Olive Oil

You’ve probably heard it is important to keep your cholesterol levels low, but if you want to protect yourself against heart disease you may be barking up the wrong tree.

Total cholesterol is actually a fairly poor predictor of heart disease, and LDL  “bad” cholesterol is only slightly better. Instead, the ratio of “good” HDL cholesterol to LDL is the most reliable indicator of cardiovascular health. That means higher HDL is as important (if not more so) than lower LDL for protecting against heart disease and atherosclerosis.

That’s right, you want higher HDL cholesterol.

HDL cholesterol scavenges the blood and removes dangerous cholesterol deposits from the arteries. An HDL level above 60 mg/dL is considered protective against heart disease whereas HDL below 40 mg/dL is a risk, even if your LDL is fairly low.

Last time I had my HDL tested it was above 80 mg/dL.

While drugs like statins are not very effective in raising HDL cholesterol, lifestyle modifications can raise HDL substantially.

10 Ways to raise your HDL cholesterol

1. Exercise Exercise can substantially increase HDL cholesterol while lowering LDL cholesterol.
2. Lose weight Weight loss is almost always accompanied by improved cholesterol numbers, including increased HDL.
3. Don’t smoke Smoking has been shown to lower HDL while raising LDL cholesterol.
4. Avoid trans fat Processed, trans fats simultaneously raise LDL cholesterol and lower HDL cholesterol, vastly increasing your risk of heart disease (similar to smoking). Margarin, shortening and other fake fats should always be avoided.
5. Avoid low-fat diets Low-fat diets lower both LDL and HDL cholesterol and are not effective at reducing heart disease.
6. Eat olive oil and avocados Monounsaturated fats such as those found in olive oil and avocados raise HDL and lower LDL.
7. Eat fish Fish (especially fatty fish like salmon and sardines) contain omega-3 fats that raise HDL and lower LDL.
8. Avoid refined carbohydrates Refined carbohydrates negatively impact HDL and raise LDL (bad news).
9. Eat whole grains Whole, intact grains contain soluble fiber and niacin, both of which raise HDL and may lower LDL.
10. Drink alcohol 1-2 drinks per day can be as effective as exercise in raising HDL levels. However too much alcohol raises risk for cancer and addiction.

For more information on cholesterol check out my video Cholesterol Explained.

Are you concerned about HDL? Is your doctor?

Originally published Sept 14, 2009.

For The Love of Food

Welcome to Friday’s For The Love of Food, Summer Tomato’s weekly link roundup.

Great information this week around the web, and I didn’t even need to call BS! Read about why being a foodie isn’t elitist, what scientists think about US agriculture policy, and what’s the big deal about dietary fat.

Want to see all my favorite links? Be sure to follow me on on Digg. I also share links at Twitter (@summertomato) and the Summer Tomato Facebook fan page. I’m very active on all these sites and would love to connect with you.

Links of the week

• Why being a foodie isn’t ‘elitist’ <<I agree with this so much it hurts. Huge props to Eric Schlosser. (The Washington Post)
• Expert Panel Calls for ‘Transforming US Agriculture’: Changes in Markets, Policies and Science Needed for More Sustainable Farming <<This is so refreshing to read. Finally scientists are being vocal about US food policy. (ScienceDaily)
• Low-Salt Diet Ineffective, Study Finds. Disagreement Abounds. <<I’m still very suspicious about the true dangers of salt. This is a good analysis. (New York Times)
• The Great Fat Debate <<Every scientist agrees total fat consumption isn’t important in heart disease, and the polyunsaturated fats can help. From there it gets complicated. (Nutrition Blogma)
• ‘Bad’ Cholesterol Not as Bad as People Think, Study Shows <<In case you’re wondering why there is a debate about fat, it’s because of data like this. (ScienceDaily)
• Mouse Study Turns Fat-Loss/longevity Link on Its Head <<Dropping body fat doesn’t increase lifespan? The most important lesson from this study is that everybody is different. (ScienceDaily)
• How Sugar Affects the Body in Motion <<Great article reminding us that sugar, like most things in nutrition, is complicated. (New York Times)
• Young adults have a ‘disconnect’ between behavior and their health <<I was totally like this when I was a kid, and it’s good to bring it into public awareness. (Los Angeles Times)
• Munchery Wants To Bring Personal Chefs To The Masses <<This sounds like a fantastic idea to me. What do you guys think? (TechCrunch)
• Cucumber Peanut Salad Recipe <<This looks light, delicious and healthy. And if you haven’t checked out Heidi’s cookbook yet, you should! (101 Cookbooks)

What inspired you this week?

