What are LDL and HDL and how do they affect my health?
Low-Density Lipoprotein (LDL) and High-Density Lipoprotein (HDL) are two types of lipoproteins (particles made of protein and fats/lipids) that transport cholesterol in the bloodstream.
LDL is often referred to as the "bad" cholesterol because it carries cholesterol from the liver to the cells and can build up in the blood vessels, increasing the risk of heart disease. However, this happens primarily to OXIDIZED LDL. LDL is oxidized by accumulating oxidative stress from toxin exposure.
HDL is considered the "good" cholesterol as it picks up excess cholesterol from the artery walls and takes it back to the liver to be removed from the body. But larger HDL is primarily responsible for this beneficial activity.
Maintaining a healthy balance of LDL and HDL cholesterol is important for overall health as high levels of LDL and low levels of HDL can increase the risk of heart disease and stroke, while high levels of HDL and low levels of LDL can help protect against heart disease. Regular exercise, a healthy diet, and avoiding smoking and excessive alcohol consumption can help maintain a healthy balance of LDL and HDL cholesterol levels.
However, there is more to LDL and HDL than a single reading. Small and large LDL and HDL affect cardiovascular health.
Large LDL is less risky and is commonly referred to as “buoyant” because it stays in circulation. This makes it less likely to penetrate the artery protective inner layer, literally bouncing off the wall like a beach ball. A preponderance of Large LDL is called a Pattern A.
Small LDL is considered higher risk. It is more “dense,” penetrating, and prone to get stuck in the wall to become fuel for inflammation which creates atherosclerotic plaque. A preponderance of Small LDL is called a Pattern B. It is associated with insulin resistance, the most common driver of arterial inflammation.
Large HDL removes cholesterol from the artery more efficiently than small HDL, transporting it to the liver for processing and removal.
To summarize, larger LDL and HDL particles reduce risk of arterial disease and events, while smaller LDL and HDL particles increase risk.
Image Source: Berkley Heart Lab
What causes smaller LDL and HDL in the body?
Smaller LDL and HDL particle size is commonly associated with insulin resistance (prediabetes, metabolic syndrome, Type 2 Diabetes), diets high in sugar and processed foods, smoking, and a sedentary lifestyle.
How can I increase the size of LDL and HDL in my body?
Lose fat (especially visceral fat), consume less sugar, starch and processed foods, including a significant amount of vegetables and fasting. Exercise (especially resistance training and increased muscle mass) is also a key driver of larger LDL and HDL production. Individuals with diabetes and prediabetes, should also work to improve control of these conditions, as they are also a factor in LDL and HDL size.