Making sense of cholesterol: the good and the bad
When you hear someone talking about cholesterol, it’s generally from a pretty negative perspective.
After all, high cholesterol levels are directly linked to serious issues like high blood pressure and atherosclerosis, and it ranks among the top contributors to heart disease and strokes according to the World Health Organization. So it’s no wonder that when we talk about improving our cholesterol, we usually frame it in the context of bringing those levels as far down as we can.
But if you’re on the quest to improve your heart health, it’s also important to make a distinction between the kinds of cholesterol that are present in your body. Because while high levels of certain kinds of cholesterol are definitely not great for your cardiovascular system, there’s also a type of cholesterol that you actually want more of.
Let’s talk about HDL, aka the “good” kind of cholesterol.
Which type of cholesterol is good?
Cholesterol is a type of fat that is created by your liver, although your cholesterol levels can also increase from both your diet and lifestyle. It’s an important component in your body, doing jobs like helping you digest certain nutrients and acting as a precursor for important hormones. As such, it’s a crucial nutrient that needs to be delivered to cells throughout your entire body via your bloodstream.
But there are several different kinds of cholesterol that you can find in your body, and not all of them are created equal.
The major difference between different types of cholesterol is how they’re “packaged.” See, cholesterol is a fatty, waxy substance, and that means that it’s hydrophilic — and if you refer back to your middle school science classes, this means that it does not mix well with water. Because the majority of your blood plasma is made of water, this presents an issue.
So cholesterol can’t travel through your bloodstream on its own: instead, it needs to be combined with proteins that can move freely through water in order to get delivered to all the cells in your body that need it. Because of this, cholesterol is packaged into different cholesterol-protein compounds called lipoproteins.
The different kinds of lipoproteins contain varying ratios of protein and cholesterol, which affects their density. If you have too much low-density cholesterol traveling through your bloodstream, it can cause major problems for your cardiovascular system down the line. Those fatty substances can accumulate, block blood flow, and lead to serious issues over time like heart disease, strokes, and heart attacks.
This is where having enough “good” cholesterol circulating in your system becomes so important.
High-density lipoproteins, or HDL, can be thought of as a “cleaning crew”. These compounds contain more protein than cholesterol, which makes them more dense and heavy than other kinds of cholesterol. This is what makes them so “good”: they go around collecting cholesterol and carrying it back to your liver, where it can then be flushed away. They’re also thought to have antioxidant and anti-inflammatory properties, which can further protect your heart from cell and tissue damage.
So your ratio of “good” to “bad” cholesterol really matters here! It’s believed that higher levels of HDL can ultimately reduce your risk of developing heart disease. So ideally, you want to increase your HDL levels in addition to decreasing the “bad” cholesterol in your system if you’re looking to give your heart all the tools it needs to stay healthy.
What are the other types of cholesterol commonly tested?
Of course, having a high amount of HDL on its own does not mean that you have a clean bill of health in terms of your cholesterol. Most cholesterol tests (otherwise known as “lipid panels”) will test for not only your HDL levels, but for some of the other important information like your LDL levels, total cholesterol, and triglyceride levels.
If HDL is the “good” cholesterol, then LDL (low-density lipoproteins) can be considered the “bad” kind of cholesterol. As opposed to HDL, LDL particles contain more cholesterol than proteins, which makes them lighter and fluffier. They are therefore the kind of cholesterol that are more likely to stick to the sides of your arteries as they travel along through your bloodstream.
If LDL is allowed to accumulate in your arteries and isn’t being carried away and “cleaned up” by HDL, it can eventually harden and form a plaque. This hardening of the plaque on the sides of the arteries is called atherosclerosis, and it can lead to high blood pressure, blood clots, strokes, and heart attacks.
Your total cholesterol reading sums up the combination of all the different kinds of cholesterol you have in your body, including LDL and HDL. Knowing how much total cholesterol is in your body can give you a good gauge of your overall heart and metabolic health.
Your triglycerides are not a type of cholesterol per se, but because they play such an important role in your overall heart health they are also often included in cholesterol blood tests to get a comprehensive bigger picture of your risk for heart disease.
What are good cholesterol levels?
For adults over the age of 20, good cholesterol levels should look something like this:
>50 mg/dL (women) and >40 mg/dL (men)
Cholesterol levels that are too high can be an indicator that you are at a higher risk for developing cardiovascular complications down the line.
How to test your cholesterol levels from home
Because your cholesterol levels are so important, it’s a good heart-healthy habit to be proactive and get them tested regularly. High overall cholesterol levels and inadequate HDL levels usually don’t have any overt, detectable signs that you can feel. Unfortunately, this means that you aren’t likely to know if your cholesterol levels are elevated until you suffer a cardiac event.
