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)
#1