HDL cholesterol: Everything you need to know

HDL cholesterol is an important part of the body's fat metabolism and is often referred to as "good cholesterol." Unlike LDL cholesterol, which can accumulate in the walls of arteries and cause cardiovascular diseases, HDL cholesterol helps remove excess cholesterol from the blood and transport it back to the liver for processing. This article provides a comprehensive overview of HDL cholesterol, its function, significance for health, and ways you can improve your HDL cholesterol levels.

HDL (High-Density Lipoprotein) is a lipoprotein that carries cholesterol in the bloodstream. Lipoproteins are combinations of fat and proteins, and their role is to transport fats, such as cholesterol and triglycerides, throughout the body.HDL cholesterol differs from other types of cholesterol, particularly LDL cholesterol, in that it transports cholesterol away from blood vessels and back to the liver. For this reason, HDL cholesterol is referred to as "good cholesterol."

The primary function of HDL cholesterol is to remove excess cholesterol from the walls of blood vessels and transport it to the liver, where it can be broken down and eliminated from the body. This process reduces the risk of cholesterol accumulating in the arteries and causing atherosclerosis, which is the hardening and narrowing of the arteries.

High levels of HDL cholesterol are associated with a lower risk of developing cardiovascular diseases.This is because HDL cholesterol helps protect blood vessels and prevents the accumulation of LDL cholesterol (i.e., "bad cholesterol") in the walls of the arteries. HDL cholesterol reduces the risk of plaque formation and promotes heart health in several ways:

 1. Cholesterol removal: HDL cholesterol transports excess cholesterol from the walls of the arteries to the liver, where it is broken down and eliminated from the body. This reduces cholesterol accumulation in the arteries and prevents their narrowing.

 2. Protective effect:  HDL cholesterol can also prevent the oxidation of LDL cholesterol, which is one of the main causes of atherosclerosis, or the hardening and narrowing of the arteries. Oxidized LDL cholesterol is particularly harmful because it promotes plaque formation.

 3. Anti-inflammatory effect:  HDL cholesterol can also help reduce inflammation in blood vessels, which is a key factor in the development of cardiovascular diseases.

Overall, high HDL cholesterol reduces the risk of heart attacks, strokes, and other cardiovascular diseases, making it an important part of maintaining heart health.

HDL cholesterol levels in the blood are usually measured in millimoles per liter (mmol/l). Generally, a higher HDL cholesterol level is better and is associated with a lower risk of cardiovascular diseases.The recommended reference values for HDL cholesterol are:

•  For men: Over 1.0 mmol/l

•  For women: Over 1.2 mmol/l

A higher HDL cholesterol level, for example over 1.5 mmol/l, provides even better protection against heart disease. If your HDL cholesterol level is below these values, it may indicate an increased risk of cardiovascular diseases.

It is important to note that while HDL cholesterol is considered "good cholesterol," its amount is only one part of a broader cholesterol profile that also includes LDL cholesterol and triglycerides. Evaluating total cholesterol levels and balancing all of these values is crucial for heart health.

The measurement of HDL cholesterol is part of a broader lipid profile test, which is conducted through a blood test. This test typically measures several different values:

•  Total cholesterol:  The total amount of all types of cholesterol in the blood.

•  LDL cholesterol:  The amount of "bad cholesterol" that can lead to atherosclerosis.

•  HDL cholesterol:  The amount of "good cholesterol" that protects blood vessels.

•  Triglycerides: The amount of fats in the blood that can also affect the risk of cardiovascular diseases.

The blood test is usually done after fasting to obtain accurate values. After this, you will receive results that help the doctor assess your risk of heart and vascular diseases and decide whether treatment or lifestyle changes are necessary.

Low HDL cholesterol can be a sign of increased risk for heart and vascular diseases. Several factors can affect HDL cholesterol levels:

Some individuals have a genetic predisposition to low HDL cholesterol. This may be more challenging to manage, but with the right lifestyle choices, it is still possible to improve HDL levels.

A diet high in saturated fats, trans fats, and sugar can lower HDL cholesterol. Adopting a healthy diet is key to improving HDL cholesterol levels.

Being overweight, especially central obesity, is often associated with low HDL cholesterol. Weight loss and a healthier diet can help raise HDL levels.

A lack of regular exercise can lead to low HDL cholesterol levels. Aerobic exercise, such as walking, running, cycling, and swimming, can improve HDL cholesterol.

Smoking lowers HDL cholesterol levels and damages blood vessels. Quitting smoking is one of the most effective ways to improve HDL cholesterol levels and reduce the risk of cardiovascular diseases.

Fortunately, there are many ways you can improve your HDL cholesterol levels and protect your heart. Here are some of the most effective ways to increase the amount of "good" cholesterol:

• Increase healthy fats: Monounsaturated and polyunsaturated fats found in olive oil, avocados, nuts, and fatty fish can help raise HDL cholesterol.

•  Avoid saturated fats and trans fats:  These can be found in fatty meats, butter, and commercially baked goods. Reduce their use and replace them with healthier fats.

•  Eat fiber-rich foods:  Whole grain products, beans, lentils, fruits, and vegetables are high in fiber, which helps manage cholesterol levels.

•  Aerobic exercise:  Forms of exercise such as walking, running, cycling, and swimming are particularly effective in raising HDL cholesterol. The goal should be at least 150 minutes of moderate exercise per week.

•  Strength training:  Strength training can also help improve HDL cholesterol levels and support overall heart health.

•  Lose excess pounds:  Weight loss, especially from the abdominal area, can significantly improve HDL cholesterol levels. This is best achieved by combining a healthy diet with regular exercise.

•  Avoid sugar and processed carbohydrates: Excessive consumption of sugar and processed carbohydrates can lead to weight gain and low HDL cholesterol levels.

•  Quit smoking: Smoking lowers HDL cholesterol levels and increases the risk of heart and vascular diseases. Quitting smoking is one of the best ways to improve HDL levels and heart health.

• Moderate alcohol consumption:  A small amount of alcohol, especially red wine, can raise HDL cholesterol. Moderate consumption means up to one drink per day for women and two drinks for men. However, it is important to be cautious, as excessive alcohol consumption can lead to other health issues.

If lifestyle changes are not sufficient to raise HDL cholesterol levels, a doctor may recommend medication. Although there are no specific medications designed solely to raise HDL cholesterol, some medications may help improve HDL levels:

•  Niacin: Niacin, or vitamin B3, can raise HDL cholesterol and lower LDL cholesterol. However, it is used less frequently to achieve high HDL levels due to potential side effects.

•  Statins: Statins are primarily designed to lower LDL cholesterol, but they can also slightly raise HDL levels. Statins significantly reduce the risk of cardiovascular diseases.

•  Fibrates: Fibrates are medications that help lower triglyceride levels and may simultaneously raise HDL cholesterol.

HDL cholesterol, also known as "good cholesterol," is a key factor in maintaining cardiovascular health. High levels of HDL cholesterol protect the arteries and reduce the risk of developing cardiovascular diseases, such as heart attacks and strokes. Healthy lifestyle choices, such as diet, exercise, weight management, and not smoking, are the most effective ways to raise HDL cholesterol and improve heart health.

If lifestyle changes do not sufficiently raise HDL cholesterol levels, discussing with a doctor is important.Medication may be necessary, especially when the risk of cardiovascular diseases is high.

Take care of your heart by improving your HDL cholesterol levels and making healthy choices that help you enjoy a long and healthy life.