Your liver produces enough cholesterol for the body to function effectively, but certain foods—primarily animal products, like eggs, dairy, and meat—also contain cholesterol.
There are two types of lipoprotein that carry cholesterol to and from cells: high-density lipoprotein (HDL) and low-density lipoprotein (LDL).
HDL is considered the “good” cholesterol because a healthy level may protect you from cardiovascular disease. On the other hand, LDL is considered the “bad” cholesterol because it contributes to fatty buildup (plaque) in your arteries.
HDL vs. LDL Cholesterol
HDL cholesterol contains a higher proportion of protein and is made up of substances that don’t lead to plaque buildup in your arteries. High-density cholesterol also carries LDL cholesterol away from the arteries back to the liver, where it’s broken down and eliminated from the body.
On the other hand, LDL cholesterol has a higher cholesterol and lower protein composition. When there’s an excess of LDL cholesterol from consuming a diet high in calories and fat, excess LDL cholesterol seeps through artery walls and oxidizes (combines with oxygen).
When oxidation occurs, macrophages (white blood cells) consume the oxidized LDL cholesterol in the artery wall and die, leading to inflammation in the artery walls. The body is then triggered to block the increasing macrophage by creating tissue in the artery walls called plaque, resulting in atherosclerosis.
HDL Cholesterol Levels
Medical experts recommend that you get a lipid panel to check your cholesterol levels starting at age 20 and every five years after that. If you’re at high risk of developing heart disease, your healthcare provider may suggest a yearly panel to monitor your HDL and LDL cholesterol levels.
Total cholesterol (HDL, LDL, and triglycerides) should fall under 200 mg/dL. HDL cholesterol should be more than 55 mg/dL for women and more than 45 mg/dL for men. LDL cholesterol should be under 130 mg/dL. However, if you have heart or blood vessel disease, diabetes, or high total cholesterol, your LDL cholesterol should be less than 70 mg/dL.
When your HDL cholesterol levels are so low that they’re unable to transport cholesterol to the liver to flush it out, you are at higher risk of plaque buildup and blockages of your blood vessels.
HDL and Heart Attack
Low levels of HDL cholesterol are generally linked to a higher risk of coronary heart disease, which is caused by plaque buildup in the walls of the arteries that supply blood to the heart. In addition to its protective role in the transport of excessive cholesterol to the liver, HDL cholesterol may also help protect you against atherosclerosis.
However, recent research questions whether HDL cholesterol really protects against atherosclerotic cardiovascular disease. One study showed that increased HDL cholesterol levels caused by certain genes are not necessarily associated with lower incidence of cardiovascular events.
People with HDL cholesterol levels greater than 60 mg/dL had a nearly 50% increased risk of dying from a cardiovascular cause or having a heart attack compared to those with HDL cholesterol levels 41–60 mg/dL.
Risks of Low HDL
A 2016 study found that low HDL cholesterol levels were linked with an increased risk of cardiovascular disease. However, low HDL cholesterol in isolation is considerably less predictive of cardiovascular disease risk in the presence of high triglycerides, high LDL cholesterol, or both.
How to Raise Good Cholesterol
The key to raising HDL cholesterol is lowering LDL cholesterol. The American College of Cardiology and American Heart Association recommend the following for increasing your HDL cholesterol level:
- Following a plant-based or Mediterranean eating plan that includes fruits, nuts, vegetables, legumes, and lean meats (preferably fish)
- Avoiding saturated and trans fats, and limiting processed meats
- Avoiding sugar and artificial sweeteners in processed foods and in beverages
- Increasing aerobic activity and getting at least 30 minutes of exercise five times per week
- Losing weight or maintaining a healthy weight
- Quitting smoking
- Keeping blood pressure below 130/80 mm Hg
- Taking medications to help raise HDL cholesterol, including niacin and fibrates, which also lower triglycerides
HDL cholesterol is also known as the “good” cholesterol because it’s associated with a lower risk of heart disease and stroke. However, research has shown that it’s not healthy to have a low level of HDL cholesterol either. It’s best to keep your HDL cholesterol level in the normal range for your age group and sex.
Frequently Asked Questions
What is a good cholesterol level?
A good cholesterol level is different for people of different ages and sexes. For example, for anyone younger than 20 years old, total cholesterol should be less than 170 mg/dL, non-HDL cholesterol should be less than 120 mg/dL, LDL cholesterol should be less than 100 mg/dL, and HDL cholesterol should be more than 45 mg/dL.
How do you raise good cholesterol?
You can increase your HDL cholesterol level through lifestyle changes, including eating a diet rich in vegetables, fruits, legumes, nuts, and lean meats (preferably fish); exercising for at least 30 minutes five times per week; quitting smoking; avoiding saturated fats and trans fats; and losing weight.
Which is the good cholesterol?
HDL is considered the “good” cholesterol that will help protect you from cardiovascular disease. High-density cholesterol carries the “bad” LDL cholesterol away from the arteries back to the liver, which breaks it down and eliminates it from the body.