Dr. Roger S. Blumenthal Tells How to Raise Your Good Cholesterol—Naturally
Decades of research have shown that to prevent cardiovascular disease and heart attack, it’s probably just as important to have high levels of HDL cholesterol—the “good” cholesterol that protects arteries by removing excess LDL (“bad”) cholesterol from the bloodstream—as it is to have low levels of LDL.
Every one milligram/deciliter (mg/dl) increase in HDL levels may reduce risk of dying from coronary disease or heart attack by 2%. The latest guidelines from the National Heart, Blood and Lung Institute now call for an HDL level of at least 40 mg/dl for men and 50 mg/dl for women. On average, women have HDL levels that are 10 points higher than men (this may be partly related to higher levels of estrogen).
Drug setback: The drug company Pfizer recently announced that it was stopping trials of its new HDL-boosting drug, torcetrapib, due to a higher number of deaths among those taking the experimental medication than among a control group.
LIFESTYLE CHANGES
Despite the failure of torcetrapib, there are a number of lifestyle changes and available medications that have been proven to safely boost your HDL levels. Their effectiveness will vary from person to person—mainly for genetic reasons.
1. Lose weight. Studies have shown that the higher a person’s body mass index, or BMI (weight in kilograms divided by height in meters squared), the lower his/her HDL cholesterol levels. So, if you’re overweight, trimming down will help raise your HDL. On average, HDL levels go up one mg/dl for every three kilograms (six and a half pounds) of weight that a person loses and keeps off. For best results, aim for a BMI of less than 25—and then remain stable at that weight, rather than fluctuating up and down. A free, easy-to-use BMI calculator can be found on the National Heart, Blood and Lung Institute Web site (www.nhlbisupport.com/bmi/bmicalc.htm).
2. Exercise. Regular exercise has been shown to raise HDL cholesterol, but it must be fairly vigorous—such as brisk walking or jogging—to have much effect. A brisk walk of 30 minutes (about two miles) each day or its equivalent may raise HDL levels five mg/dl, on average.
3. Eat sensibly. A diet high in omega-3 fatty acids can increase HDL cholesterol by as much as five mg/dl. For best results, eat several servings a week of foods rich in omega-3 fats, including cold-water fish—such as salmon and mackerel—shellfish and nuts (almonds, peanuts, walnuts, pecans). Also, consider using omega-3–rich oils when possible—for example, cook with canola oil.
You can also boost HDL levels by avoiding foods that are quickly converted into blood glucose, such as simple sugars, ready-to-eat sugary cereals, white potatoes and white bread, as well as foods containing trans fats (often called hydrogenated or partially hydrogenated vegetable oils on food labels), such as margarine, most store-bought baked goods and fast food. These foods tend to lower HDL.
4. Drink alcohol—in moderation. An analysis of existing research has found that drinking one ounce of alcohol a day (roughly the amount contained in two beers, two glasses of wine or two mixed drinks) boosts HDL cholesterol levels by an average of four mg/dl.
But don’t overdo it. For optimal cardiovascular health, experts advise drinking up to one alcoholic beverage per day for women and two alcoholic beverages per day for men. More alcohol than this starts to negatively affect heart health, because it raises levels of blood triglycerides (blood lipids), another risk factor for cardiovascular disease. Those at risk for alcohol addiction—people with a family history of alcoholism or a personal history of problem drinking—should avoid all alcohol, since this risk outweighs its potential health benefits.
5. Quit smoking. People who stop smoking cigarettes see an average HDL increase of four mg/dl. If you needed another reason to quit, here it is.
Bottom Line/Retirement interviewed Roger S. Blumenthal, MD, director, Ciccarone Preventive Cardiology Center at Johns Hopkins Hospital, and professor of medicine, Johns Hopkins School of Medicine, Baltimore. He is chairman of the American College of Cardiology Committee on Prevention of Cardiovascular Disease.
(Article originally published September 1, 2007)
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