In my last two posts (see: Reduce Triglycerides Naturally & Why Take Fish Oil if You Take a Statin Drug?), I discussed how, in my program for reversal of heart disease, we follow what I call the "Rule of 60": LDL 60 mg/dl, HDL 60 mg/dl, triglycerides 60 mg/dl, or 60:60:60.
We achieve greater control over heart disease risk by adhering to this formula, relying on as little medication as possible.
The question to consider here is: How can you achieve HDL of 60 mg/dl or greater?
First of all, many clinical studies suggest that HDL of 60 mg/dl is associated with dramatic reduction in rate of heart attack. Several studies suggest that higher levels of HDL are associated with less carotid and coronary atherosclerotic plaque. HDL particles are also protective against infections and even cancer, and are a major player in the body's fight against inflammatory patterns. In other words, HDL has clearly established itself as a blood particle that provides powerful protective functions.
Sadly, many of my colleagues are unaware of these simple yet effective methods for increasing HDL, often dramatically. With efforts like these, it is not uncommon to see 20, 30, even 40 mg/dl upwards jumps in HDL to reach levels of 50, 60, 70, even 80 mg/dl. The majority of these strategies can be followed on your own.
HDL can be raised by:
• Keeping triglycerides at a low level─Triglycerides modify HDL structure and hasten their elimination from the blood. (See last blog post on reducing triglycerides to 60 mg/dl.) Thus, keeping triglycerides low allows HDL to rise to healthier levels. Omega-3 fatty acids from fish oil are crucial for this effect.
• Reduction or elimination of foods that reduce HDL─Hydrogenated fats ("trans" fats) should be eliminated, since they reduce HDL (as well as increasing LDL and blood pressure, and have been associated with cancer). Hydrogenated fats are found in many margarines and processed foods. Because low-fat diets reduce HDL (and raise triglycerides), I advocate a diet approach that involves the elimination of foods made with wheat or cornstarch, as well as reduction or elimination of junk foods. This can skyrocket HDL enormously over time.
• Red wine─Although all alcoholic beverages raise HDL, red wine confers additional benefits, such as reduction in blood sugar and blood pressure, provided no more than 2 glasses per day are consumed.
• Dark Chocolate─Preferably 70% cocoa or greater. We ask our patients to not exceed 40 grams, or approximately 2 inches square, per day.
• Green tea─Brewed only, never instant or pre-mixed bottles. Several cups per day are required for its full effect.
• Vitamin D─Restoration of vitamin D levels to normal can yield increases in HDL of 10, 20, even 30 mg/dl, though it may require up to a year for the full effect to show.
• Exercise─The magnitude of increase in HDL depends to a great degree on your starting level. People who begin from a sedentary lifestyle can expect 10 mg/dl increase or more; people who begin with mild-moderate activity can expect less.
If the above fail to raise HDL to our desired target (but be patient!), then niacin is worth considering. For raising HDL, I find that a dose of 1000 mg per day yields maximal effect. (I use the non-prescription preparation, Sloniacin, made by Upsher Smith, exclusively. It has a proven track record of safety and is widely available in the vitamin aisle of drugstores and some department stores. I advise patients to begin with 500 mg at dinner for four weeks, then increase to 1000 mg.) Work with your doctor with niacin, but generous hydration (e.g., 2 big glasses of water) helps turn off the hot flush common with niacin.
Using the above approach in our program, HDLs of 60, 70, 80 mg/dl and higher are commonplace.