HDL – Quality May Matter More Than Quantity
"Lower your LDL bad cholesterol. Raise your HDL good cholesterol." For years, that’s what doctors nationwide have advised their patients.
And certainly, it’s vital for heart health to lower LDL levels. The research is indisputable.
But in recent years, a growing body of data, particularly a new study published last week, is causing scientists to question the "goodness" of raising HDL.
Focus on lowering your LDL bad cholesterol, "and don’t worry about the HDL," advises Dr. Barnard.
The study, published online in The Lancet and led by researchers at Massachusetts General Hospital, M.I.T., and Harvard, utilized powerful new databases of genetic information. They found that people who inherited DNA that gave them naturally higher HDL levels throughout their lives had no less cardiovascular disease than people with genes that gave them slightly lower levels of HDL. *
"I have long questioned the assertion that HDL is unequivocally a ‘good’ cholesterol," commented R. James Barnard, PhD, of UCLA Department of Integrative Biology and Physiology, and author of more than 190 studies on lifestyle and disease.
"For starters, epidemiological data do not match up." Studying populations throughout the world where heart disease is rare, scientists have found that LDL levels are indeed very low, but so are HDL levels – often 20 to 30 mg/dL.
Moreover, recent research has found that the quality of HDL in our blood can change. A saturated-fat-rich diet can foul up the ability of HDL to protect against damage to arteries, turning HDL from "good" (anti-inflammatory) to "bad" (pro-inflammatory) cholesterol.
Dr. Barnard and colleagues have made similar discoveries in their laboratories at UCLA.
"Our research from men attending the Pritikin Longevity Center revealed that pre-Pritikin, the men had HDL levels that were quantitatively normal, but their HDL was pro-inflammatory.
"Post-Pritikin, the men’s HDL had converted to anti-inflammatory despite the fact that total HDL had gone down a little."
"Our work indicates that the Pritikin lifestyle improves the quality of HDL while dramatically lowering the bad LDL cholesterol," sums up Dr. Barnard.
Bottom Line:
Focus on lowering your LDL bad cholesterol, "and don’t worry about the HDL," advises Dr. Barnard.
For lowering LDL, what you eat matters in a very big way. Reduce saturated fatty acids, hydrogenated fats, trans fatty acids, and cholesterol in your diet. And increase dietary fiber in the form of whole, nutrient-rich foods like fruits, vegetables, whole grains, and beans.
When it comes to HDL cholesterol, the story, at least right now, is a lot more complicated. More research is needed. Scientists, in particular, need to probe further into the quality of HDL in the blood. When is HDL pro-inflammatory? When is it anti-inflammatory? And will improving the quality of HDL provide protection from heart disease?
Finally, what’s most important is focusing on a heart-healthy lifestyle like Pritikin. Pritikin living will not only lower LDL levels dramatically and reduce risk of heart disease, it will also reduce risk of many other diseases, including Type 2 diabetes, hypertension, and many forms of cancer.
Numbers matter, to be sure. But overall good health – and a healthy lifestyle – matters most of all.
* http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(12)60312-2/abstract
