How Increasing Your HDL Levels May Benefit Your Overall Longevity

By Dale Mayo, January 10, 2024

Cholesterol, a waxy substance that travels through the blood, helps your body build cells and make vitamins and other hormones. The two sources of cholesterol are your liver, which produces cholesterol, and the food you eat (cholesterol is in animal products like meat, poultry, and dairy products). Some oils (palm, palm kernel, and coconut) are high in saturated fat that can cause your liver to make more cholesterol than it normally would.

There are two types of cholesterol:

• LDL (low-density lipoprotein) cholesterol, sometimes called “bad” cholesterol, makes up most of your body’s cholesterol. High levels of LDL cholesterol raise your risk for heart disease and stroke.
• HDL (high-density lipoprotein) cholesterol, sometimes called “good” cholesterol, absorbs cholesterol in the blood and carries it back to the liver. The liver then flushes it from the body. High levels of HDL cholesterol can lower your risk for heart disease and stroke.

Triglycerides are fats in your blood from foods like butter. Cholesterol is not fat and does not dissolve in blood -- rather, your liver packages cholesterol with triglycerides and proteins (called lipoproteins), which move the fatty mixture to areas throughout your body. Your body converts any calories, alcohol, and sugar that it doesn't need to use right away into triglycerides which are stored in fat cells. When your body needs energy, hormones will release triglycerides. High levels of triglycerides in your blood can lead to a higher risk of heart and vascular disease. Pure cholesterol does not dissolve in blood -- rather, your liver packages cholesterol with triglycerides and proteins called lipoproteins, which move the fatty mixture to areas throughout your body.

The National Heart, Lung, and Blood Institute recommends a first cholesterol screening between the ages of 9 and 11 and repeated every 5 years after that. Earlier or more-frequent screenings may be suggested for families with a history of childhood heart disease. A lipid panel measures HDL cholesterol, LDL cholesterol, and triglycerides. VLDL (very low-density lipoprotein) cholesterol may also be present in very low amounts if the sample is from a fasting client. The range of cholesterol levels tested in a standard lipid panel is shown in the graphic below.

An abnormal lipid panel result doesn’t necessarily mean you need treatment. While cholesterol and triglyceride levels can play a significant role in your overall health, many other factors contribute to your risk for cardiovascular disease. Talk to your healthcare provider about your health, diet, exercise, and other factors (e.g., smoking, alcohol consumption), and family history to help determine whether lifestyle changes and/or medical treatment may be beneficial. Health conditions that may lead to abnormal cholesterol are diabetes, kidney disease, polycystic ovary syndrome, pregnancy (and other conditions that increase levels of female hormones), or an underactive thyroid gland. In addition, some medications can affect cholesterol levels, including birth control pills, diuretics, beta-blockers, and some medicines used to treat depression. Smoking can reduce your HDL cholesterol levels.

How Cholesterol and Triglycerides Work in Your Body

If you have too much LDL cholesterol in your system, the LDL cholesterol can build up on the walls of your blood vessels as “plaque,” which can cause heart disease and stroke. About 38% of American adults have high cholesterol (also known as lipid disorder, hyperlipidemia, or hypercholesterolemia). For many people, high cholesterol levels may come from a diet high in fat, being overweight, and lack of exercise. Some people may have inherited a gene that causes familial hypercholesterolemia and may need to take one or more medications to control their LDL levels.

HDL cholesterol removes extra cholesterol from the arteries by gobbling up early-forming plaque and transporting it to the liver, which flushes it out of the body. Unfortunately, HDL removes only about a third or a quarter of your blood cholesterol. While we can currently measure how much HDL cholesterol we have in our bodies, we don’t have a way of testing how well it is functioning.

High Triglyceride levels are associated with several factors, including being overweight, eating too many sweets or drinking too much alcohol, smoking, being sedentary, or having diabetes with elevated blood sugar levels. Triglyceride levels are considered to be healthy below 150 mg/dL for adults (lower than 90 mg/dL for children and teens); borderline high between 150-190 mg/dL; high between 200 and 499 mg/dL; and very high 500 and above.

