Aerobic exercise. Many people don't like to hear it, but regular aerobic
exercise (any exercise, such as walking, jogging or bike riding, that raises
your heart rate for 20 to 30 minutes at a time) may be the most effective way
to increase HDL levels. Recent
evidence suggests that the duration of exercise, rather than the
intensity, is the more important factor in raising HDL choleserol. But any
aerobic exercise helps.
Lose weight. Obesity results not only in increased LDL cholesterol, but also in reduced HDL cholesterol. If you are overweight, reducing your weight should increase your HDL levels. This is especially important if your excess weight is stored in your abdominal area; your waist-to-hip ratio is particularly important in determining whether you ought to concentrate on weight loss.
Stop smoking. If you smoke, giving up tobacco will result in an increase in HDL levels. (This is the only advantage I can think of that smokers have over non-smokers -- it gives them something else to do that will raise their HDL.)
Cut out
the trans fatty acids. Trans
fatty acids are currently present in many of your favorite prepared foods --
anything in which the nutrition label reads "partially hydrogenated
vegetable oils" -- so eliminating them from the diet is not a trivial
task. But trans fatty acids not only increase LDL cholesterol levels, they also
reduce HDL cholesterol levels. Removing them from your diet will almost
certainly result in a measurable increase in HDL levels. Click here for a quick and
easy review of trans fatty acids and the heart.
Alcohol. With apologies to the American Heart Association, which
discourages doctors from telling their patients about the advantages of
alcohol: one or two drinks per day can significantly increase HDL levels. More
than one or two drinks per day, one hastens to add, can lead to substantial health problems including heart
failure -- and there are individuals who will develop such problems even when
limiting their alcohol intake to one or two drinks per day. Click here for a quick and
easy review of alcohol and the heart.
Increase the
monounsaturated fats in your diet. Monounsaturated fats such as canola oil, avocado oil, or olive oil and in
the fats found in peanut butter can increase HDL cholesterol levels without
increasing the total cholesterol.
Add soluble fiber to
your diet. Soluble fibers are
found in oats, fruits, vegetables, and legumes, and result in both a reduction
in LDL cholesterol and an increase HDL cholesterol. For best results, at least
two servings a day should be used.
Other dietary means to
increasing HDL. Cranberry juice
has been shown to increase HDL levels. Fish and other foods containing omega-3
fatty acids can also increase HDL levels. In postmenopausal women (but not,
apparently, in men or pre-menopausal women) calcium supplementation can
increase HDL levels.
HDL cholesterol, or "good" cholesterol, appears to scour the
walls of blood vessels, cleaning out excess cholesterol. It then carries that
excess cholesterol -- which otherwise might have been used to make the
"plaques" that cause coronary artery disease -- back to the liver for
processing. So when we measure a person's HDL cholesterol level, we seem to be
measuring how vigorously his or her blood vessels are being
"scrubbed" free of cholesterol.
HDL
levels below 40 mg/dL result in an increased risk of coronary atery disease,
even in people whose total cholesterol and LDL cholesterol levels are normal.
HDL levels between 40 and 60 mg/dL are considered "normal." However,
HDL levels greater than 60 mg/dL may actually protect people from heart
disease. Indeed, for several years, doctors have known that when it comes to
HDL levels, the higher the better. Click here for a quick review
of cholesterol and triglycerides.
How can We Increase Our HDL Levels?
Aerobic exercise. Many people don't like to hear it, but regular aerobic
exercise (any exercise, such as walking, jogging or bike riding, that raises
your heart rate for 20 to 30 minutes at a time) may be the most effective way
to increase HDL levels. Recent
evidence suggests that the duration of exercise, rather than the
intensity, is the more important factor in raising HDL choleserol. But any
aerobic exercise helps.
Lose
weight. Obesity results not
only in increased LDL cholesterol, but also in reduced HDL cholesterol. If you
are overweight, reducing your weight should increase your HDL levels. This is
especially important if your excess weight is stored in your abdominal area; your
waist-to-hip ratio is particularly important in determining whether
you ought to concentrate on weight loss.
Stop
smoking. If you smoke, giving up
tobacco will result in an increase in HDL levels. (This is the only advantage I
can think of that smokers have over
non-smokers -- it gives them something else to do that will raise their HDL.)
