Many Americans spend a considerable amount of time and money trying to control their cholesterol, but most of the attention until recently has been focused on lowering LDL (low-density lipoprotein) or “bad” cholesterol levels. Current research suggests more should be done to increase the level of HDL cholesterol, which is regarded as an independent factor in the onset or prevention of heart disease. In other words, even if your LDL cholesterol is within approved limits, you may be less healthy than you think if your HDL level is also low.

The reason why: HDL functions to prevent or reverse the buildup of cholesterol deposits in blood vessels, protecting the body against heart disease and stroke. The HDL molecule is actually a complex vehicle that collects cholesterol from the bloodstream and removes it to the liver, where much of it is excreted. HDL is lost in the process, so it must be continuously replaced in the body. Unfortunately, many of the most successful drugs at lowering LDL cholesterol levels also lower HDL.

How can HDL be maintained or even increased to recommended levels of 40 mg/dl or more? There are many ways to do this, some easier to achieve than others. The number one method is regular aerobic exercise – anything that raises your heart rate for 20 minutes or more at a time. This can also help you lose weight, another plus because obesity lowers HDL. Smokers can increase their HDL levels by quitting. Avoiding trans fatty acids (partially hydrogenated vegetable oils) in the diet and replacing them with monounsaturated fats (canola and olive oils plus peanut butter) can not only raise HDL, it lowers LDL. Soluble fiber found in fruits, vegetables, oats and legumes (beans and peas) can also provide this double benefit. Alcoholic drinks in moderation (1-2 per day) for those who are not susceptible to alcohol-related health problems can also increase HDL.

Some newer cholesterol medications can provide modest HDL increases along with LDL control; research is ongoing to develop improved drugs. Even these, however, may not benefit people whose LDL is already low and only need to increase HDL without further lowering their LDL levels. For them and ultimately for most people, the new word is the same old story – the best way to be healthy is a combination of exercise, weight control and a truly healthy diet. Unless evolution comes up with a gene to help us survive as fast food-eating couch potatoes, ther won’t be an easy answer.