Ways to Boost Your 'Good' Cholesterol

http://www.webmd.com/content/Article/115/111862.htm
By Elaine Magee, MPH, RD - WebMD Weight Loss Clinic

At the risk of sounding like a certain 20-something socialite, HDL is hot! Recent advances in research have brought more attention to the blood lipid (or fat) we often call "good" cholesterol.

"Good" cholesterol doesn't refer to the cholesterol we eat in food, but to the high density lipoprotein cholesterol circulating in our blood. It's one of the blood fats measured in the lipid panel blood test doctors perform. And it's the component you want more of, because increasing HDL helps lower your risk of heart disease.

A recent report from an expert panel of the National Cholesterol Education Program (NCEP) notes that although LDL or "bad" cholesterol has gotten most of the attention, there's growing evidence that HDL plays an important role.

Here are a few fast facts about "good" cholesterol from the NCEP panel:

* HDL cholesterol normally makes up 20%-30% of your total blood cholesterol.
* There's some evidence that HDL helps protect against the accumulation of plaques (fatty deposits) in the arteries.
* Research suggests that a 1% decrease in HDL cholesterol is linked to a 2%-3% increase in heart disease risk.
* In prospective studies - that is, studies that follow participants for a certain period to watch for outcomes -- HDL usually proves to be the lipid risk factor most linked to heart disease risk.
* HDL cholesterol levels are thought to have a genetic factor in some people.
* Women typically have higher HDL cholesterol levels than men. About a third of men and about a fifth of women have HDL levels below 40 mg/dL. (Doctors consider levels of less than 40 mg/dL to be low.)

Researchers from the Netherlands who analyzed 60 studies concluded that the ratio of total cholesterol to HDL (in which your total cholesterol number is divided by your HDL number) is a better marker for coronary artery disease than LDL measurement alone.

"Boosting HDL is the next frontier in heart disease prevention," says P.K. Shah, MD, director of cardiology at Cedars-Sinai Medical Center in Los Angeles. Shah says that if the new drugs designed to increase HDL levels prove effective, they could potentially reduce the number of heart attacks and strokes by 80% to 90% -- and save millions of lives. HDL-boosting drugs are now being tested.

How Does HDL Help?

Experts aren't yet sure exactly how HDL cholesterol helps reduce the risk of heart disease. But a few possibilities have emerged.

The NCEP says that high HDL levels appear to protect against the formation of plaques in the artery walls (a process called atherogenesis), according to studies in animals.

Lab studies, meanwhile, suggest that HDL promotes the removal of cholesterol from cells found in abnormal tissues, or lesions, in the arteries.

"Recent studies indicate that the antioxidant and anti-inflammatory properties of HDL also inhibit atherogenesis," says the NCEP report.