Everyone should be testing their cholesterol levels regularly (even children!). But you are at even more risk for elevated cholesterol levels if you are older, smoke, or have a family history of high cholesterol and/or heart disease. Your dietary choices and activity level could also play a role since these lifestyle choices can directly impact your cholesterol levels. For example, some people who follow the keto diet may find their cholesterol levels are affected due to the high intake of dietary fat involved.
In recent years, you would have to go to a doctor to get a cholesterol test. But now, at-home lab testing makes it easy, convenient, and relatively painless to get a glimpse into your lipid panel without big blood draws or doctor visits. Base’s At-Home Diet Test allows you to keep track of both your good and bad cholesterol, as well as your overall lipid profile. With a convenient finger prick, you’ll get quick access to your cholesterol levels, get tailored suggestions for improving your results, and have the ability to track your progress over time.
How to improve cholesterol levels
When doctors and health professionals talk about improving your cholesterol, this doesn’t just mean bringing down the amount of “bad” cholesterol (LDL) you have circulating in your blood. It also means finding ways to increase your HDL.
So improving your cholesterol levels is a multifaceted issue, and you can approach it from several different angles including taking a look at your diet and your lifestyle choices.
Limit your saturated and trans fats intake.
Dietary fat intake is one of the first culprits we look at when we have high cholesterol levels. But as it turns out, dietary fat in and of itself isn’t necessarily the issue. The kinds of fat that you’re eating, and the amount of each that you regularly ingest, can all affect your cholesterol in different ways.
Saturated fats, which can be found in many animal products like meat, butter, and dairy, can raise your LDL levels. Similarly, trans fats found in processed and fried foods can both raise your LDL and decrease your HDL. So if you want to make your diet as heart-healthy as possible, this generally means limiting your saturated fat intake to as low as you can and avoiding trans fats altogether.
But on the other hand, there are also other fats that can be good for your heart health. Choosing unsaturated fats more often can help improve your cholesterol levels. This can include plant-based fats that are liquid at room temperature, like olive and canola oils. Other good examples of heart-healthy fat are omega-3 fatty acids, which you can find in oily fish, as well as walnuts, chia seeds, and flaxseeds. Choosing these healthy fats more often is a better choice for your heart since they won’t increase your bad cholesterol.
Bulk up on your plant-based foods.
Eating less processed foods and more fruits and vegetables is a great way to improve your cholesterol levels because of how nutrient-dense they are. Plant-based foods are high in necessary nutrients like fiber, antioxidants, vitamins, minerals, and healthy fats that are great for your heart and your overall health.
In fact, a meta-analysis of several studies and trials investigating the relationship between vegetarian diets and cholesterol found that plant-based diets were effective at decreasing total cholesterol, LDL, and HDL levels. Another review found that several studies showed that plant-based diets were associated with lower cardiovascular risks.
You don’t have to eliminate meat products altogether if you don’t want to make that commitment; simply eating fewer animal products and more plant foods is a step in the right direction.
Staying active with regular physical activity is one of the best things that you can do for your heart. Not only does it make your heart work hard to pump blood throughout your entire body, but it can also directly affect your cholesterol levels by encouraging LDL to move to the liver to be disposed of (rather than sitting in your arteries and accumulating to dangerous levels).
There’s also evidence that the intensity of your exercise matters: doing high-intensity and vigorous exercise lowers LDL levels more than moderate-intensity exercises and can even increase HDL levels at the same time.
Aim to increase your physical activity by incorporating some moderate or heavy cardiovascular exercise like brisk walking, jogging, or running. Consistency is also key if you want to make a lasting impact on your cholesterol. You should try exercising several times a week for the best results.
If you’re a regular smoker but are concerned about your cholesterol levels, quitting is one of the most impactful actions that you can take to improve your heart health.
Smoking can both increase your LDL levels and decrease your HDL levels, and it can also damage your blood vessels in the process. On the bright side, one study found that quitting smoking led to improved HDL levels in participants’ lipid panels even if they gained some weight in the process.
Take a look at your weight.
Finally, it may be a good idea to lose excess weight to minimize your risk of heart disease. Being overweight or carrying excess body fat can both increase your LDL production and decrease your HDL levels, and both of these factors can increase your cardiovascular risk over time.
Losing weight requires being in a caloric deficit. Watch your portions, choose lower-calorie but nutrient-dense foods more often, and increase your physical activity for healthy and sustainable weight loss.
There’s a difference between “good” and “bad” cholesterol, and both kinds need attention if you want to improve your heart health. Familiarizing yourself with the different kinds, and participating in heart-healthy activities and dietary changes can help minimize your risk for heart disease and other life-changing chronic ailments.