All around us, we’re bombarded with messages to lower our cholesterol. But not all cholesterol is bad for you. In fact, one-quarter to one-third of your blood cholesterol should be comprised of high-density lipoprotein, or HDL, which seems to protect against heart attack. How does it do this? Experts believe that HDL, known as the “good” cholesterol, transports “bad” cholesterol away from your arteries and back to your liver, from where it leaves the body. It’s also possible that HDL removes excess cholesterol from arterial plaque, slowing the plaque’s build-up. In effect, HDL cholesterol acts as the sanitation worker of your bloodstream, gathering up unhealthy substances in your bloodstream and disposing of them.How low can you go?
Because HDL is so vital, it may surprise you to learn that even people with low total cholesterol run a substantial risk of heart disease if their HDL levels are low—possibly as much of a risk as people with high HDL levels and high total cholesterol. How low is too low when it comes to HDL? Less than 40 mg/dL is cause for concern, and some studies indicate that women are at risk if their HDL levels are below 50 mg/dL. Ideally, HDL levels should be 60 mg/dL or higher to provide the best protection against heart disease.
Low HDL levels can be caused by a host of factors, including cigarette smoking, obesity, a sedentary lifestyle, excessive carbohydrate consumption, elevated triglycerides (a form of fat in your blood that can be measured with a cholesterol test), genetic factors, type 2 diabetes and certain drugs such as beta-blockers, anabolic steroids and progestational agents.Raising the bar
Want to ensure that your HDL levels reach and stay at an optimum level? Fortunately, there are plenty of steps you can take. Among the most important:
The HDL-insulin connection
- Don’t smoke. Nearly a third of all coronary deaths in this country are directly related to cigarette smoking. If you smoke, take steps to quit as soon as possible. Smoking-cessation drugs or programs may help you reach this goal.
- Shed excess pounds. If you’re already at a healthy weight, keep up the good work! But if you’ve got some slimming down to do, begin a weight-loss program that will let you lose safely and slowly. Keeping a food diary may help you get a handle on what you’re eating and let you see your successes on paper.
- Focus on fiber. An excess of refined carbohydrates, such as white breads, some pastas and cereals and sweets, has been shown to depress HDL levels. Better choices: foods rich in fiber, such as whole-grain cereal, bread and pasta; beans; fruits; and vegetables.
- Get more healthy fats. Shaping up your diet doesn’t mean cutting out all fats. In moderate amounts, monounsaturated and polyunsaturated fats (those found in olive and canola oil, nuts, nut butters, seeds, avocados, fish and flax meal) raise HDL levels without raising total cholesterol levels. The fats to avoid are trans-fats and saturated fats, such as those found in fried foods, prepackaged baked goods, margarine and certain animal products.
- Exercise. Aim for at least 30 to 60 minutes of physical activity every day or on most days of the week. Varying your routine from day to day can help you stick with a program. Taking a walk, hopping on an exercise bike, joining an aerobics class or simply going out dancing will help you get results.
- Drink in moderation, if at all. While alcohol consumption can help HDL levels, it’s best to limit yourself to one drink daily if you’re a woman and two drinks daily if you’re a man. If you don’t drink at all right now, don’t start. And experts advise against drinking under any circumstances if you have high triglycerides.
If you have low HDL levels along with excess abdominal fat, high triglycerides, high blood pressure and a high fasting blood-glucose level, you may be suffering from a constellation of symptoms known either as insulin resistance syndrome or syndrome X. Studies indicate that this syndrome is linked to insulin resistance, a condition in which the body cannot use insulin efficiently. To compensate for this deficiency, the pancreas pumps out more insulin. Over the years, this can lead to diabetes, a recognized risk factor for heart disease.Did you know?
For every 10 pounds that you lose and keep off, your HDL levels increase by 2 mg/dL. But experts agree that weight cycling (going up and down) is better than not losing weight at all.