What Is HDL Cholesterol?
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Medically reviewed by Christopher Lee, MD
Cholesterol is a waxy, fat-like substance that helps build hormones and digests fatty substances. It travels through your bloodstream with the help of proteins called lipoproteins. They are combinations of protein and lipid.
The two types of lipoproteins are low-density lipoprotein (LDL), also known as "bad cholesterol," and high-density lipoprotein (HDL), the "good cholesterol." High levels of good cholesterol are good for your heart health and reduce the risk of heart disease and stroke. Here's what you need to know.
Why Is HDL Cholesterol Considered the 'Good' Cholesterol?
HDL is considered "good" cholesterol because it removes LDL cholesterol from the blood and returns it to the liver. LDL cholesterol breaks down and is then excreted from the body with the help of the liver.
Healthy levels of HDL have a cardio-protective effect. HDL reduces the risk of heart attack and stroke. LDL is called 'bad cholesterol' because the higher the levels of LDL in your body, the higher the risk of developing those heart conditions.
Increased levels of LDL in your body lead to atherosclerosis, which is when fat builds up inside the vessel wall. Atherosclerosis can narrow your vessels and increase the risk of heart-related problems.
What Should Your HDL Levels Be?
The HDL level a person should have depends upon the age and sex of an individual. The following table shows the optimal level of cholesterol based on those factors:
Type of Cholesterol | Level |
Total Cholesterol | 150mg/dl |
LDL | 100mg/dl |
HDL, for people aged 19 or younger | More than 45mg/dl |
HDL, for men aged 20 or older | More than 40mg/dl |
HDL, for women aged 20 or older | More than 50mg/dl |
What Can Cause Low HDL Levels?
Low HDL levels have been linked to a higher risk of atherosclerosis, heart disease, and death. However, many factors can contribute to a decrease in HDL levels. These factors include:
Alcohol: Alcohol, when used in excess amounts, can lower your HDL. Increased alcohol consumption can also lead to weight gain, which also reduces your HDL levels.
Diet: An unhealthy diet can contribute to a decrease in the level of HDL and increase the level of LDL. Eating more saturated fats, bacon or sausages, fast food, and sugar but less fiber diet all contribute to low HDL levels.
Medications: Certain medications can lower your HDL levels. Examples of such medications are beta-blockers that treat hypertension and benzodiazepines used for anxiety and insomnia.
Metabolic syndrome: Metabolic syndrome is a combination of increased blood pressure, increased blood sugar levels, and obesity that can result in reduced HDL levels.
Smoking or tobacco use: When you use tobacco, your HDL levels drop because of the nicotine content. Even secondhand smoke exposure can lower your HDL levels.
What Can Cause High HDL Levels?
If your HDL level is too high, it can also increase the risk of heart disease. The following are reasons why a person's HDL level may be elevated:
Alcohol use disorder without liver scarring and damage, which is called cirrhosis
Genetic mutations leading to a lower HDL removal rate or increased production of HDL
Primary biliary cirrhosis
Some drugs like anticonvulsant medications for seizures, insulin, and steroids
How Can You Raise Your HDL?
Higher HDL cholesterol levels can improve your overall health by reducing your stroke and heart disease risk. There are several ways to promote healthy HDL levels, from lifestyle changes to health condition management.
Avoid Alcohol and Tobacco Use
Since alcohol can affect HDL levels, it's best not to drink at all or at least drink in moderation. Recommendations include not having more than two drinks per day for men and not having more than one drink daily for women.
Also, quit smoking and using tobacco to help raise your HDL levels. A healthcare provider can work with you to determine a quit plan, which can include counseling and medications or products to decrease your desire to have nicotine.
Eat a Nutritious Diet
Eating a high-fiber diet can help increase HDL levels and reduce the risk of cardiac events. Foods high in fiber include fruits like bananas, apples, and berries and vegetables like carrots, broccoli, and corn. Additionally, you'll want to include more healthy fats in your diet. Options include nuts, seeds, fatty fish, and certain oils like canola and olive oils.
Exercise Regularly
Getting regular physical activity can raise your HDL levels and lower your LDL. Most people should aim for at least 150 minutes of moderate-intensity aerobic exercise weekly. This can look like taking a brisk walk 30 minutes daily, five days a week. Recommendations also include doing two days of strength training weekly.
Maintain a Healthy Body Weight
Excess weight gain dramatically affects your HDL level. Healthy eating and regular exercise can help you manage your weight. Reducing your weight by 5% to 10% can increase your HDL level. Consult a healthcare professional about what your ideal weight should be.
A Quick Review
Cholesterol has two forms, but HDL is the good cholesterol, and higher levels can protect your heart. Different factors—like diet, lifestyle choices, and medications—will affect HDL levels.
Actions like engaging in regular exercise and maintaining a healthy body weight are beneficial for raising HDL levels. However, you want to ensure that your HDL level is not too high or too low; talk with a healthcare provider to determine where your HDL level should be.
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