about    “good   cholesterol”    and     “bad    cholesterol,”   my  eyes
glazed   over.   Say     what?   Now,    when    a   doctor  talks   to  me
about    “good   cholesterol”    and     “bad    cholesterol,”   my  eyes
still   glaze   over,   but for a   different   reason–because  when    you
go   down    the     rabbit  hole,   the     good/bad    analogy     becomes
laughably   simplistic.
The previous    section focuses on  the LDL story   because,
all else    equal,  more    LDL particles   floating    around  for longer
means    higher  disease     risk.   High-density    lipoproteins,   or
HDL,     the     “good   cholesterol,”   on  the     other   hand,   are     less
well     understood–but  just    like    LDL,    the     total   amount  of
cholesterol in  your    HDL test    may be  less    important   than    the
number  of  healthy,    functional  particles   you have.
HDL particles   are thought to  benefit your    health  because
they    are sort    of  like    the cleanup trucks. They    pick    up  excess
cholesterol from    the far reaches of  your    body    and deliver it
back    to  your    liver,  where   it  is  converted   to  bile    and passed.
In   fact,   a   low     HDL-LDL     or  HDL-triglyceride    ratio   is  a
stronger     predictor   of  heart   disease     risk    than    high    “bad
cholesterol.”    Interestingly,  saturated   fat–while   it  does    raise
the  amount  of  LDL     in  the     body–also   raises  HDL,
maintaining a   cardiovascular-favorable    lipoprotein ratio.
But the amount  of  HDL you have    isn’t   the whole   story.
Newer   tests   are being   developed   to  look    at  the functionality
of  the HDL recycling   system. We  call    it  efflux  capacity:   how
efficiently  your    HDL     scavenges   cholesterol    from     the
overworked   white   blood   cells   in  your    damaged     arterial
plaques and shuttles    it  back    to  the liver.
The  other   aspects     of  functional  HDL     are     still   being
discovered.  It  acts    as  a   potent  antioxidant     and     anti-
                    
                      john hannent
                      (John Hannent)
                      
                    
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