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Acceptable LDL and HDL Levels

May 29, 2010 | By Walli Carranza
Acceptable LDL and HDL Levels
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Dyslipidemia is an unhealthy balance between low-density lipoprotein (LDL) and high-density lipoprotein (HDL), two vehicles the body uses to transport cholesterol throughout the body.
LDL levels should be kept low, with the optimal concentration being less than 100 mg per deciliter. HDL serves to soak up and move fats to the liver for disposal, making a high concentration beneficial. Target ranges for HDL are 40 to 82 mg / deciliter for men and 50 mg / deciliter for women, according to the National Institutes of Health (NIH) guidelines.

Acceptable LDL Levels

As a general rule, NIH guidelines say LDL should be maintained at the lowest possible level, with 100mg/dL being the "initial target." There is no longer debate among cardiologists that levels below 100 mg/ deciliter are a benefit in preventing cardiovascular disease, but some scientists in the late 1990s questioned whether levels below 70 mg/dL increase the risk of hemorrhagic cancers and depression.
A Brigham and Williams Hospital study released in the October 2005 issue of the Journal of the American College of Cardiologists attempted to put this debate to rest. The results aimed to refute the idea that LDL levels below 100 mg / deciliter were harmful and the National Cholesterol Education Program altered its recommendations in 2004 to recommend that "high-risk patients," defined as those with a 10-year risk of a cardiac event exceeding 20 percent, maintain LDL levels below 100 mg/dL, lowering it to less than 70 mg/dL.
For most men and women, this is a moot point. According to the American Heart Association, 29.8 percent to 39 percent of Americans, depending on gender and ethnicity, are living with LDL levels above 130md/dL, a level considered too high for optimal cardiovascular health.

Acceptable HDL Levels

HDL sweeps up excess fats in the blood and carries them to the liver for storage and disposal. An optimal level for women is 50 to 82 mg/deciliter, and for men it is 40 to 82 mg/deciliter.
The NIH includes diabetes, a diet too high in carbohydrates and too low in healthy, omega-3 fatty acids; smoking; and physical inactivity as causes of low HDL. Obesity, especially when it is accompanied by an abdominal circumference of more than 40 inches for men or 35 inches for women, can cause this condition even when all other risks are eliminated.

Achieving Acceptable LDL and HDL Levels

The NIH has determined that only 35 percent of adults with dyslipidemia are actively managing their cholesterol levels. As a well-informed health care consumer, it is possible to ensure you are taking all necessary steps to manage cholesterol and related risk factors.
First, ask your health care provider to order a fasting lipid profile and measure your height, weight and waist circumference. Considering the association between diabetes and lipid abnormalities, a hemoglobin A1C should also be performed. You will need current lab values, less than a year old, to help guide your decision-making process.
The use of a body mass index calculator makes determining your weight status very easy. Seek a BMI of 25 or less, aiming to lose one pound per week to achieve this goal. A diet low in simple carbohydrates that includes omega-3 fatty acids is recommended to raise HDL. To calculate your target calorie count, use a basal metabolic rate calculator, multiply your BMR by 1.2 and subtract 500 calories if you need to lose weight. In addition, stop smoking, exercise one hour each day and make getting 8 hours of sleep each night a priority.
Unless the level of LDL is dangerously high, the NIH guidelines recommend putting these changes in place for a few months before retesting your lipid levels to determine whether medications are indicated.

Medications

When indicated, two medication types are used to treat dyslipidemia, the condition of high LDL and low HDL.
When the LDL is above 130mg/dL despite lifestyle changes or above 190mg/dL on initial assessment, statins are prescribed, according to the 2004 NIH guidelines. Liver damage and pregnancy are contraindications to statin use.
Niacin, or vitamin B3, contains an active ingredient, nicotinic acid, which is prescribed specifically to raise HDL. A therapeutic dose of 1,000 to 3,000 grams per day requires prescription medication, as the amounts in food and vitamin supplements are not sufficient for this purpose.

Alcohol and Acceptable HDL

The only food proven to raise HDL is alcohol. In the March 1999 issue of the British Medical Journal, researchers reported that "Drinking one ounce of alcohol per day raises HDL by 1 mg/dL."
This benefit was the same for all forms of alcohol, and it reaches a maximum level at 4 oz. per day. Four ounces of beer or wine contribute 50 to 100 calories to each day's diet.
For those who prefer not to drink, weight loss and exercise can also produce significant elevations in HDL.

References

Article reviewed by OmahaTyppo Last updated on: May 29, 2010

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