By Adam Garcia
We will continue our previous discussion on cholesterol, specifically HDL, in diabetic dictionary today. Good cholesterol, bad cholesterol: what makes the difference? Is there a “naughty and nice” list for cholesterol? Sort of…
HDL, or high-density lipoprotein, is commonly referred to as the “good” cholesterol. Contrasting to LDL, which should be at low levels, HDL levels in the body are supposed to be fairly high. This friendly forager tours the bloodstream. As it does, it removes harmful (“bad”) cholesterol from where it doesn’t belong. High HDL levels reduce the risk for heart disease, but low levels increase the risk.HDL helps by removing the excess cholesterol through the gastrointestinal system. It is known as good cholesterol since it aids in the removal of cholesterol that can block arteries and reduce blood flow.
HDL levels are obtained with a simple blood test called a lipid profile. This blood test measures both HDL and LDL levels along with total cholesterol. The test provides a doctor with indicators that help evaluate a patient’s risk factor for heart disease. Cholesterol levels are measured in milligrams per deciliter of blood.
When a lipid profile is ordered, the doctor may require a 12-hour fasting test and may also require certain medications to be temporarily stopped. Cholesterol testing is important, especially in patients who are already at risk for heart disease, such as diabetics.
You may be asking, “What are good levels for HDL?” Each person’s target cholesterol level varies slightly, but generally, HDL levels should be 60 mg/dL or higher and not less than 40 mg/dL to avoid being at risk.
HDL levels are linked more to a person’s lifestyle than diet alone. Smoking, obesity, and sedentary activities are directly linked to low blood HDL levels. Weight loss, smoking cessation and exercise will raise HDL levels. Controlling total cholesterol is a combination of raising the good and lowering the bad, however, this is a process that should include both dietary and lifestyle changes. When lifestyle modification and diet alone are not enough, or if a patient refuses to make changes, a doctor may prescribe a medication for raising HDL levels.
The experts believe HDL cholesterol acts in a variety of helpful ways that tend to reduce the risk for heart disease:
- HDL cholesterol scavenges and removes “bad” cholesterol. HDL cholesterol can detoxify LDL, making it a less harmful form.
- HDL reduces, reuses, and recycles LDL cholesterol by transporting it to the liver where it can be reprocessed.
- HDL cholesterol acts as a maintenance crew for the inner walls of blood vessels (endothelium). Damage to the endothelium is the first step in the process of atherosclerosis, which causes heart attacks and strokes. HDL chemically scrubs the endothelium clean and keeps it healthy.
“What can I do if my HDL cholesterol level is low?” is another question you may be asking yourself. If your HDL is low, you can take several strategies to boost your HDL level and reduce your heart disease risk:
- Exercise. Aerobic exercise for 30 to 60 minutes on most days of the week can help pump up HDL.
- Quit smoking. Tobacco smoke lowers HDL, and quitting can increase HDL levels.
- Keep a healthy weight. Besides improving HDL levels, avoiding obesity reduces risk for heart disease and multiple other health conditions.
Due to many factors contributing to heart disease, cholesterol isn’t destiny. People with normal HDL cholesterol can have heart disease. And people with low HDL levels can have healthy hearts. Overall, though, people who have low HDL cholesterol will have greater risk of developing heart disease than people with high HDL levels.
Experts recommend follow-up cholesterol testing every five years for most people. People with abnormal lipid panels, or who have other risk factors, may need more frequent cholesterol exams. By working to improve the results on your next cholesterol test, or just to keep your numbers looking good, you’ll reduce your risk for heart disease.
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