Cholesterol has been getting a lot of press lately. The most recent news is the about face on dietary cholesterol. The American dietary guidelines no longer encourage restricted cholesterol consumption. Strong scientific evidence shows that dietary intake has little influence on levels of good and bad cholesterol in the body.
The message that hasn't changed is this: If your blood has a lower level of bad cholesterol (low-density lipoprotein, or LDL) and a higher level of the good kind (high-density lipoprotein, or HDL), you will reduce your risk of heart disease. Lifestyle modifications and/or medications are usually effective in shifting your cholesterol levels into a healthy range.
Surprisingly, a large number of heart attacks are seen in people with healthy levels of good cholesterol. This indicates that there is something going on beyond the numbers, and that is the quality and function of HDL.
You see, HDLs help keep LDLs under control. Their job is to prevent the oxidation of LDL, which can lead to atherosclerosis, a disease in which plaque builds up inside your arteries. LDLs become oxidized after they react with free radicals. When your HDLs are in good shape, they act as an antioxidant. Weak HDLs can also lead to inflammation.
So how do you improve the function of your HDLs? You already know that regular exercise helps prevent cardiac disease. Both cardiovascular exercise and resistance training can have a positive impact. A study published in the Journal of Applied Physiology in 2013 compared the performance of HDLs in men who participated in resistance training and men who did not. They found that the HDLs of the men who strength trained were significantly better. Both groups of men had the same levels of HDL, but the strength training group's HDLs had superior performance.
Obesity and excess weight are often blamed for many instances of heart disease. In the same strength training study, a group of overweight participants trained with weights. Their HDLs performed as well as the HDLs from the normal weight (a BMI at or under 25) participants. The quality of their HDLs was the same even if the individual had a BMI of 30 (that would be over 200 pounds for a 6-foot man). Moreover, a paper published in the Mayo Clinic Proceedings in 2012 reported that overweight and obese men have increased longevity if they have a high fitness level.
It's important to remember that fitness and health can be two very different things. Don't get me wrong – losing belly fat is always a good thing. Fat stored around your midsection may be a problem down the road. Just make sure you lose it the right way, through proper nutrition and exercise.
A major downside to using weight as a health predictor is that the scale doesn't differentiate between lean weight and fat weight. If you lose five pounds of fat and gain five pounds of muscle, you are healthier even though your weight hasn't changed.
All of this goes to show that the number on the scale is not as strong a predictor of health as we once thought. The best thing you can do to maximize the function of your HDLs and improve your health is simply start exercising. Naten Thakur, a physician at Cleveland Clinic Canada in Toronto, shares this advice with his patients who are trying to lose weight: "Just get moving. If you lose weight in the process, it's a bonus."
So don't let the weight on the scale rule you, and focus instead on increasing your level of fitness. Your HDLs will thank you for it.
Health Advisor contributors share their knowledge in fields ranging from fitness to psychology, pediatrics to aging.
Gilles Beaudin is a registered clinical exercise physiologist at Cleveland Clinic Canada.