Why Is Some Cholesterol Considered "Good"?

Although it is extremely important to the human body, cholesterol has been given a bad reputation. Cholesterol is needed for the formation of cell membranes, Vitamin D and hormones in both men and women, and is part of the bile acids that work to digest food in the intestines. It consists of LDL (low-density lipoprotein), HDL (high-density lipoprotein) and triglycerides. At annual check-ups, physicians may take a blood sample to run a lipid profile. Each cholesterol molecule is called a lipid. A lipid is a water-soluble, waxy substance that is incapable of dissolving in water or blood, and because of this cannot move naurally within the bloodstream. These lipids need help traveling to organs and tissues throughout the human body.

To facilitate their journey, cholesterol connects with protein, forming a lipoprotein. When lipoproteins have more protein than cholesterol, they accelerate through your body without interruption. Its task is to remove cholesterol from the blood stream, from LDL and from artery walls, until it reaches the liver. Once within the liver, the lipoprotein is broken down and converted into bile acids. These high-performing, high-density lipoproteins are called HDL, sometimes referred to as “good” cholesterol. Approximately, one-fourth to one-third of blood cholesterol is carried by high-density lipoprotein (HDL) throughout the human body. HDL cholesterol not only removes LDL or “bad” cholesterol, but experts believe that it also reduces, reuses and recycles LDL once it arrives at the liver where it can be reprocessed. It’s also believed by health professionals that HDL cholesterol scrubs the inner walls of blood vessels in an attempt to keep them healthy.

However, when a lipoprotein forms with more cholesterol than protein it’s called a low-density lipoprotein or “bad” cholesterol. These lipoproteins or LDL can have tremendous difficulty with the trip through the body. Cells with certain receptors latch on to these lipoproteins as they travel through the blood stream. When there is too much LDL in the blood stream, deposits can form in the walls of the coronary arteries and other arteries throughout the body. This deposit, referred to as plaque, narrows and hardens along these blood vessel walls, making it impossible for blood to flow. Plaque, over time, can build up and cause a blood clot to form, blocking the artery completely.

What is the ideal ratio of LDL to HDL?

The American Heart Association recommends that anyone 20 years of age or older have a lipoprotein profile completed once every five years. This test can be done after a nine- to 12-hour fast without food, medication or liquids.

When cholesterol is checked, a patient receives one number for the total cholesterol, a number for the HDL level, and a number for the LDL level. Test reports show your cholesterol levels in milligrams per deciliter of blood (mg/dL).

Cholesterol ratios are determined by dividing the total cholesterol number by the HDL or good cholesterol number. So, let’s say that your total cholesterol number is 180 and you HDL is 45. The total cholesterol ratio would be 4:1. The American Heart Association recommends an ideal cholesterol ratio at or below 5:1, with the ideal cholesterol ratio at 3.5:1.

What are ways to increase good cholesterol?

Before anyone can increase their good or HDL cholesterol, it’s helpful to get a cholesterol check. With a cholesterol check, blood is drawn and analyzed for three different items: HDLs, LDLs, and triglycerides (a type of naturally produced fat triggered by smoking, drinking, obesity or bad diet). For both men and women, an HDL level of 60 mg/dL or higher is recommended. A number of small lifestyle changes can help increase your HDL levels naturally, including:

• Regular physical activity. Reports have found that people who have been mostly sedentary have seen their HDL cholesterol levels increase by 5 percent when they participated in consistent aerobic exercise within a two-month period. The ideal amount of exercise to work out, whether it’s biking, running, swimming or yard work, is for 30 minutes five times a week. If it elevates your heart rate for a significant amount of time, you can see your HDL levels increase. Be sure to talk to your physician before engaging in any exercise program, especially if you’ve maintained a more sedentary lifestyle.
• Dropping some weight. Carrying extra weight can decrease HDL levels. Losing even a few pounds can increase HDL levels, and for every 6 pounds lost, you can expect an increase of 1 mg/dL. If you also eat healthy foods and participate in exercise regularly, you can further increase your HDL levels, as well.
• If you drink alcohol, drink in moderation. Drinking alcohol in moderation has been linked to higher levels of HDL; however, the key here is moderation. Moderation for healthy adults means one drink a day for women and two drinks a day for men. If you don’t drink, don’t start just to lower your HDL levels.
• Quitting tobacco. Smoking, and even second-hand smoke can be dangerous to your health. Quitting smoking has been shown to raise HDL cholesterol levels.

Medications that are prescribed to lower LDL cholesterol can also increase HDL cholesterol. It’s important to remember that even if your physician has prescribed medication, it doesn’t mean you can forego the changes you’ve made towards a healthier lifestyle.

• Statins. Statins block substances that help the liver make cholesterol. They basically forces the liver to remove cholesterol directly from the blood, since cholesterol has now been reduced in the liver. They can also help your body reabsorb plaque that has built up from your blood vessel walls.
• Fibrates. Fibrates like fenofibrate (Lofibra, Tricor) and gemfibrozil (Lopid) can help increase your HDL cholesterol level. Fibrates work by activating a gene that allows the body to produce more of the two main elements of HDL cholesterol. When triggered, the gene causes triglycerides to lower as well. Some reports indicate that fibrates can actually raise HDL levels by as much as 10 to 15 percent.
• Niacin. Prescription niacin is preferred, although over-the-counter preparations are available. Dietary supplements carrying niacin have been found ineffective in lowering triglycerides and increasing HDL levels.