I just had lab work done as part of my routine physical. My HDL cholesterol level is really low — 30. I am really scared. What can I do to improve the number? Is it possible to make it go up?
—Freaked out about HDL
This is a great question since cholesterol problems are quite common in Americans. High cholesterol affects 42 million Americans, and 63 million more have borderline high cholesterol. To learn more about cholesterol and what those numbers mean, just
Cholesterol is a waxy substance that is found in the fats (lipids) in your blood. While your body needs cholesterol to continue building healthy cells, having high or abnormal cholesterol levels can increase your risk of heart disease or stroke. According to the Mayo Clinic, when you have high cholesterol, you may develop fatty deposits in your blood vessels. Eventually, these deposits make it difficult for enough blood to flow through your arteries. Decreased blood flow to the heart can result in chest pain or a heart attack, while decreased blood flow to the brain can result in a stroke.
Cholesterol levels should be measured at least once every five years for everyone over the age of 20. For women over the age of 45 and men over the age of 35, routine (at least yearly screening) of cholesterol is recommended. The screening test that is usually performed to check cholesterol levels is called a lipoprotein profile. The profile measures more than just total cholesterol, but also measures levels of low density lipoprotein (LDL) cholesterol, high density lipoprotein (HDL) cholesterol, and triglycerides.
Total cholesterol is a composite measurement that includes LDL cholesterol, HDL cholesterol, and the other lipid components. Most physicians recommend that total cholesterol levels are less than 200 mg/dL. Triglycerides are the chemical form in which most fat exists in food and in the body. A triglyceride value less than 150 mg/dL is considered normal. LDL cholesterol is often referred to as "bad cholesterol" because its buildup on the walls of one's arteries can increase the chances of developing heart disease. The lower the LDL cholesterol level, the better it is for one's health. An LDL level below 100 mg/dL is optimal for people at risk for heart disease, and below 130 mg/dL is near ideal/optimal.
HDL cholesterol is often referred to as "good cholesterol" because it protects against heart disease by taking the "bad cholesterol" (LDL) out of the blood and keeping it from building up in the arteries. Thus, the higher the HDL level, the less LDL in the blood. An HDL level of 60 mg/dL is optimal. In the case of the person who asked this week's question, the HDL level is 30 mg/dL, which is considered low. Below 40 in men and below 50 in women are considered to be low levels of HDL.
Increasing HDL cholesterol levels can help reduce one's risk of heart disease, and it is very possible to increase one's HDL level. First, lifestyle modifications go a long way when it comes to improving your HDL cholesterol levels. Quitting smoking can increase one's HDL cholesterol by 10 percent! Other lifestyle modifications that can help increase HDL levels are losing weight, frequent aerobic exercise, limiting alcohol consumption, and a healthier diet including healthier fats.
A healthy diet can include some fat, and recommendations say that 25-35 percent of daily calories can come from fat, and saturated fat should be less than 7 percent of daily calories. Monounsaturated and polyunsaturated fats — found in olive, peanut, and canola oils — tend to improve HDL levels. Nuts, fish, and other foods containing omega-3 fatty acids are other good choices for improving LDL and HDL levels. Other foods that have a healthy effect on blood cholesterol levels include whole grains (such as oatmeal and oat bran) and nuts (such as walnuts, almonds, and brazil nuts). There are prescription medications and over-the-counter supplements that can help cholesterol levels, however, these should really only be discussed or started with the direction of a physician.
Hopefully this information will help you understand what the different types of cholesterol are and lead you to either get your levels checked if that has not been done, or to discuss with your physician what your results mean if they are abnormal. Cholesterol levels can be improved not only with lifestyle modifications, but also with medications and supplements. Thus, if you had abnormal results or are concerned, you should discuss this with your primary care physician to determine what the best lifestyle modifications and treatments will be for you!
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