Cut out
the trans fatty acids. Trans
fatty acids are currently present in many of your favorite prepared foods --
anything in which the nutrition label reads "partially hydrogenated
vegetable oils" -- so eliminating them from the diet is not a trivial
task. But trans fatty acids not only increase LDL cholesterol levels, they also
reduce HDL cholesterol levels. Removing them from your diet will almost
certainly result in a measurable increase in HDL levels. Click here for a quick and
easy review of trans fatty acids and the heart.
Alcohol. With apologies to the American Heart Association, which
discourages doctors from telling their patients about the advantages of
alcohol: one or two drinks per day can significantly increase HDL levels. More
than one or two drinks per day, one hastens to add, can lead to substantial
health problems including heart failure -- and there are individuals who will
develop such problems even when limiting their alcohol intake to one or two
drinks per day. Click here for a quick and
easy review of alcohol and the heart.
Increase the
monounsaturated fats in your diet. Monounsaturated fats such as canola oil, avocado oil, or
olive oil and in the fats found in peanut butter can increase HDL cholesterol
levels without increasing the total cholesterol.
Add soluble fiber to your diet. Soluble fibers are found in oats,
fruits, vegetables, and legumes, and result in both a reduction in LDL
cholesterol and an increase HDL cholesterol. For best results, at least two
servings a day should be used.
Other dietary means to increasing HDL. Cranberry juice has been shown to
increase HDL levels. Fish and other foods containing omega-3 fatty acids can
also increase HDL levels. In postmenopausal women (but not, apparently, in men
or pre-menopausal women) calcium supplementation can increase HDL levels.
What about a low-fat diet?
While Americans traditionally have
ingested too much fat in the diet, and while limiting total fat in the diet is
useful not only for cholesterol control but also for weight reduction, evidence
is emerging that too little fat in the diet can be dangerous. A diet in which
fat has all but been eliminated can result in a deficit in the essential fatty
acids - certain fatty acids that are essential to life, but which the body
cannot manufacture itself. Furthermore, ultra-low-fat diets have been reported
to result in a significant reduction in HDL cholesterol in some individuals.
The
best advice regarding fat in the diet appears to be this: 1) reduce the fat
intake to 30 - 35% of the total calories in the diet - but probably no lower
than 25% of total calories; 2) try to eliminate saturated fats and trans fats
from the diet, and substitute monounsaturated and polyunsaturated fats instead.
(That is, eliminate animal and dairy fat, and substitute unprocessed vegetable
fats. Click here for a quick review
of the various types of fatty acids.) Such a diet will avoid the
problems seen with an ultra-low-fat diet, and should help raise HDL cholesterol
levels.
What about drugs for raising HDL cholesterol?
Drug therapy for raising HDL
cholesterol levels has, so far, been less successful than for reducing LDL
cholesterol. Statins,
in particular, are often not very effective at increasing HDL levels.
Of
the drugs used to treat cholesterol, niacin appears to be the most effective at
raising HDL levels. Niacin is one of the B vitamins. The amount of niacin
needed for increasing HDL levels are so high, however, that it is classified as
a drug when used for this purpose. Furthermore, "niacin" takes several forms, including nicotinic acid, nicotinamide,
and inositol hexaniacinate - and all of these are labelled as
"niacin." Unfortunately, only nicotinic acid raises HDL cholesterol,
and this drug can be difficult to take because of its propensity to cause flushing,
itching and hot flashes. In general, taking niacin to treat cholesterol levels
should be supervised by a doctor. ( Read
about niacin here.)
A
three-drug regimen of niacin,
cholestyramine, and gemfibrozil has been shown to increase HDL cholesterol
substantially, but this drug combination can be particularly difficult to
tolerate.
Now
that HDL levels are attracting more and more attention, several drug companies
are attempting to develop new drugs aimed specifically at increasing HDL. Unfortunately,
there have been early disappointments and it will be several years
before we can expect to see such drugs on the market.
Tell
us how you raised your HDL.
Raising your HDL levels can be a challenge, because it usually requires
lifestyle changes rather than simply taking a pill. So every bit of
encouragement we can give each other will help. Share with other readers what
you did to raise your HDL levels.
Click
on the link (under "Readers Respond," below) to participate.
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