Concerned with Low HDL

Originally Published: January 24, 1997 - Last Updated / Reviewed On: October 22, 2004
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Dear Alice,

I am a 60-year-old man who exercises daily — runs and walks over 30 miles a week. My "bad" cholesterol was 124 and my "good" cholesterol was 39. I know the 124 is OK, but I am worried about the 39. Do you think I have a problem? I have a sweet tooth and eat a lot of candy. Can this be a problem? I follow a rather low fat diet and eat little red meat.

Dear Reader,

Hearty congratulations on your regular exercise. It's also admirable that you're interested in getting to the bottom of your blood test results. Because of all the talk about "good" and "bad" cholesterol, making sense of cholesterol numbers isn't as straightforward or clear as we might like.

The current best method for using blood cholesterol to gauge one's risk for heart disease (taking into account the research and the theory behind cholesterol and heart disease) is to look at the ratio of total cholesterol level to the level of "good" cholesterol, or HDL. "Total cholesterol" includes not only LDL ("bad" cholesterol) and HDL levels, but also accounts for levels of another kind of fat in the blood stream called triglycerides. So, the easiest way to determine whether or not your low HDL itself is a risk would be to get your total cholesterol level and divide it by your HDL level. If the result is less than 3.5, the numbers say you're in the clear, but if it's greater than 3.5, you might consider some ways to reduce this ratio. Research suggests that increasing the amount of mono- and poly-unsaturated fats (the good fats) you eat can have this effect, both raising HDL and lowering LDL levels.

As for your sweet-tooth, here's some food for thought: eating plans high in refined sugars and simple carbohydrates are associated with elevated levels of blood triglycerides, which are associated with high total cholesterol, low HDL levels, and increased risk for heart disease. So, unfortunately, your heart might be bitter about your sweet-tooth.

Keep in mind that cholesterol levels are only one risk factor for heart disease. Family history, body mass index (weight to height ratio), if you are a smoker, and high blood pressure also need to be considered. Your health care provider can help you interpret your test results as well as your other pertinent medical history and point you to ways to decrease your overall risk of heart disease.

Alice

August 13, 2004

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Dear Alice,

I just wanted to say thank you for the information in Concerned with low HDL. I was reassured because doctors keep...

Dear Alice,

I just wanted to say thank you for the information in Concerned with low HDL. I was reassured because doctors keep commenting on my relatively low HDL level (45 for a 29-year-old woman), but my total cholesterol is relatively low, as well, as are my triglycerides. Learning that people with lower cholesterol often have lower HDL levels, too, is reassuring.

Thanks,
Rebecca