Putting the “Good” In Good Cholesterol

How to Boost Your ‘Good’ Cholesterol

At the risk of sounding like a certain 20-something socialite, High-Density Lipoprotein (HDL) is hot! Advances in research have brought more attention to the blood lipid (or fat) we often call “good” cholesterol.

“Good” cholesterol doesn’t refer to the cholesterol we eat in food, but rather to the high-density lipoprotein cholesterol circulating in our blood. It’s one of the fats measured in the lipid panel blood test doctors perform. And it’s the component you want more of, because a higher HDL is associated with a lower risk of heart disease.

Experts from the National Cholesterol Education Program (NCEP) note that although LDL or “bad” cholesterol has gotten most of the attention, there’s growing evidence that HDL plays an important role.

Facts About “Good” Cholesterol

  • HDL cholesterol normally makes up 20%-30% of your total blood cholesterol.
  • There is evidence that HDL helps protect against the accumulation of plaques (fatty deposits) in the walls of coronary arteries.
  • Research suggests that a five-point drop in HDL cholesterol is linked to a 25% increase in heart disease risk.
  • In prospective studies — that is, studies that follow participants for a period of time to watch for events like heart attacks or death from heart disease — HDL usually proves to be the lipid risk factor most linked to heart disease risk.
  • HDL cholesterol levels are thought to be impacted by genetics.
  • Women typically have higher HDL cholesterol levels than men. About a third of men and about a fifth of women have HDL levels below 40 mg/dL. Doctors consider levels of less than 40 mg/dL to be low.

Researchers from the Netherlands who analyzed 60 studies concluded that the ratio of total cholesterol to HDL (in which your total cholesterol number is divided by your HDL number) is a better marker for coronary artery disease than LDL measurement alone.

“Boosting HDL is the next frontier in heart disease prevention,” says P.K. Shah, MD, director of cardiology at Cedars-Sinai Medical Center in Los Angeles. Shah says that if the new drugs designed to increase HDL levels prove effective, they could potentially reduce the number of heart attacks and strokes by 80% to 90% — and save millions of lives. HDL-boosting drugs are now being tested.

How Does HDL Cholesterol Help Your Heart?

Experts aren’t yet sure exactly how HDL cholesterol helps reduce the risk of heart disease. But a few possibilities have emerged.

The NCEP says that high HDL levels appear to protect against the formation of plaques in the artery walls (a process called atherogenesis), according to studies in animals.

Lab studies, meanwhile, suggest that HDL promotes the removal of cholesterol from cells found in plaques, or lesions, in the arteries.

“Recent studies indicate that the antioxidant and anti-inflammatory properties of HDL also inhibit atherogenesis,” says the NCEP report

What many people don’t know is that some diet and lifestyle changes may help to increase HDL cholesterol levels, although to a small extent.

Here are some of the contenders:

1. Orange Juice. Drinking three cups of orange juice a day increased HDL levels by 21% over three weeks, according to a small British study (at 330 calories, that’s quite a nutritional commitment). This study could be highlighting an effect from high-antioxidant fruits and vegetables. Stay tuned in the years to come.

2. Glycemic Load. The glycemic load is basically a ranking of how much a standard serving of a particular food raises your blood sugar. And as the glycemic load in your diet goes up, HDL cholesterol appears to go down, according to a small recent study. Along these lines, the NCEP report recommends that most of our carbohydrate intake come from whole grains, vegetables, fruits, and fat-free and low-fat dairy products. These foods tend to be on the lower end of the glycemic scale.

3. Choosing Better Fats. Replacing saturated fats with monounsaturated fats can not only help reduce levels of “bad” cholesterol, it may also increase levels of “good” cholesterol, according to the Food & Fitness Advisor newsletter from Cornell University’s Center for Women’s Healthcare.

4. Soy. When substituted for animal-based products, soy foods may have heart health benefits. Soy products are low in saturated fats and high in unsaturated fats. Soy products are also high in fiber. An analysis found that soy protein, plus the isoflavones found in soy “raised HDL levels 3%, which could reduce coronary heart disease risk about 5%,” says Mark Messina, PhD, a nationally known soy expert. Messina notes that soy also may lead to a small reduction in LDL cholesterol and triglycerides (another type of blood fat), and a possible enhancement in blood vessel function. Other studies have shown a decrease in LDL cholesterol (about 3%) and triglycerides (about 6%) with about three servings of soy a day. That adds up to 1 pound of tofu, or three soy shakes. Further research should focus on whether a higher soy diet intervention is associated with a reduction in heart disease risk.

5. Alcohol in Moderation. Drinking moderate amounts of alcohol is associated with a higher level of HDL. Alcohol is also associated with a lower risk of cardiovascular disease in men and women.

6. Aerobic exercise. Moderately intense exercise of at least 30 minutes on most days of the week is the exercise prescription that can help raise your HDL, according to many health care professionals.

7. Stopping smoking. Experts agree that kicking the habit can increase your HDL numbers a bit, too.

8. Losing weight. Being overweight or obese contributes to low HDL cholesterol levels, and is listed as one of the causes of low HDL, according to the NCEP.

Bottom Line: Not all cholesterol is bad.  HDL is the good cholesterol and this article from the Wall Street Journal provides suggestions for boosting your HDL

 

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