My ldl is high328, hdl normal. im confused some drs say its genetic, some say eat less fat/animal protein/carbs. what do i do? will exercise help?

Cholesterol: You need treatment. Diet and exercise will not in any way change your LDL profile or risk. Good health habits will help your life and your heart, but they will not change this part of the Cholesterol panel much if at all. LDL of 328 represents significant risk and is most likely related to genetics.

You need medication.: An LDL that high is clearly genetic and you clearly need medication to lower it. At best, an optimal diet and exercise regimen would be expected to lower that number about 25%, which would not be nearly enough (246).