Fit And Healthy, But Still At Risk? Dean’s Story Says It’s Possible

You can eat clean, exercise daily, and still face high cholesterol. It’s like maintaining your car, only to have the check engine light come on anyway.

Cholesterol is often seen as something we can control with diet and exercise, but that’s only part of the picture. For Dean Mastrojohn, who lost weight and worked out regularly, his cholesterol numbers still didn’t improve — they got worse.

The culprit? Genetics — something diet and exercise can’t fix.

His story shows that high cholesterol isn’t just about lifestyle; it’s a complex condition influenced by multiple factors, and for some, clean living isn’t enough.

He Was Fit But Still Had High Cholesterol

High cholesterol is often linked to poor diet, lack of exercise, or excess weight. But for Dean, a communications consultant from Maywood, New Jersey, the cause was genetic.

With a family history of high cholesterol, Mastrojohn’s doctor recommended early intervention.

“My doctor — the same one my parents see — kept a close watch on my numbers and strongly recommended I lose some weight and exercise regularly to avoid going on medication,” he says.

Mastrojohn followed the advice: he lost nearly 20 pounds, worked out regularly, and felt in peak physical shape. But when his lab results came back, his LDL cholesterol and triglycerides had increased.

“That’s when my doctor explained this wasn’t just about lifestyle — it was genetic,” says Mastrojohn. “He strongly recommended I begin taking a statin. It was a shock.”

What Actually Drives High Cholesterol?

High cholesterol isn't solely caused by poor diet or lack of exercise. It's a complex condition influenced by various factors, including genetics.

Cholesterol is a waxy, fat-like substance produced by your liver and essential for building cells. However, when levels become elevated, excess cholesterol can form fatty deposits in blood vessels, narrowing arteries and increasing the risk of heart disease and stroke.

Several factors contribute to high cholesterol:

• Diet

Consuming foods high in saturated and trans fats can raise cholesterol levels.

• Physical Activity

Lack of exercise can lead to weight gain, which may increase cholesterol levels.

• Medical Conditions

Conditions like diabetes and hypothyroidism can contribute to high cholesterol.

• Genetics

A family history of high cholesterol can increase your risk, as genetic factors can affect how your body processes cholesterol.

The CDC recommends keeping total cholesterol below 200 mg/dL. However, total cholesterol alone doesn't provide a complete picture. It's important to understand the breakdown:

• LDL (Low-Density Lipoprotein)

Often referred to as "bad" cholesterol, high levels can lead to plaque buildup in arteries.

• HDL (High-Density Lipoprotein)

Known as "good" cholesterol, it helps remove other forms of cholesterol from the bloodstream.

• Triglycerides

Elevated levels can also increase the risk of heart disease.

Managing high cholesterol typically involves a combination of lifestyle changes and, when necessary, medication. It's crucial to work with your healthcare provider to develop a personalized plan.

How High Cholesterol Is Treated

High cholesterol treatment isn’t the same for everyone. It depends on a range of personal factors — not just lab results.

“I see high cholesterol every day, and each case is different,” says Dr. Robert Greenfield, cardiologist and cofounder of California Heart Associates.

“You have to look at the person, not just the lab values.”

A treatment plan typically considers your age, cholesterol levels, lifestyle, and medical history — including whether you smoke, drink, or have conditions like diabetes, high blood pressure, or past heart issues.

Diet and exercise play a key role. A heart-healthy diet — low in saturated fat and refined carbs, and rich in fiber, fruits, vegetables, and healthy fats — can help lower LDL cholesterol. Regular physical activity, such as brisk walking, also supports healthy cholesterol and improves circulation.

But lifestyle changes may not be enough — especially for people with a genetic predisposition or multiple risk factors.

“If someone is considered high risk, based on their medical history or additional conditions like diabetes, we don’t wait,” says Dr. Greenfield.

The goal isn’t just to lower cholesterol — it’s to reduce overall cardiovascular risk and prevent heart attack or stroke.

How Walking Supports Heart Health

Ten years after starting statins, Dean Mastrojohn still keeps his cholesterol in check — not just with medication, but with consistent, heart-healthy habits.

“I’m usually out there for 1.5 hours during each walk, through rain, sun, snow, sleet, and hail. It’s hard to say exactly how much of my progress is from walking versus the medication, but I have more energy now, and it’s definitely not hurting my numbers — probably only helping.” Dean says.

Along with strength training and gym workouts, he walks five miles a day, at least four days a week. That routine has boosted both his physical health and mental clarity.

Walking and other aerobic exercise can raise HDL (good) cholesterol, lower triglycerides, and help reduce LDL (bad) cholesterol — especially when combined with weight loss and a healthy diet. The American Heart Association recommends at least 150 minutes of moderate-intensity aerobic activity each week, and walking is an easy, accessible way to hit that goal.

“Walking is a great exercise because it’s aerobic, easy to do, and accessible. You don’t need a gym,” says Dr. Nieca Goldberg, medical director at Atria New York.

She adds that running, swimming, or dancing can offer similar benefits. Cholesterol-lowering medications are effective, but lifestyle still matters.

“Modern medications can normalize cholesterol numbers on their own,” says Dr. Robert Greenfield.

But a healthy lifestyle — including diet, exercise, sleep, and stress management — should always be part of the plan. The benefits go far beyond cholesterol.

For Dean, the combination works. Medication brought his numbers down. But daily movement — especially walking — helped restore his energy, focus, and sense of control over his health.

Cholesterol Control Is a Long Game

For Dean, keeping his cholesterol in check isn’t something he thinks about once in a while — it’s part of his everyday routine. He takes his medication as prescribed and checks in with his doctor every six months to track his numbers. It’s not always fun, but he knows it’s worth it.

The tricky thing about high cholesterol is that it doesn’t usually come with symptoms. You can feel fine and still be at risk for serious problems like a heart attack or stroke. That’s why regular testing matters, especially if heart issues run in your family.

Dean does what he can — from staying active to eating well — but he also understands that lifestyle alone isn’t always enough. Genetics play a big part in his case, and medication helps fill in the gaps.

At the end of the day, it’s not just about his own health. Dean wants to be around for the people he loves, and that means staying on top of the things he can control.

Simple Ways to Take Charge of Your Cholesterol:

• Get screened regularly

A simple blood test can reveal your numbers before problems develop.

• Don’t dismiss medication

Lifestyle changes are important, but in many cases, they need to be paired with treatment to reduce long-term risk.

• Stay active

Simple daily movements like walking, biking, or gardening support heart health and cholesterol balance.

• Focus on food quality, not just calories

Limit saturated fats and processed foods, and choose whole, plant-based options when possible.

Cholesterol management isn’t about perfection. It’s about consistency, awareness, and working with your body, not against it, for the long haul.