Also known as: HDL; HDL-C.
Formal name: High-density lipoprotein cholesterol.
HDL cholesterol: Lipoproteins, which are combinations of lipids (fats) and proteins, are the form in which lipids are transported in the blood. The high-density lipoproteins transport cholesterol from the tissues of the body to the liver so it can be gotten rid of (in the bile). HDL cholesterol is therefore considered the “good” cholesterol. The higher the HDL cholesterol level, the lower the risk of coronary artery disease.
Even small increases in HDL cholesterol reduce the frequency of heart attacks. For each 1 mg/dl increase in HDL cholesterol there is a 2 to 4% reduction in the risk of coronary heart disease. Although there are no formal guidelines, proposed treatment goals for patients with low HDL cholesterol are to increase HDL cholesterol to above 35 mg/dl in men and 45 mg/dl in women with a family history of coronary heart disease; and to increase HDL cholesterol to approach 45 mg/dl in men and 55 mg/dl in women with known coronary heart disease.
The first step in increasing HDL cholesterol levels is life style modification. Regular exercise, loss of excess weight (fat), and cessation of cigarette smoking will increase HDL cholesterol levels. When life style modifications are insufficient, medications are used. Medications that are effective in increasing HDL cholesterol include nicotinic acid (niacin), gemfibrozil (Lopid), estrogen, and to a lesser extent, the statin drugs.
Increasing the GOOD cholesterol
HDL cholesterol, or “good” cholesterol, appears to scour the walls of blood vessels, cleaning out excess cholesterol. It then carries that excess cholesterol — which otherwise might have been used to make the “plaques” that cause coronary artery disease — back to the liver for processing. So when we measure a person’s HDL cholesterol level, we seem to be measuring how vigorously his or her blood vessels are being “scrubbed” free of cholesterol.
HDL levels below 40 mg/dl result in an increased risk of coronary artery disease, even in people whose total cholesterol and LDL cholesterol levels are normal. HDL levels between 40 and 60 mg/dl are considered “normal.” However, HDL levels greater than 60 mg/dl may actually protect people from heart disease. Indeed, for several years, doctors have known that when it comes to HDL levels, the higher the better.
HDL Cholesterol Levels
How can We Increase Our HDL Levels?
- ExerciseMany people don’t like to hear it, but regular exercise (any exercise, such as walking, jogging or bike riding, that raises your heart rate for 20 to 30 minutes at a time) may be the most effective way to increase HDL levels. Recent evidence suggests that the duration of exercise, rather than the intensity, is the more important factor in raising HDL choleserol. But any exercise helps.
- Lose weightObesity results not only in increased LDL cholesterol, but also in reduced HDL cholesterol. If you are overweight, reducing your weight should increase your HDL levels. This is especially important if your excess weight is stored in your abdominal area; your waist-to-hip ratio is particularly important in determining whether you ought to concentrate on weight loss.
- Stop smokingIf you smoke, giving up tobacco will result in an increase in HDL levels.
- Cut out the trans fatty acidsTrans fatty acids are currently present in many of your favorite prepared foods — anything in which the nutrition label reads “partially hydrogenated vegetable oils” — so eliminating them from the diet is a good thing. But trans fatty acids not only increase LDL cholesterol levels, they also reduce HDL cholesterol levels. Removing them from your diet will almost certainly result in a measurable increase in HDL levels.
- Increase the monounsaturated fats in your dietMonounsaturated fats such as canola oil, avocado oil, or olive oil and in the fats found in peanut butter can increase HDL cholesterol levels without increasing the total cholesterol.
- Add soluble fiber to your dietSoluble fibers are found in oats, fruits, vegetables, and legumes, and result in both a reduction in LDL cholesterol and an increase HDL cholesterol. For best results, at least two servings a day should be used.
- Other dietary means to increasing HDLCranberry juice has been shown to increase HDL levels. Fish and other foods containing omega-3 fatty acids can also increase HDL levels. In postmenopausal women (but not, apparently, in men or pre-menopausal women) calcium supplementation can increase HDL levels.
When it comes to HDL cholesterol — “good” cholesterol — the higher the number, the lower your risk. This is because HDL cholesterol protects against heart disease by taking the “bad” cholesterol out of your blood and keeping it from building up in your arteries. The table below explains what the numbers mean.
|HDL Cholesterol||HDL-Cholesterol Category|
|60 and above||High; Optimal; associated with lower risk|
|Less than 40 in men and less than 50 in women||Low; considered a risk factor for heart disease|
HDL Cholesterol Benefits
Lowering your LDL cholesterol is easier to do than raising your HDL cholesterol. However, there is great benefit in bringing your HDL numbers up and even greater benefit by doing both – lowering LDL/raising HDL.
For a long time, focus was primarily on LDL and the need to bring numbers down. However, researchers and physicians have now identified that bringing the HDL level up is just as beneficial and a natural way of fighting off bad cholesterol.
There are definite steps you can take to help raise your HDL:
- Weight Loss
- B3 (Niacin)
Some studies have shown that when antioxidants are coupled with cholesterol-reducing medications such as Statin-type drugs along with Niacin, there was some level of benefit.
Further research suggests that in women with high plasma levels of HDL, the risk of heart attack becomes reduced.
The higher your HDL levels the better. Today, the average for women is between 50 and 55 mg/dl and for men 40 to 45 mg/dl. Again, getting this level over 60 is a very effective start toward improving overall cholesterol ratios.