Understanding Cholesterol

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Over the past 15 years we have on a regular basis looked at our client’s cholesterol levels and discussed the two types of cholesterol: LDL, considered the bad cholesterol and HDL the good cholesterol.

Why is HDL cholesterol good for you? Why is some cholesterol helpful to the heart and other cholesterol (namely LDL) harmful?

 

A little about low-density lipoprotein (LDL) - Cholesterol travels through the bloodstream in protein packages called lipoproteins. The lipoprotein of greatest concern is LDL, the so-called bad cholesterol. If your body produces more LDL than the cells can absorb, it lodges in artery walls and contributes to the build-up of atherosclerotic plaque.

Bringing down LDL has been the main target for improving cholesterol levels. Powerful cholesterol-lowering drugs called statins are available to do just that. Studies have shown that taking a statin can cut the risk of developing and dying from heart disease by 30% to 40%. Although in most cases a decent diet full of fibrous fruit and vegetable is at least, if not more effective.

 

So what about high-density lipoprotein (HDL) -  there's more to the story of cholesterol and cardiovascular risk than LDL. Another key player is HDL, dubbed the "good" cholesterol. HDL removes LDL from the artery walls and ferries it back to the liver for processing or removal. HDL also helps reduce inflammation and protects the cells lining the arteries' inner surface (endothelium).

HDL also is:

• An antioxidant. Researchers believe antioxidants can protect against coronary artery disease by preventing LDL cholesterol from reacting with oxygen, which leads to the progressive thickening and hardening of the walls of arteries.
• An anti-inflammatory. Though inflammation is an essential part of the body's defences, it can cause problems. In the heart, inflammation can trigger atherosclerosis and influence the formation of artery-blocking clots, the ultimate cause of heart attacks and many strokes.
• An antithrombotic. Thrombosis is the forming of clots, and preventing these clots from forming in the coronary arteries can prevent heart attack and stroke.

People with low levels of HDL are more likely to have heart attacks and strokes; high levels appear to be protective. In the Framingham Heart Study, low levels of HDL were an even more potent risk factor for heart disease than high levels of LDL. Other studies have linked high HDL levels to a reduced risk of stroke, greater longevity, and better cognitive function in old age.

Luckily, there are things you can do to increase HDL, your lifestyle has the single greatest impact on your HDL cholesterol. Even small changes to your daily habits can help you meet your HDL target.

• Don't smoke. If you smoke, quit. Quitting smoking can increase your HDL cholesterol by up to 10%. Quitting isn't easy, but you can increase your odds of success by trying more than one strategy at a time. Talk with your doctor about your options for quitting.
• Lose weight. Extra kilograms take a toll on HDL cholesterol. If you're overweight, losing even a few kg’s can improve your HDL level. For every 2.7 kg you lose, your HDL may increase by 0.03 mmol/L. If you focus on becoming more physically active and choosing healthier foods, two other ways to increase your HDL cholesterol, you'll likely move toward a healthier weight in the process.
• Get more physical activity. Within two months of starting, frequent aerobic exercise can increase HDL cholesterol by about 5% in otherwise healthy sedentary adults. Your best bet for increasing HDL cholesterol is to exercise briskly for 30 minutes, five times a week. Examples of brisk, aerobic exercise include walking, running, cycling, swimming, playing basketball, raking leaves, anything that increases your heart rate. You can also break up your daily activity into three, ten-minute segments if you're having difficulty finding time to exercise.
• Choose healthier fats. A healthy diet includes some fat, but there's a limit. In a heart-healthy diet, between 25 and 35% of your total daily calories can come from fat, however saturated fat should account for less than 10-15% percent of your total daily calories. Avoid foods that contain trans fats, which raise LDL cholesterol and damage your blood vessels.Monounsaturated and polyunsaturated fats, found in olive oils, tend to improve HDL's anti-inflammatory abilities. Nuts, fish and other foods containing omega-3 fatty acids are other good choices for improving your LDL cholesterol to HDL cholesterol ratio.
• Drink alcohol only in moderation. Moderate use of alcohol has been linked with higher levels of HDL cholesterol. If you choose to drink alcohol, do so in moderation. This means no more than one drink a day for women and everyone over age 65, and two drinks a day for men. If you don't drink alcohol, don't start just to try to raise your HDL levels.