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When it comes to cholesterol, most people focus on lowering their low-density lipoprotein (LDL), often referred to as “bad cholesterol” to reduce their risk of heart disease. However, high-density lipoprotein (HDL) cholesterol, known as “good cholesterol,” plays an equally critical role in heart health and overall metabolic function. Despite its importance, many doctors fail to stress the need for patients to increase their HDL levels. Why is that? And what constitutes a healthy HDL level?

What is HDL Cholesterol?

High-density lipoprotein (HDL) cholesterol is responsible for carrying excess cholesterol from the bloodstream back to the liver, where it can be processed and removed from the body. This process, known as reverse cholesterol transport, helps prevent the buildup of plaque in the arteries, reducing the risk of atherosclerosis, heart attacks, and strokes.

Beyond its role in cholesterol transport, HDL also has anti-inflammatory and antioxidant properties, which help combat oxidative stress and reduce the risk of cardiovascular disease.

LDL Cholesterol: The Full Picture

LDL cholesterol is often categorized as “bad cholesterol,” but it’s important to understand that not all LDL is created equal. There are two primary types of LDL:

• • Small, Dense LDL (sdLDL): This type is more likely to oxidize and contribute to arterial plaque buildup, increasing the risk of cardiovascular disease.
  • Large, Buoyant LDL: This type is less likely to oxidize and is considered less harmful.

Most standard lipid panels lump these two together under “total LDL,” which can lead to an incomplete assessment of cardiovascular risk. Advanced lipid testing can differentiate between these types, providing a clearer picture of heart health. If you have an elevated total LDL cholesterol, it is important to demand that your doctor conduct an advanced lipid test rather than assume total LDL is dangerous. Many physicians will otherwise prescribe a statin to lower LDL cholesterol without considering whether it is the harmful small, dense LDL or the benign large, buoyant LDL.

For those who want to assess whether they have arterial blockage rather than relying solely on a basic cholesterol panel, tests such as a Coronary Artery Calcium (CAC) Scan or a Carotid Intima-Media Thickness (CIMT) Test can provide a clearer picture of cardiovascular health. Additionally, a Coronary Angiogram (using CT or catheterization) can offer detailed imaging of arterial blockages, helping individuals make informed decisions about their cardiovascular care.

What is a Healthy HDL Level?

A healthy HDL cholesterol level is generally considered to be:

• • Men: 40 mg/dL or higher
  • Women: 50 mg/dL or higher
  • Optimal for both: 60 mg/dL or higher

Higher HDL levels are associated with a lower risk of heart disease, though extremely high levels (above 100 mg/dL) may not always provide additional benefits and, in some cases, could indicate dysfunction in HDL metabolism.

Why Don’t Doctors Emphasize Increasing HDL?

Despite the well-documented benefits of HDL cholesterol, doctors rarely focus on increasing it. There are several reasons for this:

1. 1. The Pharmaceutical Focus: The medical system is largely driven by pharmaceutical interventions. While statins and other drugs effectively lower LDL cholesterol, there are no highly effective, FDA-approved medications that specifically raise HDL in a way that reduces cardiovascular risk.
   2. Outdated Research Priorities: For years, research focused on LDL reduction because high LDL was a more obvious and modifiable risk factor. However, emerging research suggests that HDL functionality—how well it removes cholesterol and reduces inflammation—may be more important than HDL levels alone.
   3. Misinterpretation of Studies: Some studies have suggested that merely raising HDL does not always translate to lower cardiovascular risk. This has led some physicians to de-emphasize HDL altogether. However, these studies often fail to differentiate between functional HDL and dysfunctional HDL, which can result from chronic inflammation, poor diet, and metabolic dysfunction.

Success Stories: The Impact of BalanceOil+ on HDL Cholesterol

In my practice, I reviewed the lab work of 34 clients, and every single one of them experienced an average increase of 8 points in their HDL cholesterol within just six months of taking BalanceOil+.

Take Susy, for example. She had been struggling to increase her HDL cholesterol for over 10 years. Despite numerous attempts with different dietary and lifestyle changes, her HDL remained stagnant at an average of 46 mg/dL. However, after just six months of consistently taking BalanceOil+, her HDL cholesterol jumped to an impressive 62 mg/dL! 🎉👏🏽 That’s a major win for her heart health and a testament to the power of optimal omega-3 intake.

How to Naturally Increase and Improve HDL Function

Instead of relying on medications, lifestyle and dietary changes are the best ways to raise HDL and improve its function:

1. 1. Increase Healthy Fats: Omega-3 fatty acids (found in wild-caught fish, grass-fed meats and butter, and walnuts) and monounsaturated fats (found in olives, avocados, and nuts) have been shown to improve HDL function.
   2. Reduce Omega-6 Intake: Modern diets are excessively high in omega-6 fatty acids from vegetable and seed oils, which contribute to inflammation and impair HDL function. Restoring a healthier omega-6 to omega-3 balance is essential.
   3. Consume Polyphenols: Found in dark berries, extra virgin olive oil, and green tea, polyphenols help improve HDL’s antioxidant capabilities and overall function.
   4. Exercise Regularly: Aerobic exercise, resistance training, and high-intensity interval training (HIIT) have all been shown to increase HDL levels and enhance its ability to remove cholesterol.
   5. Reduce Sugar and Processed Foods: Excess sugar and refined carbohydrates lead to insulin resistance and metabolic dysfunction, which can impair HDL function.
   6. Maintain a Healthy Weight: Excess body fat, especially visceral fat, is linked to lower HDL and higher cardiovascular risk.
   7. Consider Omega-3 Supplementation: Given the difficulty of obtaining adequate omega-3s from diet alone, supplementing with a high-quality source like BalanceOil+ can help support HDL function and overall metabolic health.

Conclusion

HDL cholesterol is a powerful protector against heart disease, yet it remains underappreciated in mainstream medicine. While doctors often focus on lowering LDL with medications, increasing HDL naturally through diet and lifestyle changes can provide significant cardiovascular benefits. Instead of waiting for physicians to highlight its importance, individuals should take proactive steps to improve their HDL levels and overall heart health.

If you want to assess your metabolic health, including your omega-3 index and HDL function, consider scheduling a consultation with a nutrition expert who understands the bigger picture of heart disease prevention.

References

1. 1. Barter, P. J., & Rye, K. A. (2006). High density lipoproteins and cardiovascular disease. Circulation Research, 98(10), 1022-1033.
   2. Tall, A. R. (2008). Cholesterol efflux pathways and other potential mechanisms involved in the atheroprotective effect of high-density lipoproteins. Journal of Internal Medicine, 263(3), 256-273.
   3. Rohatgi, A., Khera, A., Berry, J. D., et al. (2014). HDL cholesterol efflux capacity and incident cardiovascular events. New England Journal of Medicine, 371(25), 2383-2393.
   4. Madsen, C. M., Varbo, A., & Nordestgaard, B. G. (2017). Extreme high high-density lipoprotein cholesterol is paradoxically associated with high mortality in men and women: Two prospective cohort studies. European Heart Journal, 38(32), 2478-2486.

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Robert Ferguson is a California- and Florida-based single father of two daughters, nutritionist, researcher, best-selling author, speaker, podcast and television host, health advisor, NAACP Image Award Nominee, creator of the Diet Free Life methodology, Chief Nutrition Officer for iCoura Health, and he serves on the Presidential Task Force on Obesity for the National Medical Association. You can e-mail Robert at robert@dietfreelife.com.

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