HDL: The ‘Good’ Cholesterol

There are two main types of cholesterol, LDL and HDL.

LDL: The ‘Lousy’ Cholesterol

Low-density lipoprotein (LDL) is considered to be bad because higher levels are strongly associated with cardiovascular disease.

LDL takes fat from the liver and deposits it on the wall of vessels in fatty streaks, or plaques. Plaques that contain high amounts of fat are considered unstable since they predispose us to blood clots (thrombosis) that cause heart attacks and strokes.

To remember its harmful role, think of LDL as the “lousy” cholesterol.

HDL: The ‘Good’ Cholesterol

High-density lipoprotein (HDL) is thought to be good because it protects us against cardiovascular disease. Experts consider a very high level of HDL good. HDL works somewhat like a garbage collector, traveling to vessel walls and removing fat from the plaques. HDL carries the unwanted fat back to the liver to be destroyed by enzymes.

To remember its helpful function, think of HDL as the “healthy” cholesterol.

What Causes Low HDL

Your level of HDL is determined primarily by the genes you inherit from your family. Most people with HDL levels above 60 are simply fortunate to have picked the “right” parents. Women naturally have higher levels of HDL than men.

HDL levels of 40 or below are considered unhealthy.

The most common cause of low HDL is obesity. Fat deposited in the middle of the body (the socalled “apple” shape) is linked to both low HDL levels and elevated levels of another kind of fat, the triglycerides.

Most women with a waist size above 35 inches and men with waists above 40 inches have both high triglycerides and a low HDL. This pattern is called dyslipidemia and is an important component of the metabolic syndrome. Over 80 percent of people with type 2 diabetes have this condition. People with dyslipidemia have an increased risk of cardiovascular disease.

A helpful fact is that for every 1 percent that you increase your HDL, you lower your cardiac risk by 1 percent as well. So if you are able to increase your HDL from 40 to 50, you have decreased your risk for a heart attack by 10 percent. So even if your total cholesterol and LDL levels are on target, don’t forget about the importance of HDL, the “healthy” cholesterol. Your life could depend on it!

Ways to Increase Your HDL Levels

  1. Lose weight.
  2. Exercise.
  3. Add soy protein to your diet. Soy proteins contain isoflavones, which raise HDL.
  4. Drink red wine if your doctor says it’s safe to include alcohol in your meal plan. Grapes used for red wine contain a substance know as resveratrol that increases HDL. Researchers believe that because red wine is part of the daily diet in France, many people there are protected from heart disease in spite of a high-fat diet (this is known as the “French paradox”). Check first with your doctor or pharmacist to be sure alcohol doesn’t interact with your medications. And remember—drinking alcohol can cause hypoglycemia (low blood glucose) for people on medications such as insulin or oral diabetes drugs that stimulate insulin production.
  5. Stop smoking. Among the many health hazards associated with tobacco use is that it lowers HDL levels.

If these strategies do not help you to raise your HDL, your physician might decide to prescribe a medication such as one of the fibrates (Lopid or Tricor) or nicotinic acid (niacin).

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