Cholesterol is a waxy, fat-like substance found in the bloodstream and all cells of the body. People often think all cholesterol is “bad”, but your body needs cholesterol to make hormones, fat-soluble vitamins (i.e., Vitamins A, D, E, and K) and bile acids to help digest food. In addition, cholesterol is needed for a healthy brain. Cholesterol is made by the body, and it’s also found in some foods.
Cholesterol travels through the bloodstream in small packages called lipoproteins. These lipoproteins are made of fat on the inside and protein on the outside. Two kinds of lipoproteins carry cholesterol throughout your body: low-density lipoproteins (LDL) and high-density lipoproteins (HDL).
What is HDL?
HDL is the “good” fat. Having high levels of HDL cholesterol is important because it is a scavenger that carries LDL away from the arteries and back to the liver for elimination. LDL is the “bad” cholesterol because it contributes to fatty build-up in arteries and around vital organs (visceral fat). HDL levels are often lower in people who have metabolic syndrome.
What is so bad about a low HDL level?
- Increased risk of heart disease and stroke
- Poor memory and memory decline
- Transfats (often found in shortening, margarines, fried foods, processed food)
- Overweight or obesity
- Sedentary lifestyle
- Insulin resistance/uncontrolled diabetes
- Medication (e.g., beta blockers, thiazide diuretics, sex hormones, anabolic steroids)
- Genetics (this is rare)
At risk Desirable
Women < 40 mg/dL 60 mg/dL (1.6 mmol/L)
(1.0 mmol/L) < 100 mg/dL (2.5mmol/L)
Men < 50 mg/dL 60 mg/dL (1.6 mmol/L)
(1.3 mmol/L) < 100 mg/dL (2.5mmol/L)
How can I raise my HDL level?
Medications can do this, but the first strategy involves lifestyle changes:
- Eliminate transfats and limit saturated fats
- Use the Mediterranean diet to guide healthy food choices, such as avocado, olives/olive oil, nuts, seeds, and fatty fish. Choose low carbohydrate options for vegetables, fruits, and beans.
- Increase physical activity
- Maintain a healthy weight. Even weight loss of just 5-10% of body weight can improve levels of blood fats.
- Keep abdominal girth <31.5” in women, 40” in men. Read more about this risk factor here.
- Quit smoking.