Excessive blood cholesterol is considered an important risk factor of cardiovascular diseases. Excessive blood cholesterol has both genetic and dietary component. It is also known that cholesterol is either LDL (low density lipoprotein) HDL, also known as “good cholesterol” and “bad cholesterol”, respectively.

The non-pharmacological strategy to improve blood cholesterol is improving diet (broadly – less junk food and more salad) and exercise, which are aimed at lowering LDL without lowering HDL[1]. The most effective foods for lowering LDL are oatmeal, kidney beans, apples, pears, bananas, berries, fish, nuts, avocados, olive oil, and, good news for body builders, whey protein. On the other hand, dairy fats (cream, butter, cheese) and trans fats (crackers and cakes, especially the cheaper ones) raise the bad cholesterol [2]. Especially in overweight subjects, calorie restriction lowers increased cholesterol [3]. For high risk patients, statins are used. From the field of herbal medicine, several lines of evidence suggest that berberine works similarly well [4],[5] with the reservation that berberine research lacks the industry-supported large studies. Cocoa is a well-researched food, and while chocolate is suspicious due to huge sugar content, cocoa supplements significantly improve the metabolic profile as well [6]. Of research chemicals, cardarine has been one of the more promising substances: while the research of the substance has been abandoned by the industry, it is used for research. While the original effects revealed very specific effect of raising good cholesterol in very low doses and lowering bad cholesterol in higher doses, later research has revealed that it counteracts especially bad, endothelium-damaging form of cholesterol called oxLDL [7].

Exercise program of older men showed that after a year or half, there were no improvements in grip strength, body mass index or bad cholesterol but there were improvements in body shape, walking speed, one leg standing and good cholesterol [8]. On the other hand, in children a rather intriguing counter-intuitive association was found: fatter children had more good cholesterol [9]. In addition, higher muscle mass may lower cardiovascular risks for boys only [10]. However, the good news is that for older folks, even two strength training sessions per week helped to lower cardiovascular risks, especially in case of higher blood pressure and elevated cardiovascular inflammation marker hsCRP[11]. Research suggests that for adults, both men and women, hand grip strength (relative to body mass) and relative fat mass (fat mass index) may be the best independent predictors of cardiovascular health [12].

SARMs are double edged swords. In one hand, SARMS seem to have good safety combined with beneficial effects on muscle and bone, they have some drawbacks similar to steroids: SARMS lower good cholesterol significantly and dose-dependently according to multiple studies [13],[14],[15],[16]. The effects of androgens on blood profile are not just negative because the triglyceride levels tend to be improved. A monkey study of a novel dermally administered SARM that demonstrated increased muscle mass without lowering good cholesterol by reducing exposure of liver to that SARM, and a SARM that atypically did not lower good cholesterol have been revealed in clinical human studies, as well [Ahv],[Ahv+1].

Time will tell whether newer SARMs will have the same benefits as those that have been investigated for a longer time (i.e. ostarine) without having the drawback of lowering the good cholesterol. The research is improtant, because the effects seem really interesting for older people especially, and the proportion of older people is increasing proportionally almost worldwide.

[1] https://www.ncbi.nlm.nih.gov/pubmed/30953636
[2]https://www.mayoclinic.org/diseases-conditions/high-blood-cholesterol/in-depth/cholesterol/art-20045192
[3] https://www.ncbi.nlm.nih.gov/pubmed/31252598
[4] https://www.ncbi.nlm.nih.gov/pubmed/26520899
[5] https://www.ncbi.nlm.nih.gov/pubmed/31094214
[6] https://www.ncbi.nlm.nih.gov/pubmed/31056655
[7] https://www.ncbi.nlm.nih.gov/pubmed/27573670
[8] https://www.ncbi.nlm.nih.gov/pubmed/31111014
[9] https://www.liebertpub.com/doi/full/10.1089/chi.2019.0122
[10] https://www.ncbi.nlm.nih.gov/pubmed/30813304
[11] https://www.ncbi.nlm.nih.gov/pubmed/30774600
[12] https://www.ncbi.nlm.nih.gov/pubmed/30424569
[13] https://www.ncbi.nlm.nih.gov/pubmed/28449232
[14] https://onlinelibrary.wiley.com/doi/full/10.1007/s13539-011-0034-6
[15] https://www.ncbi.nlm.nih.gov/pubmed/22459616
[16] http://www.jbc.org/content/285/22/17054.full
[17] https://www.ncbi.nlm.nih.gov/pubmed/26683992
[18] https://www.ncbi.nlm.nih.gov/pubmed/29527831