Low HDL cholesterol
High-density lipoprotein (HDL) helps perform many beneficial functions that protect against atherosclerosis. At its best, HDL will help reverse atherosclerosis by taking cholesterol out of the walls of your arteries and out of plaque and disposing of it in the liver in a process known as reverse cholesterol transport. Recent research has also found that the larger these molecules are, the more effective they are in this process.
HDL particle size: Just as larger LDL particles are healthier for you, so are larger HDL particles, because larger HDL is better at the “reverse cholesterol transport”, which actually takes the cholesterol out of plaque in artery walls. HDL2 is the most efficient HDL particle for reverse cholesterol transport. While this test will specifically tell you the size of your HDL particles if that is a concern to you, the good news is that the higher your HDL cholesterol is in standard cholesterol tests, the more likely it is that you also have large HDL particles.
While healthy weight is again crucial, strictly low-fat diets will reduce your HDL and its particles’ size. This is why the Mediterranean diet, which includes fats in monounsaturated form, is better than calorie-reduction diets. Strategies that increase LDL particle size will also increase HDL particle size.
For HDL to perform its most vital functions, it must have an enzyme called paraoxonase 1 (PON 1) attached to it. However, as we get older, your HDL will not be as effective as it could be without also raising your PON 1. PON 1 is crucial not just to vascular health but also to preventing diabetes, strokes, arthritis, and certain forms of cancer because it works as both an antioxidant and an anti-inflammatory agent. Low serum PON 1 levels can even be an independent risk factor for heart disease. The good news is that you don’t need an expensive drug to encourage your liver to produce more PON 1. The most recent studies show that pomegranate and its extracts significantly boost both PON 1 levels and PON 1 activity.
In a recent study in Israel, researchers found that after only two weeks of consuming pomegranate juice daily, test subjects had a 20 percent increase in PON 1 activity and a markedly reduced amount of the LDL “clumping” that leads to the formation of foam cells. Pomegranate juice and its extracts boosted the outflow of cholesterol by 39 percent. After a year in the study, subjects realized an 83 percent increase in PON 1 and a 90 percent decrease in oxidized LDL. While the artery flow of the placebo group narrowed by 9 percent, the test group saw a 30 percent reversal of narrowing in the arteries. Because of this evidence, expert recommend adding 400-500 mg of standardized pomegranate extract or its equivalent, 2-4 ounces of pomegranate juice twice a day, to your daily diet.
Since excess abdominal fat appears to contribute to low HDL, experts suggest not only reaching and staying at your healthy weight but also adding regular physical activity and aerobic exercise to encourage higher HDL levels. So make room in your schedule for regular aerobic exercise.
Also do daily supplementing your diet with the following:
• Niacin (1,000 mg, two times a day after breakfast and dinner with one baby aspirin)
• Quercetin (200 – 400 mg, three times daily)
• Resveratrol (175 – 500 mg a day)
• Pomegranate (400 mg, two times a day, or 2 -4 ounces, tow times a day, of pomegranate juice)
Bioidentical hormone therapy is also something you should consider if your HDL levels are not improved. Also you may add more niacin, up to 2,000 mg, after breakfast, and 2,000 mg after dinner. Gradually increase the dose and take one or more enteric-coated aspirins with the niacin to avoid the flushing. Check liver function tests each month while increasing the dose of niaicin.