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Expert Q&A

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What should we eat to improve HDL, LDL, triglycerides?

Asked by Kashif, Houston, Texas

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What should we include in our diet to increase HDL and lower LDL and triglycerides?

Expert Bio Picture

Diet and Fitness Expert Dr. Melina Jampolis Physician Nutrition Specialist

Expert answer:

Hi Kashif. This is an interesting question, as different components of the diet can be more important for different types of cholesterol abnormalities. Knowing which of your numbers are too low or too high can help you focus your efforts more effectively, although getting to and staying at a healthy weight and eating an overall heart healthy diet like the one that I discussed in an earlier response is the most important overall strategy.

Here is a little primer on where your levels should be in general and how to get them there.

LDL (low-density lipoprotein) or "bad" cholesterol: Elevated LDL cholesterol is highly associated with heart disease. Lowering levels to less than 100 mg/dL (less than 70 mg/dL if you are at very high risk of a heart attack or sudden cardiac death) is very important for reducing your risk of heart attack and stroke.

There are several ways to lower LDL, including limiting saturated fat to less than 7 percent of your total calories; avoiding dangerous trans fats (hydrogenated oils) as much as possible (aim for less than 1 percent of your diet per day or less than 2 grams total if you are consuming 2,000 calories per day); and increasing your intake of soluble fiber found in things such as oatmeal, whole grains, barley, beans, peas, apples, strawberries and psyllium. Try to consume a variety of soluble fiber containing foods every day.

HDL (high-density lipoprotein) or "good" cholesterol: HDL cholesterol is important for transporting less-healthy cholesterol away from the heart, thereby preventing the buildup of unhealthy cholesterol in your coronary arteries. Low levels increase your risk of heart disease. Women should aim for a level of 50 mg/dL or more and men should aim for a level of 40 mg/dL or more.

While it is more difficult to raise good cholesterol, there are a several things that you can do, including losing weight (particularly the unhealthy fat that accumulates around your midsection); exercising (at least 150 minutes a week); drinking moderate amounts of alcohol (1-2 servings a day but don't feel like you need to start drinking if you don't already and avoid sugar-filled cocktails); and taking an omega 3 fatty acid supplement (1 gram of fish oil per day) or eating fatty fish such as salmon, sardines and tuna at least twice a week.

Triglycerides: These are another type of fat in the blood that is associated with an increased risk of heart disease. High levels of triglycerides (greater than 150 mg/dL) are often found in conjunction with low levels of HDL (good cholesterol) and suggest a condition known as metabolic syndrome that represents a constellation of findings that may also include high or high/normal blood sugar, waist size greater than 35 inches for women and 40 inches for men, and high blood pressure.

Metabolic syndrome can significantly increase your risk of heart disease and diabetes, and the best treatment is weight loss. In my clinical practice, which is guided by current research, I find that overweight patients with metabolic syndrome tend to respond better to a lower or moderate carbohydrate/higher protein diet.

I highly recommend against cutting carbohydrates completely, as the lack of fiber in your diet may cause the bad cholesterol to increase (aim for about 3 servings of whole grains per day). It is particularly important to limit refined sugar and highly processed carbohydrates if you have elevated triglycerides. Higher levels of omega 3 fatty acids (2-4 grams per day) may also help lower triglycerides, but talk to your doctor first.

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