It has long been known that elevated levels of LDL, or “bad cholesterol,” increase the risk of developing cardiovascular problems like heart disease and stroke. Millions of dollars were spent and billions of dollars made developing drugs that lowered LDL, reducing the risk of these related diseases and saving millions of lives. It wasn’t until the mid-2000s that we began to focus on HDL, or “good cholesterol,” and its relationship to cardiovascular diseases.
LDL and HDL are two types of lipoproteins that carry cholesterol through your bloodstream and deliver it to the places where it can be used. Unfortunately, LDL in high concentrations tends to dump some of this cholesterol inside the walls of blood vessels leading to the formation of plaques that can grow over time, blocking the blood flow. If this occurs in your heart you develop heart disease and if this occurs in your brain it can lead to stroke or other harmful changes over time. Not only is this build up bad over time, it also leads to inflammation at the site of the plaque that can cause sudden breakdown of the blood vessel wall leading to a cascade of events resulting in a sudden heart attack or stroke.
HDL is the antithesis of LDL. This lipoprotein picks up loose cholesterol in the bloodstream from excess LDL and removes it from the bloodstream by delivering it to the liver or other organs that make bodily products like hormones or even new cell walls. HDL also “scrubs” the blood vessel walls cleaning up the deposits of cholesterol and reducing or even eliminating the plaques and associated inflammation.
So with all that said, it seemed to the medical world that if drugs used to decrease bad cholesterol were effective at saving lives, drugs boosting good cholesterol would have the same effect, if we could correlate low HDL levels to increased risks for cardiovascular diseases. The studies done looking at people with low HDL’s seemed to correlate with more disease and other studies seemed to correlate “naturally” high levels of HDL with significantly less disease. One study also suggested that people who tended to live 100 years or longer, had significantly elevated HDLs. The race to develop the next big drug was on.
However, with a few years of efforts at raising HDL’s under our belts, the new studies are showing little if any benefits from these therapies as well as strong evidence of harm caused from the side-effects of the drugs used. What happened?
First of all, let’s look at the studies done convincing us to raise low HDLs. When looked at closely, the studies relating low HDL’s to increased cardiovascular risks also showed that the apparent significance was not as evident when compared to the individual’s elevated LDL levels, i.e. it’s more likely that the elevated LDLs were the cause of increased disease and not the low levels of HDL. Also, the studies looking at decreased disease and increased longevity with “naturally” high levels of HDL, show that the increased readings were likely linked to healthy lifestyles.
So where does that leave us? With the evidence at hand, the best assumption is that HDL is a “marker” of healthy living. People who have “naturally” high levels of HDL have healthier diets and healthier lifestyles. So what are these healthier habits? They are probably already familiar to you.
Exercise. This is a no brainer when it comes to health. Regular exercise (30-45 minutes, 5-7 days a week), especially aerobic, raises the HDL levels.
Diet. No, I’m not talking about “dieting,” but what you eat. As mentioned by me in previous articles, diets high in animal products tend to be unhealthy for the human body; it will not only raise LDL but also lower HDL. Introducing more fresh whole plant based foods, especially high in fiber, into your diet will raise your HDL.
Good Fats. As alluded to earlier, the body needs fats to survive and thrive. Our body makes some of it’s own, so we don’t need large quantities in our foods. The best fats are the Omega-3s, found in fish and many plants.
Bad Fats. As I’m sure we’ve all heard, trans fats are super bad. They lower HDL levels, likely through the inflammatory process, how this fat tends to do all its damage to the body.
Weight. Maintaining an ideal body weight not only lowers the LDL, but tends to maintain elevated levels of HDL (again, this might be a side effect of the healthy habits above).
Smoking. Smoking tobacco, like high levels of LDL, causes blood vessel inflammation not only directly increasing your risk of cardiovascular diseases, but also through its effect on lowering HDL.
Alcohol. As those of you who have read my prior articles, I am a proponent of alcohol in moderation (2-3 per day for women, 3-5 per day for men) for it’s health benefits. Not surprisingly, then, it also raises HDL levels.
These recent studies again support that living a healthy lifestyle and eating nutritious fresh whole foods is much more important and beneficial to overall health than trying to take a pill to prevent disease.
(I DO NOT recommend stopping any of your medicines without prior consultation with your personal physician).