What are HDL (good) and LDL (bad) cholesterol?

Picture of a doctor holding up a chalkboard with HDL and LDL cholesterol.

Cholesterol is a fat-like (lipid-like) substance that your body uses as a building block to produce hormones, vitamin D, and digestive juices that help you break down fats in your diet. HDL (high-density lipoprotein, or “good” cholesterol) and LDL (low-density lipoprotein, or “bad” cholesterol) are two types of lipoproteins that carry cholesterol to and from the body’s cells in the blood.

The body needs some cholesterol to function, but when levels get too high, fatty deposits can accumulate in blood vessels, which causes them to narrow. This narrowing of the blood passageways by these lipids can lead to heart attacks, coronary artery disease, strokes, or other vascular diseases.

Triglycerides are components found in body fat, and fats from the foods you eat. Triglycerides show what you have recently eaten, and cholesterol shows what you have eaten over a long period. If you eat a fatty meal, it gets absorbed as triglycerides, so in the first few days after eating a fatty meal you will have high levels of triglycerides in your blood. The liver then packages these triglycerides as fats in your adipose tissue, and turns some of it into cholesterol. This leads to high cholesterol levels in the blood for a few days to weeks after eating a fatty meal. Like cholesterol, you need some triglycerides to keep the body healthy, but increased levels can cause health problems.

Therapeutic Lifestyle Changes to Lower LDL (Low) Cholesterol Levels

Therapeutic lifestyle changes to lower LDL cholesterol can help lower and maintain levels naturally. This may involve:

  • Losing weight
  • Eating a heart healthy diet low in saturated fat and cholesterol, for example, the Mediterranean Diet.
  • Eating a healthy diet low in triglycerides and sugar.

What do HDL and LDL mean?

LDL and HDL are the two main types of cholesterol (blood fats, or lipids) that make up your total cholesterol.

  • HDL (high-density lipoproteins), or “good” cholesterol, may protect the body against narrowing blood vessels
  • LDL (low-density lipoproteins), or “bad” cholesterol, may make arterial narrowing worse

There is a third type of cholesterol called VLDL (very-low-density lipoproteins), which is another type of “bad” cholesterol produced in the liver, and contains a high amount of triglycerides.

Why is HDL the good cholesterol and LDL the bad?

Your total cholesterol is the sum of the fats in your blood, which includes the LDL and HDL cholesterol. This number can give you an indication of your risk factors for developing cardiovascular disease, coronary artery disease, vascular disease, or stroke.

More importantly, the amounts of each type of cholesterol are a better predictor of risk for disease than the total amount. Doctors and other health care professionals consider LDL cholesterol the “bad” cholesterol. Increased numbers of LDL cholesterol indicate more risk for blocked arteries and health problems.

Doctors consider HDL cholesterol the “good” cholesterol, and they interpret its levels in the opposite manner of LDL. The higher your HDL cholesterol numbers, the lower your risk is for heart disease, vascular disease, and stroke. HDL cholesterol also may have a protective effect on the blood vessels, and a high level of HDL in your body may keep cardiovascular disease from developing.

Triglycerides also are part of a cholesterol profile, and these numbers are more indicative of the amount of fats you have eaten recently. High triglyceride levels greatly increase your risk for developing coronary artery disease, vascular disease, and stroke.

SLIDESHOW

Cholesterol: High Triglyceride Foods to Avoid See Slideshow

What can lower LDL cholesterol levels?

Lifestyle and diet modifications are the main way to prevent high LDL cholesterol, and to keep a healthy level of HDL cholesterol. Eat a low-fat/high-fiber diet, exercise regularly, maintain a healthy weight, and do not smoke.

Some risk factors for high LDL cholesterol are genetic and may require medical treatment to keep cholesterol levels in a healthy range.

What foods help lower LDL cholesterol?

A heart-healthy diet that is high in fiber and plant-based foods can help lower total and LDL cholesterol levels. Mainly vegetarian or vegan diets have been shown to reduce cholesterol levels and the risk of blocked arteries. Foods that can help lower LDL cholesterol include:

  1. Oatmeal
  2. Whole grains
  3. Barley
  4. Beans
  5. Fruits and vegetables
  6. Leafy greens such as spinach, kale, collard greens, lettuce
  7. Avocado
  8. Eggplant
  9. Nuts
  10. Soybeans and tofu
  11. Fatty fish such as salmon and tuna (in moderation)
  12. Red wine (in moderation)
  13. Black tea
  14. Garlic
  15. Fiber supplements

QUESTION

What is cholesterol? See Answer

What lifestyle changes and medications help lower LDL cholesterol numbers?

The first step in lowering cholesterol is diet and exercise. Talk with your doctor, nutritionist, or other healthcare professional to come up with a diet and exercise plan that is right for you.

Other lifestyle modifications and changes can be made to help lower your cholesterol, for example;

If diet, exercise, and lifestyle changes are not enough to lower your cholesterol to healthy ranges, then your doctor may prescribe medication. The type of cholesterol lowering medication depends upon your levels of LDL, HDL, and triglycerides; and any current medications you are currently taking, and your overall health.

Medication options to reduce cholesterol include statins, niacin, and fibric acid agents (fibrates). Your doctor may prescribe one or several types of these drugs to reduce your cholesterol levels to a healthy range.

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What increases HDL (good) cholesterol?

Raising your HDL levels by diet alone is very difficult. Your best solution to increase your HDL levels is to eat a heart-healthy diet low in fat and high in fiber. You also can help improve your HDL number if you lose weight, quit smoking, and cut sugar out of your diet.

Some statin medications may potentially increase HDL levels moderately. Discuss this treatment option with your doctor.

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Medically Reviewed on 12/11/2019
References
HDL (Good), LDL (Bad) Cholesterol and Triglycerides. American Heart Association. Updated: April 30, 2017.
<https://www.heart.org/en/health-topics/cholesterol/hdl-good-ldl-bad-cholesterol-and-triglycerides>

What Your Cholesterol Numbers Mean. American Heart Association. Updated: April 30, 2017.
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ATP III At-A-Glance: Quick Desk Reference.NIH; National Heart, Lung, and Blood Institute. Updated: Apr 30, 2017.
<https://www.nhlbi.nih.gov/health-pro/guidelines/current/cholesterol-guidelines/quick-desk-reference-html>

Cholesterol Levels: What You Need to Know. NIH; MedlinePlus. Summer 2012 Issue: vol 7; no2; 6-7.
<https://medlineplus.gov/magazine/issues/summer12/articles/summer12pg6-7.html>

Singh, VN, MD, et al. Low HDL Cholesterol (Hypoalphalipoproteinemia) Treatment& Management." Medscape. Updated Updated: Nov 03, 2016.
<http://emedicine.medscape.com/article/127943-treatment>
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