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Best Ways to Bump Up Your 'Good' Cholesterol

Q. How do I raise my good cholesterol levels?

A. Glad you asked. HDL cholesterol (the good cholesterol) helps to prevent our arteries from becoming blocked due to LDL (the bad cholesterol). It does this by "hauling" away the excess cholesterol lining the walls of our blood vessels, then bringing it back to the liver for reprocessing. This in turn helps to keep our arteries clear from a sticky build-up. And, if your levels of HDL are high enough (a level of 40 and above in males, 50 and above in females), it can also decrease your risk for a heart attack.

Raising HDL levels is important and I'll tell you why: For every one-point increase in HDL, there is a 3 percent decrease in a person's risk of suffering a fatal heart attack. There are two main ways to increase these levels: lifestyle modifications and medication therapy.

Lifestyle Modifications

Exercise. Just 20-30 minutes of aerobic exercise on most days of the week can jump-start your HDL in the right direction.

Break the tobacco habit. Quitting smoking can raise your HDL levels by about four points.

Lose weight. Losing 10 pounds can increase your HDL by one and a half points. Aim for a weight loss goal to achieve a body mass index (BMI) of 25 or below.

Choose the better fat. Minimize the saturated and trans fats in your diet. These substances increase the bad cholesterol while decreasing your good cholesterol. Instead, switch to products containing unsaturated fats (olive, canola, flaxseed, etc.). These may raise your HDL levels. However, this is not a free fatty-pass, because we still have to watch the calories!

Cut back on simple carbohydrates. Cakes, cookies and highly processed cereals and breads are high-glycemic foods that can lower your HDL and raise the levels of another fat in your bloodstream, triglycerides.

Drink alcohol in moderation, with a caveat! Alcohol should not be considered medicine—if you don't drink, don't start—but some studies have found mild alcohol consumption (one drink per day for women, two for men) can raise HDL by up to four points. Important caveat: Alcohol may be harmful to those with liver or addiction problems. In these cases, the risks certainly outweigh the benefits.

Feast on cold-water fish. Eating salmon, mackerel or other fish from icy waters several times a week can have a very positive effect on your HDL levels. They contain omega-3 fatty acids, which may help to explain their health benefits.

Add fiber. The soluble fiber found in fruits, vegetables, nuts and grains might boost your HDL.

Avoid anabolic steroids. These decrease your HDL levels, in addition to all their other potential health dangers.

Medication Therapy

Niacin, which is also known as nicotinic acid or vitamin B3. This is by far our best therapy for raising HDL levels. Studies have shown increases of 20 percent to 35 percent. Unfortunately, every rose has its thorn, and niacin has a big one called side effects (flushing, racing heart, etc). We often prescribe low doses in the beginning to minimize these effects. (There is also a non-prescription form of niacin called hexanicotinate, which may be better tolerated but is nowhere near as effective).

Fibrates, including fenofibrate and gemfibrozil. This category of medication has the potential to boost your HDL by up to 20 percent.. Side effects may include upset stomach and diarrhea.

Statins. These are better known for their remarkable ability to lower the harmful LDL cholesterol. However, certain drugs within this class (atorvastatin, rosuvastatin and simvastatin) can raise HDL by up to 15 percent.

I am a big believer in taking charge of your health. Please know your HDL level and remember that simple changes can dramatically improve your health..

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