July 14, 2016 
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Have you ever felt you have a superpower inside of you? Well, you do! Every single one of us does—it’s our High Density Lipoprotein (HDL).  What makes HDL a superpower? HDL particles in the blood- helps to clear out excess cholesterol from your arteries helping to reduce your risk of forming a blockage which could lead to a heart attack or stroke.1

HDL is made of different sized particles, but only some particles provide you with super powers. HDL-particles become “superheroes” when they are large.  Large HDL particles are most effective at removing excess cholesterol from the body. Knowing your level of HDL cholesterol is not the same as knowing whether you have enough large HDL particles. Even with the right amount of HDL cholesterol, if it is mostly in small particles of HDL, then it is too weak to remove the cholesterol effectively from your body.

In a nutshell, having too many small HDL particles can make your cholesterol results look good but you still have a risk for heart attack or stroke because the small HDL isn’t as protective.  Large HDL particles—your superpower—are important as they are big and strong enough to remove excess unhealthy  cholesterol before it builds up and creates a blockage (plaque).

Many factors can contribute to your risk of heart disease. Some are in your control and some are not.  Your age, family history, or history of heart disease is beyond your control.  However, the risk factors that you can influence such as—weight, smoking, and diet—have a significant impact on your HDL particle levels.

5 Tips to Increase Large HDL Particles

How can you increase the good kind of HDL cholesterol—your superpower?

  1. More aerobic exercise. Runners/marathoners tend to have higher HDL and it is no wonder why. HDL levels increase with moderate to high intensity aerobic exercise.  Studies also indicate that every 10-minute extension of exercise per session was associated with an additional increase in HDL levels.  The best rise in HDL was observed with duration of exercise of at least 20 minutes.2-3
  1. Replace unhealthy fats with healthy ones. Studies have shown that super low fat diets can actually drop your HDL levels.  In the past it was thought that a strict low fat diet approach was best for heart health.  More recently, studies have shown that a wide range of fat in the diet—even up to 40%—can still be healthy for the heart.4  The healthiest fats are those found in nuts, all natural nut butters, seeds, avocado, and fatty fish like salmon, trout or sardines.  Studies have shown using monounsaturated fats such as avocado, nuts (almonds, hazelnuts, peanuts), or plant based oils rich in monounsaturated fat can increase HDL levels.
  2. Stop smoking. This can have a huge impact on raising your HDL levels. Studies have shown HDL levels increased significantly with smoking cessation. 6  Stopping smoking can be very challenging, but you don’t have to go it alone.  There are a large number of support organizations that can help. Check out the https://www.smokefree.gov for some tips and resources on how to stop smoking.
  3. Lose weight. The more excess weight you lose, the more you improve your HDL. 7  Losing weight may also seem daunting and you may not know where to start.  Please read my blog on finding the right diet for you.  One of the most important steps you can take is to start journaling your food intake.  The simple process of writing down everything you eat and drink can help you increase your weight loss.  In one study, participants who kept a food journal as part of a nutrition intervention program lost double the weight com­pared to those who kept no record. 8  If you have had Boston Heart testing done, make sure you take advantage of the Boston Heart Lifestyle Program and utilize your personalized Nutrition and Life Plan.
  1. Reduce sugar intake and improve quality of carbohydrates you eat. Studies have shown that increased simple sugars and starches in the diet can lead to less than ideal lipid profiles, namely an increase in small, dense LDL and reduced HDL.  Low carbohydrate diets may have the opposite effect.9-10   A heart healthy approach is to focus on carbohydrate quality as well as quantity.  For example, choose brown rice over white rice to improve quality and manage the quantity by keeping your portion at 1 cup or less.  Following the American Heart Association guidelines for sugar—6 teaspoons (or 24 grams) per day for women and less than 9 teaspoons (or 36 grams) per day for men is a good way to reduce simple sugars. These two steps could benefit you by raising your levels of large HDL particles

Together, these lifestyle choices can bring out the “superhero” in you!  Improvements in your levels of large HDL particles provide a great way to measure the beneficial effects of your lifestyle changes on heart health.

References

  1. Expert Panel on Detection, Evaluation and Treatment of High Blood Cholesterol in Adults. Executive summary of the third report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). JAMA. 2001;285:2486–2497.
  2. Tambalis K, et al. Responses of blood lipids to aerobic, resistance, and combined aerobic with resistance exercise training: a systematic review of current evidence. Angiology. 2009;60(5):614-32.
  3. Kodama S, et al. Effect of aerobic exercise training on serum levels of high-density lilpoprotein cholesterol: a met-analysis. Arch Intern Med. 2007;167:999-1008.
  4. Estruch T, et al. Primary prevention of cardiovascular disease with a Mediterranean diet. N Engl J Med 2013;
  5. Schaefer EJ. Lipoproteins, nutrition and heart disease. Am J Clin Nutr 2002;75:191-212.
  6. Maeda K, et al. The effects of cessation from cigarette smoking on the lipid and lipoprotein profiles: a met-analysis. Prev Med. 2003;37(4):283-90.
  7. Dattilo AM and Kris-Etherton PM. Effects of weight reduction on blood lipids and lipoproteins: a meta-analysis. Am J Clin Nutr. 1992;56(2):320-8.
  8. Hollis et al. Weight Loss During the Intensive Intervention Phase of the Weight-Loss Maintenance Trial. Am J of Preventive Med. 2008; 35(2): 118-126.
  9. Dansinger, et al. Comparison of the Atkins, Ornish, Weight Watchers, and Zone Diets for Weight Loss and Heart Disease Risk Reduction. JAMA 2005;293(1):43-53.
  10. Siri PW and Krauss RM. Influence of Dietary Carbohydrate and Fat on LDL and HDL Particle Distributions.  Dept Atherosclerosis Research. 2005;7(6):455-9.
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Clinical and Science, Health and Wellness