL) cholesterol contributes to plaque build up, while high-density lipoprotein (HDL) cholesterol contributes to the process that removes plaque from the body. Past research has investigated the effects of exercise on increasing HDL cholesterol. However, results have been mixed, as well as limited in middle-aged and older adults.
How the review was done
This is a systematic review and meta-analysis of 42 studies. These studies were published between 2003 and 2023 and included a total of 2633 participants.
Key features of the studies:
- Participants were middle-aged and older adults.
- Participants engaged in exercise programs consisting of one or more of the following exercise types: aerobic (e.g., brisk walking, jogging), resistance (e.g., training with elastic bands), and stretching (e.g., Pilates, tai chi).
- Exercise programs lasted 6 weeks to one year.
- Researchers measured changes in HDL cholesterol.
- Participants engaging in exercise were compared to control groups who did not engage in exercise.
What the researchers found
Moderate certainty evidence shows that compared to no exercise, exercise can increase HDL cholesterol. However, the exercise type can matter. For instance, aerobic exercise appears effective for this outcome, while resistance and stretching exercises do not.
Conclusion
In middle-aged and older adults, compared to no exercise, aerobic exercise can increase levels of HDL cholesterol.
Glossary
Cholesterol
A fat-like substance with a soft, waxy texture.
Control group
A group that receives either no treatment or a standard treatment.
Meta-analysis
Advanced statistical methods contrasting and combining results from different studies.
Systematic review
A comprehensive evaluation of the available research evidence on a particular topic.
Vascular
The body's network of blood vessels. It includes the arteries, veins, and capillaries that carry blood to and from the heart.
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JBI Database of Systematic Reviews and Implementation Reports (2016)
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JAMA: Journal of the American Medical Association (2017)
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International Journal of Environmental Research and Public Health (2017)
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DISCLAIMER These summaries are provided for informational purposes only. They are not a substitute for advice from your own health care professional. The summaries may be reproduced for not-for-profit educational purposes only. Any other uses must be approved by the McMaster Optimal Aging Portal
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info@mcmasteroptimalaging.org).