A new review of research shows that elite athletes—even Olympic competitors—can have unhealthy cholesterol levels despite their intense training. Scientists discovered that cholesterol problems are common in athletes but often go unnoticed because people assume fit people are automatically healthy. The type of sport matters: endurance athletes like runners tend to have better cholesterol, while power athletes like weightlifters may have worse levels. Researchers are calling for new tools to check athletes’ heart health and better ways to help them manage cholesterol without interfering with their athletic performance.
The Quick Take
- What they studied: Whether elite athletes have healthy cholesterol levels and what factors affect their cholesterol, even when they exercise a lot
- Who participated: This was a review of existing research about Olympic athletes, Paralympic athletes, and other elite competitors across different sports
- Key finding: Many elite athletes have unhealthy cholesterol levels that doctors miss, and the problem varies based on the type of sport they play, their gender, and their ethnicity
- What it means for you: If you’re an athlete or know one, don’t assume that being fit means having healthy cholesterol—regular cholesterol checks are still important. Talk to a doctor about your specific risk, especially if you play power or skill sports rather than endurance sports.
The Research Details
This is a comprehensive review, meaning researchers looked at many existing studies about cholesterol in elite athletes and summarized what they found. Instead of doing their own experiment, they gathered information from previous research to see patterns and trends. They examined how different factors—like the type of sport, whether someone is male or female, their ethnic background, and whether they have disabilities—affect cholesterol levels in athletes. The researchers also looked at current methods doctors use to assess heart disease risk in athletes and discussed whether those methods work well for this special population.
Reviews like this are important because they help doctors and coaches understand a problem that’s been overlooked. By combining information from many studies, researchers can see the bigger picture and identify gaps in what we know. This helps create better tools and strategies specifically designed for athletes, rather than using the same approach for everyone.
This review was published in a well-respected medical journal focused on heart disease prevention. The authors examined the current scientific evidence carefully and highlighted where more research is needed. However, because this is a review rather than a new study, the strength of the findings depends on the quality of the studies they reviewed. The lack of a specific sample size is normal for this type of research.
What the Results Show
The main discovery is that cholesterol problems are surprisingly common in elite athletes, even though people often think athletes are automatically healthy. The research shows that different types of sports affect cholesterol differently. Endurance athletes—people who do activities like running, cycling, or swimming for long distances—tend to have the healthiest cholesterol levels. In contrast, power athletes (like weightlifters and sprinters) and skill athletes (like gymnasts) are more likely to have unhealthy cholesterol levels. This suggests that the type of training matters just as much as how much someone exercises. The review also found that gender, ethnicity, and whether an athlete has a disability all play roles in cholesterol levels, meaning there’s no one-size-fits-all approach to managing heart health in athletes.
The researchers found that current tools doctors use to predict heart disease risk don’t work well for athletes. These tools were designed for regular people and don’t account for athletes’ unique situations. The review proposes a new tool called the ‘Lipid Athlete Score’ that would better identify which athletes are at higher risk for heart problems. The research also shows that some athletes take medications to lower cholesterol, but doctors need to be careful because these medications might affect athletic performance. Additionally, the review discusses newer treatments and supplements that might help athletes manage cholesterol without interfering with their training.
This review builds on earlier research that noticed cholesterol problems in athletes but didn’t fully explain why or how common the problem really is. Previous studies looked at specific sports or groups of athletes, but this comprehensive review brings all that information together. It confirms what some researchers suspected: that being an elite athlete doesn’t automatically protect you from cholesterol problems. The review also goes further by proposing new solutions, like the Lipid Athlete Score, which is a step forward in athlete-specific care.
Because this is a review of other studies rather than new research, the findings are only as good as the studies reviewed. Some sports and populations (like Paralympic athletes) may not have been studied as much as others. The review also notes that doctors don’t always measure cholesterol in athletes the same way, which makes it hard to compare results across different studies. Additionally, most research has focused on certain types of athletes, so we may not know as much about cholesterol in less common sports.
The Bottom Line
Athletes should have their cholesterol checked regularly, just like everyone else, even if they feel healthy and fit (moderate confidence). If cholesterol is high, the first step should be improving diet and exercise habits before considering medications (high confidence). If medications are needed, athletes should work with doctors who understand both heart health and athletic performance to find the right treatment (moderate confidence). Athletes should be aware that their sport type may affect their cholesterol risk differently than other athletes.
Elite athletes and competitive sports participants should definitely pay attention to this research. Coaches and athletic trainers should encourage cholesterol screening. Doctors who work with athletes should use athlete-specific tools rather than standard risk calculators. Parents of young athletes may also want to discuss cholesterol screening with their child’s doctor. This research is less directly relevant to casual exercisers, though the general message about not assuming fitness equals perfect health applies to everyone.
Changes in cholesterol from diet and lifestyle improvements typically take 4-12 weeks to show up in blood tests. If medications are needed, they usually start working within 2-4 weeks. However, the real benefit—reducing heart disease risk—takes months to years to measure. Athletes should expect ongoing monitoring rather than a quick fix.
Want to Apply This Research?
- Log cholesterol test results every 6-12 months and track the specific numbers: total cholesterol, LDL (‘bad’ cholesterol), HDL (‘good’ cholesterol), and triglycerides. Note your sport type and training intensity to see if patterns emerge.
- Set reminders to schedule annual cholesterol checks. If cholesterol is high, use the app to track dietary changes (like reducing saturated fats) and monitor how training intensity affects your numbers over time. Log any medications or supplements you’re taking.
- Create a long-term tracking dashboard that shows your cholesterol trends over years, not just months. Compare your numbers to athlete-specific ranges (once available) rather than general population ranges. Track correlations between training phases, diet changes, and cholesterol levels to identify what works best for your body.
This review summarizes research about cholesterol in elite athletes but is not medical advice. If you are an athlete concerned about your cholesterol or heart health, consult with your doctor or a sports medicine specialist who can evaluate your individual situation, review your personal and family health history, and recommend appropriate testing and treatment. Do not start, stop, or change any medications without medical supervision. The findings in this review apply primarily to elite and competitive athletes; talk to your healthcare provider about whether these recommendations apply to your specific circumstances.