The what-what on LDL/HDL (that’s your blood lipids)

Usually we find out what the heck LDL and HDL are when we got to the doctor and we find out that the annual blood test we sweated through (okay I’m projecting but who loves it) showed that we’ve got an artery full of LDL and not enough HDL.

If our LDL levels are high enough, the doctor will prescribe a statin to lower them, and for many people these drugs are a godsend. However, if you can do without them, you should. But how do you know if you can do without statins if you don’t know what LDL is, let alone how to lower it? Or raise HDL, whatever that is? That’s when people usually get the “LDL is bad cholesterol, HDL is good cholesterol” rap and sent on their way (with pills). LDL causes heart disease — bloody true, but is that really enough information? Not if you need to make dietary changes.

My friend and neighbor Phyllis just celebrated her 81st birthday, and on that day related to me that the doctor had found just such a thing (to not need a statin before you’re 81 is akin to a miracle) and the doctor prescribed simvastatin (same stuff John McCain takes). She takes a tiny dose, and her cholesterol is only a tad high — lucky her. But when you’re on a statin to lower your cholesterol output, you have to make sure to have your blood tested every few months to be sure your liver enzymes are humming along (and to make sure the stuff is working). So what are LDL and HDL anyway? Phyllis wanted to know, so I’m guessing you might too:

LDL stands for “low density lipoprotein.” Have you ever floated oil and water (or vinegar) together and noticed that the oil part ends up on top? Heard that fat floats? It does, because it’s less dense. A lipoprotein is a little transporter. Fats do not dissolve in water, but we’re made up mostly of water, so we need a way to get fats (as triglycerides and cholesterol) around the body for use and storage. A low density lipoprotein would be carrying mostly fat, and in this case, it’s mostly choleserol.

Cholesterol is needed throughout the body — it’s not always a bad thing (more on this later, I’m on a roll). LDL carries cholesterol from the liver to all the cells in the body through the arteries. The trouble is that if there’s a lot of it, or not enough HDL, the cholesterol oxidizes and forms fatty streaks on the artery walls. These get firmer with oxidation and create arterial plaque. Get enough of this junk built up and it’s like putting your thumb over a running water hose — the pressure goes up. If the blood pressure goes up as a result of this or other factors, it can break off a chunk of this plaque and cause a heart attack, stroke or embolism.

Eat more than 10% of calories from saturated fat, just about any trans fat, or more than 300 milligrams of cholesterol from food a day and you’re helping this scenario along. Put that together with lack of exercise and you’re damned near killing yourself a little every day. Any good news? Why yes. Read on…

HDL stands for “high density lipoprotein.” It’s higher in density because it carries more protein and less fat. It also has the handy habit of surfing around the arteries to pick up that excess cholesterol before, and possibly during the time when they’re causing arterial damage. It delivers the stuff back to the liver where it’s sent packing from the body. Thus, while it’s not a cholesterol itself, it’s a “good” transporter because it gets what we don’t need out of there before it causes harm.

And this is why you want a good ratio of HDL to LDL — to be sure you get less deposits in the arterial bank. Exercise daily: 30 minutes min. 60 to lose weight or maintain weight loss. That raises HDL.

Think oils not fats. Saturated fat is solid at room temperature — like butter. Oils are liquid at room temperature and are much higher in monounsaturated fats, which are far better for you (read the label, don’t get crazy and go overboard — swiping bread through a gallon of olive oil is still not a great idea, Dad people). Avoid anything that says partially hydrogenated like the plague (that is a sign that the product contains trans fat, which not only raises LDL but lowers HDL). Read the ingredients not the just the label for this, because sometimes products list no trans fat but there may be half a gram or less and they can still claim no trans fat. In this case, you want NONE.

And cholesterol?  Well, you make it, and you don’t need ANY, but read labels and don’t go over 300 mg and I’ll tell you more about it later (pant, pant).  Hint: it comes from animals and never a plant.

Here are some guidelines, but for more info on LDL and HDL, there’s a nice link to the CDC. Your individual risk may require different recommendations, but here are the general CDC guidelines for a healthy lipid profile:

  • A lipoprotein profile can be done to measure several different kinds of cholesterol as well as triglycerides (another kind of fat found in the blood). Desirable or optimal levels for persons with or without existing heart disease are

Total cholesterol: Less than 200 mg/dL.

Low Density Lipoprotein (LDL) cholesterol (“bad” cholesterol): Less than 100 mg/dL.

High Density Lipoprotein (HDL) cholesterol (“good” cholesterol): 40 mg/dL or higher.

Triglycerides: Less than 150 mg/dL.

More on cholesterol in a bit. Whew!


5 responses to “The what-what on LDL/HDL (that’s your blood lipids)

  1. Holy cow, oops, guess I should refrain from meat and eggs. Tomorrow I will learn more from my doctor. The test results are in.
    Wish me luck.

    • You should try to refrain from fatty meats and egg yolks — have an omelette made with just the whites — they are a good source of protein and contain no serious fat at all. Good luck!

  2. Saturated fat, rather than just cholesterol alone, seems to drive LDL levels higher and should be considered. Trans fat, however, drives LDL up and HDL down and should be avoided like the plague. If something says partially hydrogenated or hydrogenated, it’s a food to consume only occasionally if at all. Egg yolks are fine to eat some of the time, but when eaten daily, 2 at a time, they are significant contributor of saturated fat as well as cholesterol. There are Americans who consume 2 or more daily, top it off with bacon and cheese, and you see where I’m going with this?

  3. A little update: Phyllis is just fine and kicking at 84, and the blood tests for statin drugs are now more widely spaced than 3 months for many people once the intial tests show stability with the drug because we know a bit more about their safety.

  4. Pingback: Blood sugar: Don’t kill the messenger | Foodspace

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