Enough people have asked me if the kind of cholesterol in egg yolks is good or bad (hint: it’s neither) that I think it is time for a brief tutorial on this misunderstood molecule.

Rather than put you to sleep with a watered down version of a Wikipedia article I decided to explain the interaction of diet and cholesterol in a short video. Hopefully this will help clear up what cholesterol is and how you should eat to minimize your risk of heart disease.

As always, feel free to drop me questions in the comments.

If you like this story follow me on the new Digg!

http://forms.aweber.com/form/30/split_210533730.htm

Further reading:

• How To Raise Your HDL Cholesterol
• Intact Grains vs Whole Grains
• How To Make Eggs Taste As Good As Bacon
• Book Review: Good Calories, Bad Calories

Drug treatments that raise the “good” high density lipoprotein (HDL) cholesterol do not improve health outcomes, according to a new analysis. But some researchers suspect raising HDL through lifestyle changes may still be effective in treating heart disease.

HDL is the form of cholesterol that actively removes dangerous lipids from the blood, and has long been thought to be protective against heart disease. This form of cholesterol is believed to work in opposition to low density lipoprotein (LDL) cholesterol, which is strongly correlated with heart disease and cardiovascular mortality. Thus the ratio of HDL to LDL cholesterols is often considered the most important indicator of heart disease risk.

Strong clinical evidence shows that LDL lowering drugs like statins can protect against heart disease and cardiovascular mortality. However there is still no effective way of improving cardiovascular outcomes by directly targeting HDL cholesterol.

Pharmacological treatments that raise HDL cholesterol levels include fibrates, niacin and a Pfizer drug called Torcetrapib. However, trials that tested these drugs for improved cardiovascular outcome have yielded mixed results. Rather than lowering mortality risk, evidence suggests that fibrates and Torcetrapib actually increase mortality in patients. Some trials have shown niacin to be effective at reducing cardiovascular events, but the data are inconsistent.

A new meta-analysis published in the British Medical Journal asked whether pharmacological treatments that are known to raise HDL can improve cardiovascular outcomes. After adjusting for several known confounders (including the effect of LDL cholesterol) pharmacological treatments that raise HDL were not effective at protecting against heart disease.

Does this mean that HDL is not important for heart disease? Not necessarily.

The original studies that implicated HDL in heart protection were observational. For example, it was shown in the Framington Heart Study that people with HDL levels greater than 60 mg/dL have a reduced risk of heart disease compared to individuals with lower HDL. Likewise, individuals with less than 40 mg/dL of blood HDL are considered at risk for coronary heart disease, even when LDL cholesterol is relatively low.

Additionally, lifestyle choices that contribute to raising HDL are associated with a lower risk of heart disease. Examples of these are physical activity, weight loss, not smoking, increased omega-3 fatty acid consumption, decreased trans fat consumption, alcohol consumption and dietary soluble fiber. Also, diets low in saturated fat but relatively high in unsaturated fats have been shown to raise HDL and decrease heart disease risk.

All these HDL raising activities can improve cardiovascular outcome. However, this does not mean that HDL itself prevents heart disease. Rather, it seems to be a good biomarker (observational correlate) of heart disease.

Why are pharmacological methods of raising HDL not helpful (and possibly even harmful) at treating heart disease?

One possible explanation for this discrepancy is the observation that HDL has different forms, some that are protective and others that are harmful. For instance, some interventions may raise HDL cholesterol by limiting its breakdown (harmful), while others raise it by increasing HDL production (more beneficial). Also, some methods that increase HDL do so in a way that creates new problems, such as increased blood pressure.

The complex interaction between pharmacological interventions, HDL metabolism and cardiovascular outcome may have made it difficult to detect any benefit of raising HDL cholesterol in this meta-analysis. Since pharmacological intervention for raising HDL does not consistently help (and sometimes harms) cardiovascular outcome, lifestyle changes remain the most promising target for raising HDL to protect against heart disease.

Anyone want to guess how high my HDL cholesterol is??