Researchers jolted the world of simplicity this past week when they announced that HDL cholesterol can help cause heart disease instead of prevent it. The million dollar question now becomes, “How do you know if you have good or bad HDL cholesterol?”
Getting right to the point, you have more bad HDL cholesterol when you are overweight, when your triglyceride level is more than twice your HDL score, and when you are in a state of inflammation, either chronic or acute.
A few years back it became obvious that your quality of HDL cholesterol was of great importance, as I explained in my article, The Amazing New World of HDL Cholesterol. Briefly, I like to say that LDL cholesterol is like a UPS truck, loaded with fat-soluble nutrition packages that need to be delivered to cells or can be used to help defend you should the LDL encounter a hostile neighborhood when traveling around your body. In comparison, HDL cholesterol functions as a tow truck for damaged or spent LDL cholesterol, towing the LDL UPS truck back to your liver so it can be recycled or reloaded with more packages.
You need enough HDL cholesterol to carry on its important role, plus that HDL needs to be in high quality condition. If your tow truck gets a flat tire of its own or if its equipment malfunctions, then its ability to do what it needs to do is compromised. The new study shows that HDL, in a compromised state of health, actually becomes part of the problem in terms of being associated with increased cardiovascular risk. At this time it is not clear whether or not poor quality HDL is actually causing heart disease, but it sure isn’t helping the problem. In fact, a higher amount of poor quality HDL is predictive of many other cardio problems that are locking themselves into place.
The new study focuses on a type of naturally occurring HDL particle called HDL apoC-III, which may or may not be present on any given HDL molecule. The researchers followed 32,826 women and 8,225 men for 10-14 years, comparing levels of HDL apoC-III to see who developed coronary artery disease. Those with the highest levels of HDL apoC-III had a 60 percent increased risk of developing coronary artery disease.
I should point out that HDL apoC-III is far from “bad” and is part of the natural balance of how HDL cholesterol functions. It is a signaling molecule that is helping to prevent the break down and clearance of HDL cholesterol. In other words, it is saying you need more tow trucks for some reason.
It is pretty obvious what drives up the amount of HDL apoC-III: being overweight, having elevated triglycerides, and having an ongoing low-grade or acute inflammation issue. The more locked in the metabolic problem, such as type 2 diabetes, the more likely that HDL apocC-III is problematically elevated, primarily because the metabolic problem keeps triglycerides elevated.
When you are overweight it is typical that you have extra blobs of fat (triglycerides) heading to your liver. Your liver has to defend itself from this onslaught of potential injury due to excess calories, thus it makes more LDL cholesterol, piles the fat blobs onto the UPS truck, and tries to drive them out of the liver – a defense mechanism against your liver being poisoned and damaged by fat.
Inflammation can be acute, like an infection or injury, or chronic, like an ongoing health problem including being overweight. Inflammatory signals in your bloodstream create a hostile environment for both LDL and HDL, increasing the risk of damage. LDL actually uses its fat-soluble antioxidants to help combat the problem, changing from a UPS truck to a police car. Higher amounts of LDL are damaged under such conditions, meaning that more HDL tow trucks are needed. Thus, HDL apoC-III is elevated to help prop up the number of HDL particles.
Being overweight is not a normal situation during human evolution. To the contrary, we are genetically designed to handle food scarcity. Being overweight drives up triglycerides as well as inflammation, which simultaneously provides two main reasons that elevate HDL apoC-III. Unfortunately, this forces HDL into a compromised position and renders it inefficient at preventing heart disease. I personally do not think elevated HDL apoC-III is causing anything harmful. Rather, it is simply a sign that many other issues of metabolism are not in good condition and those issues are the ones that are causing heart disease.
This is why engaging the process of consistent weight loss is vital to cardiovascular health. Thankfully, you don’t have to be a perfect weight before you reverse the need to have elevated HDL apoC-III – but you do have to stay in positive trend to maintain low risk. As your triglyceride levels come down and you feel more fit with less wear and tear, rest assured that your HDL apoC-III is in better shape and the quality of your overall HDL is improving.
Having adequate HDL cholesterol, especially high quality HDL cholesterol, will always be important for optimal cardiovascular health. Many nutrients are vital for the formation of HDL and the preservation of its quality. These include higher dietary protein (especially whey protein), DHA, tocotrienol E, vitamin D, pantethine, silymarin, pomegranate, niacin, and likely many others – even chocolate! Nutrients in and of themselves will not fix a problem. You must as a priority engage the process of weight loss. When you combine good nutrients with a consistent weight loss program, then you have optimized your path to health and well-being and boosted your cardiovascular vitality.



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