Defining HDL and Cholesterol
High density lipoprotein (HDL) is a carrier molecule for cholesterol, phospholipids and triglycerides.
Think of HDL as a boat.
Cholesterol (cargo) can’t float in the blood; it needs to be carried around by the lipoprotein (the boat).
This video summarizes what cholesterol and the lipoproteins are.
When you look at blood work, you’ll see HDL-C. This tells you how much cholesterol (cargo) is on the HDL (boat). There can be varying amounts of cargo on each boat. As you’ll soon learn, it is beneficial to have a high HDL-C. In other words, we want a lot of cargo on the HDL boats.
What Does HDL Do?
HDL carries cholesterol away from cells and takes it to the liver to either be removed from the body or reused. The process of taking cholesterol from the peripheral tissues back to the liver is called reverse cholesterol transport , . On the other hand, low density lipoprotein (LDL), takes cholesterol to the cells. The reason LDL is considered ‘bad’ is because when cholesterol is attached to it, that cholesterol is susceptible to damage and may contribute to atherosclerosis, and subsequently heart disease. Learn more about LDL cholesterol here.
The video below depicts what HDL does.
Why Do We Want to Increase HDL-C?
As mentioned above, HDL basically cleans up the blood and cells of cholesterol, thus minimizing the cholesterol’s chance of being oxidized or damaged.
There are many established risk factors for heart disease. Diagnoses such as obesity, diabetes, kidney disease, and hypertension are just a few co-morbidities that increase cardiovascular disease risk . Certain blood lipids will be tested and associated with risk. HDL-C is considered a negative risk factor  – meaning it protects against heart disease .
HDL is anti-inflammatory , , minimizes oxidative stress  , inhibits cells in the blood from sticking to each other  and possibly plays a role in improving diabetes and glucose metabolism  . So you can see why we want HDL to be high. For HDL to have its protective effect, we aim to keep it above 1.55 mmol/L (60 mg/dL) .
Low HDL-C is associated with hypertriglyceridemia, diabetes, overweight/obesity, physical inactivity, cigarette smoking, very high carbohydrate intake, certain drugs (beta-adrenergic blockers, anabolic steroids, progestational agents), and genetic factors .
HDL is a carrier protein, transporting cholesterol around the body. Cholesterol is important, as discussed here. HDL plays an important role in cardiovascular disease prevention. We must aim to keep it high.
Interested in learning more?
Read on in our series of articles on Heart Health!
About the Author - Dr. Johann de Chickera
Dr. Johann is a licensed naturopathic doctor and co-owner of Absolute Health and Wellness. He completed his 4-year degree at the Canadian College of Naturopathic Medicine (CCNM). His clinical focus lies in chronic disease, such as those related to the Gastrointestinal, Endocrine, and Immune Systems.
His approach to medicine relies on working with the patient to come up with a feasible, multi-factorial approach that addresses all complaints at once. He employs a strong background in diagnostic medicine and human physiology and pathology to diagnose and treat. His treatment involve a combination of nutritional counselling, botanical medicine, eastern medicine (acupuncture), nutraceutical supplementation and hands on physical medicine.
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