Cholesterol question

[72Twenty]

I just had mine tested, and everything is in a very desireable range, except my HDL is a little low. (supposed to be at or above 40)

First, what is it?

Second, how can I get it up; what should I add to my diet, etc.?

My doctor mailed me my results, but didn't give me much of a description...

[Vinman]

HDL = High Densisty Lipoprotein, these are the good kinds of fats. fats like Omega-3 (fishy/seafood fats) and unsaturated fats like Oilve oils among others are good sources of HDL

[Core Shot]

Second, how can I get it up; what should I add to my diet, etc.?

Hookers and blow.

[72Twenty]

Ok, more salmon it is!

Hookers and blow.

I knew that was coming..... (err, wait...)

[LAN]

Here's the way I've always remembered the types of cholesterol. Lame, but easy:

HDL: "Hero" DL
LDL: "Loser" DL

You want more Heros and less Losers. Check with your doc, but you can take fish oil capsules as well.

[Littlejerry]

I also think that exercise increases ones HDL

[road trip]

I also think that exercise increases ones HDL

Yes, exercise does.

Typical HDL-raising plans include exercise (specifically, weight training), diet changes (more fish and nuts), and / or therapeutic options.

Take a multivitamin with niacin - that is an HDL-raising compound.

There is some debate about HDL. It hasn't been approved as a surrogate marker for drug studies (i.e. you can't register a drug to raise HDL like you can a drug to lower LDL) because nobody's been willing to pony up the cash to do the definitive studies. That being said, there is a general consensus (based on the classic "Framingham" epidemilogical study) that high HDL correlates with less cardiovascular endpoints.

Pfizer is developing a compound (that will come in a combination tablet with Lipitor) which raises HDL... I think that will be approved sometime in 2006.. but in the meantime, niacin-supplements will work.

[Endlessseason]

High-Density Lipoproteins (HDL) are molecules that basically "latch on" to bad lipoproteins (VLDL, LDL) and carry them out of circulation. This, in part, reduces the quantity of bad fats available for glomming onto the walls, cracks, and inflamed areas of your blood vessels, a.k.a. arteriosclerosis.

We want to get that number as high as possible through many of the methods already mentioned, as well as a few others: exercise, not smoking (smoking drops HDL several points), soluble fibers (pectins, guar, acacia, locust bean, barley), nuts, oils (fish, flax, borage), natural resins (such as guggal), circumin, soy, chromium, policosanol, niacin, and, as a last resort; some statin drugs and fibrates.

Men should be well above 40 on their HDL number, and women above 55.

[road trip]

Good information re: cholesterol at this website.

National Cholesterol Education Program

This actually has treatment guidelines. Of note, HDL is still a "secondary" target.

Also, some studies (imaging studies) have shown that patients who increase their HDL actually show reversal of plaque build-up in their carotid arteries.

Lastly, Endless and I differ somewhat on our "numbers"...

I have always followed the paradigm that an HDL under 40 for men and under 55 for women is "bad" - - conversely, over 55 for men and over 65 for women is "good." The in between levels (40-55; 55-65) are "normal." These numbers are often used when looking at a patient's overall "cardiac risk" (i.e. the likelihood that they'll have a heart attack or something in the future).

[Endlessseason]

RT-

Nah, we're in agreement. That's why I put "well above."

[powderdave]

Great info above, especially endlessseason's contribution.

Interestingly, a study found that people whose only dietary meat was fish (specifically tuna and salmon) had higher HDL levels than vegetarians.

If you are physically active and adjust your diet but still have an HDL below 40 you should consider asking your physician about medication. Even in young people with cholesterol problems it may be appropriate.

Good luck.

[Spats]

Regular exercise is a lot more important than diet:

http://www.hbns.org/news/exercise11-04-03.cfm

I had a couple other studies bookmarked and lost them somewhere, but there were a couple interesting conclusions. Both had a similar protocol to the above study (large cohort, long period of time), and came up with the results that:

-For men, regular exercise was the #1 correlation to low risk of heart disease. The biggest dietary factor was several times less important. Cholesterol levels were weakly correlated.
-For women, cholesterol levels were not correlated *at all* to deaths from heart disease. Regular exercise was the #1 correlation.

Moral: don't stress so much about absolute numbers, and go talk a brisk walk or ride your bike. You're better off eating Twinkies and skiing every day than eating nothing but organic wheatgrass and sitting on your butt.

However, I will note that a baby green salad with pine nuts, olive oil, and balsamic vinegar, and some blue cheese crumbles on top, is delicious.

[road trip]

-For men, regular exercise was the #1 correlation to low risk of heart disease. The biggest dietary factor was several times less important. Cholesterol levels were weakly correlated.
-For women, cholesterol levels were not correlated *at all* to deaths from heart disease. Regular exercise was the #1 correlation.

Hey Spats - if you find 'em, can you post a link/send me those studies? I'd be intrigued to read them...

That being said, Americans being who we are, prescribing medication to lower LDL is so much easier than "diet and exercise". As such, all prescribing information calls for using LDL-lowering products "secondary to lifestyle changes"...

[roll - gybe]

My HDL is very sensative to excercise. Both my LDL and HDL are really low, so I'm told the ratio becomes less reliable, but slacking off even a little will take my HDL ratio way down. I've tested it before, after, and after again...