Sunday Health Newsletter - HDL (Good Cholesterol)
Sunday July 24th, 2022
“Can it really be true that a chemical compound, so important that the liver synthesizes at least five times as much as you consume in food, can be disastrous to our health. All cell membranes need it, our brains need it, almost all of our hormones are made out of it, and it is used to make vitamin D in our skin. It has always seemed to me that having too little cholesterol is just as likely to be damaging as having too much – probably more so.”
- Malcolm Kendrick, MD
DISCLAIMER: David Beruh (Grand Strand Health Coaching) is an American Council of Exercise (ACE) Certified Health Coach and National Association of Sports Medicine (NASM) Certified Personal Trainer.
The information in this newsletter is for educational purposes only. It is not intended nor implied to be a substitute for professional medical advice. You should always consult your health care provider to determine the suitability of the information presented or if you have questions about a medical condition, treatment, or lifestyle change.
Two weeks ago, I discussed Metabolic Syndrome. Last week’s topic was one of the symptoms of Metabolic Syndrome, High Blood Pressure. This week I will take a look at another factor of Metabolic Syndrome, High Density Lipoprotein (HDL) Cholesterol. The so-called good cholesterol.
First a little background. As the name indicates HDL, like LDL (Low Density Lipoprotein) is not cholesterol but a protein molecule that ferries cholesterol throughout the body, but its presence is used as a marker for cholesterol. As medical science has progressed the cholesterol story has gotten more complicated.
Originally it was thought Total Cholesterol was bad. Then it was found cholesterol is made up of two types, LDL and HDL and that HDL is protective against heart attack and was thus named good cholesterol.
But what you may not know, is that now the so-called bad cholesterol (LDL) has been further subdivided into particle size. According to Dr. Mark Houston and Dr. Sara Gottfired, the number of particles you have (LDL-P) is more predicative of heart disease than the total LDL amount shown on a standard cholesterol panel.
Further, the more small dense particles you have, the greater the risk. Thus, it is possible to have a high total cholesterol but low heart disease risk due to the nature of the cholesterol particles or conversely have low or normal total cholesterol and have a high heart disease risk.
In other words, it is more complicated than previously assumed. And unfortunately, the same is also true with HDL. That doesn’t mean you should ignore the traditional LDL and HDL numbers, but just know there may be more to the story.
Our current knowledge says if your HDL is below 40 (men) or 50 (women) you are at greater risk of Coronary Heart Disease (CHD). If your HDL is above 60 you are protected from CHD.
The 12 year follow up for the Framingham Heart Study found men with HDL below 35 mg/dl (the bottom 20%) were four times as likely to die of a heart attack as men with HDL levels of 54 mg/dl or greater (the top 20%). Women with HDL less than 45 were three times as likely to die of a heart attack than those with HDL above 69 mg/dl.
There is some evidence that HDL might follow a U-Curve and that for men the ideal HDL level is around 73 mg/dl and 93 mg/dl for women, so that more HDL is not necessarily better.
Doctors spend more time worrying about high Total Cholesterol and LDL Cholesterol than low HDL and yet HDL appears to be a better predictor of health outcomes (good outcomes if your HDL is high and bad outcomes if it is low) than LDL.
In the 30-year follow up of the Framingham study it was found for those over 50, the lower the Total Cholesterolthe higher the risk of heart attack death. Read that again, lower Total Cholesterol increased heart attack rates.
It is an interesting question of why doctors are more focused on Total Cholesterol and LDL rather than HDL. It could be that it has been established wisdom that high total cholesterol and in particular LDL was a coronary risk and humans are adverse to change.
The cynic would note that the pharmaceutical industry has successfully developed and marketed drugs for lowering LDL (statins) but have not had a similar success in finding a drug that raises HDL.
Regardless, this brings us the question of what can you do to raise your HDL? Here are some suggestions:
1. Exercise (even a moderate amount of walking)
2. Lose weight.
3. Quit smoking.
4. Eat a low carbohydrate diet (under 150 grams of carbohydrate a day or less.)
5. Eat Omega 3 rich foods such as fatty fish.
6. Eat more saturated fats such as found in beef, dairy, eggs, and coconut oil.
7. Avoid artificial trans fats.
8. Probiotic supplements have been shown to boost HDL. However, I would recommend adding fermented foods such as sauerkraut and kimchi to your diet rather than supplements. Yogurt is also a great option; but choose the full fat option with no added sugar.
Everyone knows the key to living healthy is "eat right and exercise". So why is losing weight on your own so hard?
With so much conflicting advice it's almost impossible to figure out what actually works.
Not to mention, eating bland food and exhausting workouts does not sound like fun.
Grand Strand Health Coach provides custom plans for your exact situation, no matter what your age or current physical condition.
Getting started is quick and easy.
1. Take a quick questionnaire - assess your current health and determine your goals
2. Get a custom plan - Get results with Motivation, Information and Accountability built into every session
3. Start looking and feeling better - small changes over time get big results
Schedule your free consultation at: www.DaveBeruh.com or Text: 610-235-7567 or email: DaveBeruh@GMail.com