Healthy Habits to Reduce Heart Disease Risk

The bullets below are healthy habits suggested by the Mayo Clinic as ways to reduce your risk of heart disease and possibly lower your cholesterol.

Research into cholesterol and cardiovascular disease has resulted in medical treatments focused on reducing LDL levels. The drugs used to reduce LDLs are statins that draw cholesterol out of plaque (the waxy buildup of cholesterol deposits in the walls of arteries that can lead to heart attack and stroke). According to Johns Hopkins cardiologist Michael Blaha, M.D., statins were originally viewed as purely cholesterol-lowering drugs, but because they also benefit people with lower levels of cholesterol who are at a high risk of heart disease, statins are now viewed as risk-reducing drugs.

Can Raising Your HDL Cholesterol Level Lower Your Risk of Cardiovascular Diseases and Increase Longevity?

Scientists are also interested in whether high levels of HDLs may offset high levels of LDLs and whether high levels of HDLs may offer some protection from various diseases in general. Recently, drugs have been developed that increase the amount of HDL in the blood, but disappointingly failed to reduce the risk of cardiovascular disease and were never brought to market.

There are potentially 200 different protein-defined HDL subspecies that function differently from each other in the body. The Harvard Chan School of Public Health found that recently, we’ve been studying 16 out of the potentially 200 or so different protein-defined HDL subspecies and found that while some are associated with a reduced risk of cardiovascular disease as you’d expect, some show no association or are even associated with increased risk.

Studies that challenge the accepted benefit of high levels of HDL cholesterol include those examining the differences in degrees of protection based on sex and race. For example, in a review of data from almost 24,000 adults in the U.S. (Reasons for Geographic and Racial Differences in Stroke Study), researchers looked at cholesterol levels from Black and white middle-aged adults from across the country without heart disease and follow up on future cardiovascular events. Although low levels of HDL cholesterol predicted a higher risk of heart attacks for white adults, this did not hold true for Black adults – nor were higher HDL cholesterol levels associated with reduced cardiovascular disease risk for either group. A nationwide cohort study of South Koreans showed a difference in the 10-year mortality rate between men and women with high HDL levels: HDL-C levels >90 mg/dL increased the risk of 10-year all-cause mortality by 35.9% in males and 9.5% in females compared to reference levels (40–90 mg/dL in males, 50–90 mg/dL in females).

The Harvard Chan School study underscores “the need to learn more about HDL subspecies to find out what functions these proteins perform. HDL isn’t just a cholesterol transporter. It also has anti-inflammatory, antioxidant, immunological, and other actions that affect disease risk. We need to find out which HDL subspecies are protective and which ones are detrimental. Once we know that, we can work to produce therapies that will target increases of the good types of HDL or reductions of the bad. And it’s not just drug therapies. Our group will soon publish new research on the effects of healthy diets associated with reduced risk of heart disease that increase HDL cholesterol, and do so by increasing the good HDL subspecies and not the bad.”

This need for more information is recognized across disciplines. The International Journal of Molecular Sciences will soon devote a special issue to High-Density Lipoproteins in Health and Disease. According to the information provided in the call for papers for the special issue, recent data demonstrated that low levels of HDL and/or the presence of dysfunctional particles may contribute to the development of such diseases as neurodegenerative disorders, cancer, autoimmune diseases, pathogen-driven pathologies, and acute organ injuries. Research to understand how HDL work and of which components of the particles are involved may lead to new treatment approaches targeting HDL.

Finally, the Harvard Chan School promises that “our group will soon publish new research on the effects of healthy diets associated with reduced risk of heart disease that increase HDL cholesterol, and do so by increasing the good HDL subspecies and not the bad.”

Foods to Raise Your Good HDL Cholesterol

In the meantime, here’s what we know about how you can lower your LDL levels and raise your HDL levels with healthy foods.

