Myths vs facts: HDL and Sport

Myth: 'More exercise always raises HDL significantly, and high HDL fully protects against heart disease.' Fact: Endurance exercise can modestly increase HDL cholesterol (about 2–5 mg/dL), but the effect varies by genetics, diet, and training type. Resistance training shows smaller changes. Moreover, HDL's protective role is more nuanced: HDL function (e.g., cholesterol efflux capacity) matters more than HDL level alone. Some individuals with genetically high HDL do not have lower cardiovascular risk. Exercise improves many other risk factors (blood pressure, insulin sensitivity, inflammation) that collectively outweigh HDL changes. Evidence: human-strong for exercise-induced HDL increase, but human-moderate to mixed for HDL's causal protection. Caveat: Never interpret HDL in isolation.