HDL serves as a chemical shuttle that transports excess cholesterol from peripheral tissues to the liver. This pathway is called the RCT system. In this system, plasma HDL takes up cholesterol from the peripheral tissues, such as fibroblasts and macrophages. (A study by El Khoury et al indicated that in persons with HALP, macrophages have an increased plasma cholesterol efflux capacity. [18] ) This may occur by passive diffusion or may be mediated by the adenosine triphosphate (ATP)–binding cassette transporter 1. The latter interacts directly with free apo A-I, generating nascent, or so-called discoidal, HDL. Cholesterol undergoes esterification by lecithin-cholesterol acyltransferase (LCAT) to produce cholesteryl ester, which results in the production of the mature spherical HDL. Cholesterol is also taken up from triglyceride-rich lipoproteins in a process mediated by a phospholipid transfer protein (ie, CETP). [19, 20, 21, 22]

Pasta and heart health together in one sentence seems to be an oxymoron, however with one small tweak spaghetti can become a cholesterol-busting meal. Instead of opting for white, refined noodles, choose the less-processed, vitamin-enriched counterpart: whole grain pasta. Barilla makes one that has 7 grams of fiber per serving, and — what’s more — none of the stress-fighting B-vitamins have been removed. A B vitamin known as niacin has been found to decrease LDL levels and increase HDL when taken in doses above your vitamin requirement, according to a guide to lowering your cholesterol by the U.S. Department of Health and Human Services.

As a result of all this, doctors don’t just want you to lower your total cholesterol count; they want you to change the ratio as well, so you have more HDL and less LDL. “When we looked at the data, we found that the higher your HDL went, the lower your risk of heart attack,” says cardiologist William Castelli, M.D., former director of the Framingham Heart Study in Massachusetts. An HDL level of 75 or more seems to convey extra longevity for many people, while a count of 100 or more is so beneficial that it was dubbed the “Methuselah syndrome” by one researcher. HDL less than 35 or so, meanwhile, can carry significant risk of heart disease. Genetics plays a large role in HDL. A few guys have naturally low levels and need to keep their LDL low as well to make up for it. (As Castelli puts it, you don’t need a substance that removes cholesterol from your blood if you don’t have much to begin with.) But there’s plenty that everyone else can do to pump up their HDL. Never one to shirk from a task that doesn’t involve housecleaning, I managed to find two handfuls of ways to turn my “good” numbers into great numbers.
Muscle pain, also called myopathy, occurs in 2% to 11% of people treated with statins, reported investigators at the University of Wisconsin Hospital and Clinics in Madison, and although the pain usually subsides once the statin is discontinued, it can take several months to do so. Like previous studies, the Wisconsin scientists also found that the negative side effects of statins increased as dosages increased.
Altering your diet is the easiest way to lower your elevated LDL cholesterol, and should be your first course of action, as every cholesterol-lowering strategy starts with your dietary habits. A balanced diet consisting of fruits, vegetables, whole grains, fish, and various plants will significantly help you lower your LDL cholesterol level. It’s best to limit the amount of red meat, eggs, and dairy you consume. Plant-based diets not only help lower your LDL, but they can also help clear plaque buildup from your arteries.
An under-valued element of bone and cardiovascular health is the role of Vitamin K2, which many individuals are unknowingly deficient in. Found in the Japanese breakfast delicacy “natto” (fermented soybeans), vitamin K2 not only helps remove calcium from the arteries and soft tissues to prevent atherosclerosis, but it also draws calcium into the bones to prevent the risk of fracture. Nattokinase, an enzyme found in natto, may help to increase HDL levels while lowering total cholesterol and LDL cholesterol levels, according to an Asia Pacific Journal of Clinical Nutrition study.
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