I as able to diet my way out, for now. Went from 190lb LDL=182 HDL=48 to 140lb LDL=90 HDL=75 in 1 year by going vegan +fish -fried (avoid hydrogenated and saturated oil) and try to limit sugar. Eggs did little the next year (LDL=92) but the last year I started eating "vegan meat" and was back to 160lb and LDL=116 HDL=60s. I am going to try staying around 150lb and cut out the "vegan meat" to see if that makes a difference.

My strength training exercise has stayed about the same but my ~20 miles a week 11min mile "running" basically stopped the first year so didn't make a huge difference, still walk around 10 miles a week though. I really need to get back to running though, made me feel much better.

My grandfather did a self triple bypass (as in his heart grew 3 bypasses naturally), was very active walker, ate mostly well when I knew him, and was not overweight. Over a couple years his mind had basically regressed to a kid (believing he was 5yo kid, asking for people that dies 50+ years ago, didn't recognize his wife who died 20 years earlier) when he died at the age of 92 years old. I am told I look and act a lot like him and my other parent has no cholesterol issues (but has diabetes) so I am guessing sooner or later I will need to give up grapefruit and pomegranate to get on statins (and hope I don't have some of the horrible side effects) then possibly go out the same way he did. If this is true though and I watch my cholesterol maybe I can increase my compression of mortality.

NOTE: I am not saying just diet going to be true for everyone, some can watch diet and exercise and still have dangerously high levels while others eat horrible stuff and still fine (well at least cholesterol). You asked the question so I was just giving one data point where diet helped me, for now.