Plus, what to eat to raise your good cholesterol levels.

Karla Walsh; Reviewed by Lisa Valente, M.S., RD
April 13, 2021
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Ever since the low-fat diet days of the '90s—and even a few decades before as scientists dove into the topic of dietary cholesterol sources—the prevailing societal view has been that cholesterol is a "bad guy."

But we've moved on from the no-yolks phase (hallelujah!) and are learning that healthy fats are absolutely worth including in our diets, and some of the cholesterol in our body is actually a boon for our overall health.

Before we dive into this new research, let's recap the two types of cholesterol that make up your total cholesterol count (learn more about cholesterol numbers and what they mean):

  • Low-density lipoprotein (LDL) cholesterol, often referred to as "bad" cholesterol, can accumulate on walls of blood vessels, narrowing the path for blood to flow. These can also lead to clots that trigger heart attacks and strokes. An easy way to remember this is that you want to aim for low levels of low-density lipoprotein (or less than 100 mg/dL for adult men and women).
  • High-density lipoprotein (HDL) cholesterol, often referred to as "good" cholesterol, picks up excess cholesterol in the blood and escorts it to the liver where it's broken down and excreted from the body. You want high levels (north of 60 mg/dL for adult men and women).
good cholesterol foods

In new research published on Monday in the American Heart Association's (AHA) journal Circulation, scientists found that the ability of HDL to combat inflammation within blood vessels may be able to help doctors pinpoint and predict who might be at higher risk for heart attacks, strokes or other cardiovascular events. The connection is so potentially impactful that the anti-inflammatory capacity of HDL may become part of an overall heart disease risk panel, the researchers believe.

Testing HDL levels is already part of the process when medical pros try to assess heart disease risk, but an additional test of the anti-inflammatory qualities of the HDL may offer even more insights about—even independent of the amount of HDL in the body.

"HDL are very complex particles with anti-atherosclerotic functions that are not reflected by measuring just the cholesterol quantity," senior study author Uwe J.F. Tietge, MD, PhD, professor and head of the division of clinical chemistry at the Karolinska Institute in Stockholm, Sweden tells the AHA. "Atherosclerosis [AKA a build-up of plaque in the arteries] underlying cardiovascular disease is increasingly recognized as a disease with a strong inflammatory component, and a central biological function of HDL is to decrease inflammation."

To gauge this, the researchers studied data from 680 adults in the Netherlands. All were healthy at the beginning of the study more than 20 years ago, but since, 340 have experienced heart attacks or were diagnosed with a heart condition. The scientists matched this smaller group to 340 other people of similar age, sex, smoking status and HDL cholesterol levels who didn't have cardiovascular disease. As a result, they found:

  • HDL's anti-inflammatory aptitude was about 32% higher in those who fell into the "healthy" category compared to those who were diagnosed with cardiovascular disease.
  • People were 23% less likely to have a cardiovascular event in the next 10 years for every 22% increase in the anti-inflammatory abilities of HDL particles within the blood vessels cells.
  • This connection between HDL's anti-inflammatory capacity and cardiac health was stronger in women than in men.

"The HDL cholesterol level is a good, established, simple and cost-efficient CVD risk biomarker," Tietge adds. "Our results, however, demonstrate that the anti-inflammatory capacity or assays looking at HDL function in general have the potential to provide clinically relevant information beyond the static HDL cholesterol measurements.

While many factors influence cholesterol levels, including genetics and exercise, there are foods that can improve your HDL levels—and their subsequent potential inflammation-fighting abilities. These anti-inflammatory foods, such as olive oil, legumes, whole grains, fiber-rich fruits and veggies, omega-3 rich fish, nuts and seeds are also good for your cholesterol levels. Looking for a lifestyle plan that includes all of these good cholesterol-boosting foods? Try following the Mediterranean diet. We have plenty of Mediterranean diet meal plans to provide inspo.