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CHOLESTEROL / HDL
It has long been understood that elevated LDL ("bad") cholesterol increases the risk of heart disease. In 2003 health authorities (NCEP) announced new, lower recommended goal levels for LDL, especially for patients with known cardiovascular disease or diabetes. If you are one of my patients, you are probably already on appropriate cholesterol-lowering medication and thus in full compliance with the new LDL guidelines.
There is another type of cholesterol, HDL ("good" cholesterol), that seems to actually remove existing cholesterol deposits from artery walls. In the past few years there has been mounting evidence that having higher levels of HDL cholesterol (above 40) can further decrease cardiac risk even when the LDL levels are well within the recommended guidelines. The higher you can get your HDL, the lower will be your risk.
Unfortunately, even our best cholesterol-lowering medicines raise HDL levels only slightly and sometimes even lower HDL; so we must often resort to other methods to raise HDL to "safer" levels. Here are several ways you can raise your HDL:
- Aerobic Exercise (a daily 30-minute walk is adequate) will raise HDL several points
- Weight Loss will raise HDL
- Smoking Cessation will raise HDL
- Omega-3 Fatty Acids help raise HDL (eat 2 servings of fish per week or take Fish Oil capsules twice daily).
- Reduce Fat intake to no more than 30-35% of daily calories
- Minimize "Trans Fatty Acids" (called "partially hydrogenated vegetable oils" on nutrition labels) - high levels found in fried foods, fast foods, packaged baked goods
- Use "Monounsaturated Fats" in your diet (canola oil, olive oil)
- Add Soluble Fiber to your diet (oats, fruits, vegetables, and legumes)
- Alcohol - one drink a day will raise HDL levels
- Niacin can raise HDL if taken in high enough doses (unfortunately high doses of Niacin can sometimes produce flushing, headaches, and other unpleasant symptoms; so niacin should be taken only at bedtime)
Although all of these techniques can produce some improvement in HDL, my favorites are weight loss and regular aerobic exercise because of all their other benefits. Please visit the Fitness Section of this web site for more information.
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