Managing High Cholesterol: Tips for Balancing HDL and LDL Levels

Q: Managing High Cholesterol: Tips for Balancing HDL and LDL Levels

Hello： 1. <br>Currently, there are no primary methods for treating elevated high-density lipoprotein (HDL) cholesterol; however, if HDL cholesterol levels are already high, it is advised not to supplement with related health products. <br>2. <br>If HDL cholesterol is elevated, do

High total cholesterol

Hello, Doctor.
During my health check-up, I found that my total cholesterol is above the normal range.
I have noticed a trend of increasing total cholesterol in the past few years: total cholesterol (161→186→194→227), triglycerides (60→58→82→79).
This time, my high-density lipoprotein (HDL) cholesterol was 100 mg/dL.
I usually take fish oil and a lutein complex, but I read online that having HDL cholesterol above 100 is not ideal, and that fish oil might contribute to an increase in HDL cholesterol.
Therefore, I stopped taking fish oil and lutein supplements and switched to red yeast rice supplements.

I see that most articles about lowering cholesterol focus on reducing total cholesterol, primarily targeting low-density lipoprotein (LDL) cholesterol.
In the case where both HDL and LDL cholesterol levels are high, how can I lower my cholesterol? Currently, I am taking red yeast rice and hibiscus supplements, trying to increase my exercise, reduce fat intake (though I can't completely avoid eating out), and maintain a regular schedule.
However, I am underweight, so I can't reduce cholesterol through weight loss.

1.
How can I lower high-density lipoprotein (HDL) cholesterol, considering there are already many articles on total cholesterol and low-density lipoprotein (LDL) cholesterol?
2.
How should I adjust the frequency of taking fish oil supplements? (I used to take one a day, but I am currently not taking any.)
3.
Since I cannot avoid trans fats and saturated fats in my diet, what is the maximum daily intake I should aim for? (I enjoy snacks and cookies, which may contain some trans fats or saturated fats, but the amounts are not high according to the labels.)
4.
Many articles mention that cholesterol levels are related to genetics and body constitution.
If it is indeed influenced by my constitution, will having high cholesterol affect my health?
5.
Are fluctuations in cholesterol levels typically short-term (within one month) or long-term (over three months)? Thank you, Doctor.

Chai Chai, 20~29 year old female. Ask Date: 2022/10/15

Dr. Lin Jianliang reply Internal Medicine

Hello: 1.
Currently, there are no primary methods for treating elevated high-density lipoprotein (HDL) cholesterol; however, if HDL cholesterol levels are already high, it is advised not to supplement with related health products.
2.
If HDL cholesterol is elevated, do not supplement with related health products.
3.
Trans fats should be minimized; it is recommended that trans fatty acids comprise less than 1% of total daily caloric intake, with a maximum daily intake not exceeding 2.2 grams.
For sedentary individuals weighing 70 kg for men and 55 kg for women, the suggested upper limit for saturated fat intake is 23 grams for men and 18 grams for women.
4.
It will affect 5.
Long-term.

Reply Date: 2022/10/15

More Info

Managing high cholesterol levels is a critical aspect of maintaining cardiovascular health. Your recent health check indicates that your total cholesterol is elevated, and while your HDL (high-density lipoprotein) is high, it’s essential to understand how to balance both HDL and LDL (low-density lipoprotein) levels effectively.

Understanding Cholesterol Levels
1. Total Cholesterol: This is the sum of all cholesterol in your blood, including HDL and LDL. A total cholesterol level above 200 mg/dL is considered high.

2. HDL (Good Cholesterol): Levels above 60 mg/dL are considered protective against heart disease. However, excessively high levels (over 100 mg/dL) can sometimes indicate other health issues, although this is less common.

3. LDL (Bad Cholesterol): Ideally, LDL levels should be less than 130 mg/dL. Higher levels are associated with an increased risk of heart disease.

Tips for Balancing HDL and LDL Levels
1. Dietary Adjustments:
- Increase Fiber Intake: Foods high in soluble fiber, such as oats, beans, lentils, fruits, and vegetables, can help lower LDL cholesterol.

- Healthy Fats: Incorporate sources of healthy fats, such as avocados, nuts, and olive oil, while reducing saturated fats found in red meat and full-fat dairy products.

- Limit Trans Fats: Aim to keep trans fat intake as low as possible. The American Heart Association recommends that trans fats should make up less than 1% of your total daily calories.

- Moderation with Sweets: While enjoying snacks like cookies is fine occasionally, try to choose options that are lower in sugar and unhealthy fats.

2. Exercise Regularly: Aim for at least 150 minutes of moderate aerobic activity or 75 minutes of vigorous activity each week. Regular physical activity can help raise HDL cholesterol and lower LDL cholesterol.

3. Monitor Supplements: If you have been taking fish oil and have decided to stop, consider consulting with a healthcare provider about the potential benefits and risks of continuing or discontinuing these supplements. Fish oil is known to improve heart health but may also influence cholesterol levels.

4. Understand Your Genetics: Cholesterol levels can be influenced by genetics. If you have a family history of high cholesterol or heart disease, it’s crucial to be proactive in managing your levels through lifestyle changes and regular check-ups.

5. Regular Monitoring: Cholesterol levels can fluctuate based on diet, exercise, and other lifestyle factors. It’s advisable to have your cholesterol checked at least once a year, or more frequently if you are making significant lifestyle changes or if your levels are particularly concerning.

Addressing Your Specific Questions
1. How to Lower High HDL: There are no specific treatments to lower HDL cholesterol, as it is generally considered beneficial. However, if your HDL is excessively high, it may be worth discussing with your healthcare provider to rule out any underlying health issues.

2. Fish Oil Supplement Frequency: If you are unsure about the effects of fish oil on your cholesterol levels, it may be best to consult with a healthcare professional. They can provide personalized advice based on your health status.

3. Trans and Saturated Fat Intake: The American Heart Association recommends limiting saturated fat to less than 6% of total daily calories and keeping trans fats as low as possible. For a 2,000-calorie diet, this means no more than 120 calories from saturated fat (about 13 grams) and as little trans fat as possible.

4. Impact of Genetics: If high cholesterol runs in your family, it can indeed affect your health. Genetic factors can lead to conditions like familial hypercholesterolemia, which requires more aggressive management.

5. Cholesterol Fluctuations: Cholesterol levels can fluctuate over time due to various factors, including diet and lifestyle changes. Regular monitoring is essential to understand your trends over the long term.

Conclusion
Managing cholesterol levels effectively involves a combination of dietary changes, regular exercise, and monitoring your health. It’s essential to work closely with your healthcare provider to develop a personalized plan that considers your unique health profile and family history. By making informed lifestyle choices, you can significantly impact your cholesterol levels and overall cardiovascular health.

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