• Eat unsaturated fats that you find in vegetable oils (especially extra virgin olive oil), oily fish, nuts, seeds, and some vegetables. Eat less food high in saturated fats (meat and dairy products) and trans fats (baked goods made with partially hydrogenated vegetable oils).
• Eat fiber such as the soluble fiber in oatmeal and fruits.
• Eat plant sterols and stanols which are naturally occurring plant compounds similar in structure to cholesterol. When you eat them, they help limit the amount of cholesterol your body can absorb. Plant sterols and stanols are found in an increasing number of food products such as spreads, juices, and yogurts.
• Find a diet that works for you. There are many diets that can help reduce LDLs and increase HDLs, but unless you like what you’re eating, you most likely will not stick with it.

Sizzlefish offers several kinds of salmon, one of the best fish to eat to raise your good HDL levels.

References

1. American Heart Association - About Cholesterol
2. Centers for Disease Control and Prevention - LDL and HDL Cholesterol
3. Cleveland Clinic - Triglycerides
4. Mayo Clinic - Triglycerides
5. Cleveland Clinic - Triglycerides
6. Mayo Clinic - Familial Hypercholesterolemia
7. Penn Medicine - High Cholesterol
8. Centers for Disease Control and Prevention - LDL and HDL Cholesterol
9. UPMC - Hypercholesterolemia
10. Penn Medicine - High Cholesterol
11. Mayo Clinic - Familial Hypercholesterolemia
12. The Heart Foundation - HDL Cholesterol: Good or Bad?
13. National Heart, Lung, and Blood Institute - Updated Test Measures How Well Good Cholesterol Works
14. Rohatgi, A., Khera, A., Berry, J.D., Givens, E.G., Ayers, C.R., Wedin, K.E., Neeland, I.J., Yuhanna, I.S., Rader, D.R., de Lemos, J.A., and Shaul, P.W. (2014). HDL Cholesterol Efflux Capacity and Incident Cardiovascular Events. N Engl J Med 2014; 371:2383-2393.
15. Mayo Clinic - Cholesterol Test
16. National Heart, Lung, and Blood Institute - High Blood Triglycerides
17. Mayo Clinic - High Blood Cholesterol
18. Johns Hopkins Medicine - How Statin Drugs Protect the Heart
19. Blanding, M. (2022). Why Good Cholesterol May Not Always Be Good. Harvard School of Public Health.
20. Blanding, M. (2022). Why Good Cholesterol May Not Always Be Good. Harvard School of Public Health. "In particular, we found that HDL that contains a protein called apolipoprotein C3 (apoC3) is associated with a higher risk of cardiovascular disease, including stroke and heart attack, and type 2 diabetes. We also found that HDL that contains Complement C3 or alpha-2-Macroglobulin (α2M) is also associated with higher risk. HDLs that lack these proteins are more protective than total HDL. Conversely, HDL that contains apolipoprotein E (apoE) or apolipoprotein C1 (apoC1) is more protective against heart disease."
21. Study: Zakai, N.A., Minnier, J., Safford, M.M., et al. (2022). Race-Dependent Association of High-Density Lipoprotein Cholesterol Levels with Incident Coronary Artery Disease. J Am Coll Cardiol. 2022; www.doi.org/10.1016/j.jacc.2022.09.027
22. Yang, H.S., Jeong, H.J., Kim, H., Lee, S., Hur, M. (2023). Sex-Specific Relationships Between HDL-Cholesterol Levels and 10-Year Mortality in Individuals with Atherosclerotic Cardiovascular Disease: A Nationwide Cohort Study of South Koreans. Metabolites 2023, 13, 1175.
23. Blanding, M. (2022). Why Good Cholesterol May Not Always Be Good. Harvard School of Public Health.
24. International Journal of Molecular Sciences - Special Issue: HDL in Diseases
25. Blanding, M. (2022). Why Good Cholesterol May Not Always Be Good. Harvard School of Public Health.
26. Harvard Health Publishing - 4 Ways to Eat Your Way to Lower Cholesterol