HDL Cholesterol: The "Good" Cholesterol Explained
HDL cholesterol protects your heart. Discover how to increase HDL levels and what your test results mean.
What is HDL Cholesterol?
High-density lipoproteins (HDL) are a type of particle that shuttle excess cholesterol in our blood. They are smaller, denser particles that serve mainly to transport cholesterol back to the liver for breakdown and removal (via a process called reverse cholesterol transport). HDL-cholesterol (HDL-C) measures the amount of cholesterol being carried inside these HDL-particles.
What does it assess?
HDL-cholesterol is commonly referred to us “good” cholesterol as studies have observed that individuals with higher levels of HDL have lower incidence of cardiovascular disease. However, having higher levels of HDL does not eliminate or negate the risk associated with high apolipoprotein B or LDL-cholesterol. Medications that increase HDL-cholesterol levels have also not resulted in a reduction in heart disease, suggesting a more complicated relationship between HDL-C and heart health. Ultimately, levels often correlate with healthy metabolism and dietary habits, but are not the best predictor of cardiovascular risk.
How do I optimize my HDL Cholesterol levels?
Consuming healthy fats, particularly monounsaturated and polyunsaturated fats, is key to boosting HDL cholesterol. Foods like olive oil, avocados, nuts, and seeds are rich in healthy fats that support HDL production. Fatty fish, such as salmon and sardines, are also excellent sources of omega-3 fatty acids, which have been shown to improve HDL cholesterol levels. Replacing unhealthy fats, like those found in processed foods and trans fats, with these heart-healthy fats can help optimize HDL cholesterol. Exercise is one of the most effective ways to increase HDL cholesterol. Aerobic exercises, such as brisk walking, jogging, cycling, or swimming, can significantly raise HDL levels. Engaging in at least 150 minutes of moderate-intensity exercise per week, or 75 minutes of vigorous-intensity exercise, is recommended to improve HDL cholesterol. Resistance training, such as weightlifting or bodyweight exercises, also contributes to higher HDL levels by improving overall metabolism and fat loss, which enhances lipid profiles. Smoking has a detrimental effect on HDL cholesterol, lowering its levels and impairing its function. Quitting smoking can lead to a rapid improvement in HDL cholesterol levels, as studies show that former smokers often experience significant increases in HDL within weeks of quitting. In addition to raising HDL, quitting smoking improves overall cardiovascular health by reducing inflammation, enhancing endothelial function, and lowering LDL cholesterol levels. Avoiding secondhand smoke is also important, as it can have similar negative effects on lipid profiles.
What do high and low HDL Cholesterol levels mean?
In general, high HDL-C is associated with better metabolic health and cardiovascular outcomes. However, high HDL-C does not negate the negative effects of suboptimal apoB levels, and lowering apoB levels should remain the focus of interventions. Lower HDL-C is often associated with poor metabolic health and fitness. However, with regards to risk of cardiovascular disease, apoB remains the main predictor of risk, and when it comes to improving cholesterol status, lowering apoB remains the main goal.
