HDL cholesterol vs. LDL Cholesterol: What's the Difference Between Them and What Do They Actually Do?

We increase our bad cholesterol in proportion to how much animal fat and fried food we eat. Good cholesterol, on the other hand, makes friends with, for example, healthy fish oil. The debate surrounding cholesterol is still open, but you must remember that it is necessary for the proper functioning of the body. "The body uses cholesterol to create hormones and vitamin D, as well as support digestion," says internist Angelica Balingitová. It is interesting that the liver produces enough cholesterol to manage all bodily functions, but we increase its level through diet, mostly meat and dairy products.

It is important to understand the difference between LDL and HDL cholesterol, which we will now look at.

HDL is good cholesterol because it rids the body of excess cholesterol and keeps blood vessels healthy

At the beginning, let's ask ourselves a fundamental question: Why is HDL cholesterol called "good"? This is because it helps the body get rid of excess (LDL) cholesterol, which significantly reduces the risk of developing cardiovascular disease. "Cholesterol normally travels from the liver to the bloodstream, from where it is distributed to various cells in the body to support important functions, such as the creation of cell membranes and hormones," the Cleveland Clinic experts explain.

However, sometimes there is too much cholesterol in the blood. More than the body needs. Then the activation of the so-called cholesterol reverse transport. Reverse transport is a complex process in which HDL cholesterol undoubtedly plays a role, but scientists are still investigating how big. "We know that HDL transports excess cholesterol from the bloodstream back to the liver, where it is broken down and leaves the body in the stool," added internists from the Cleveland Clinic.

This is an essential process preventing the development of atherosclerosis. “Removing excess cholesterol isn't the only job HDL does. It also has an anti-inflammatory effect and protects cells from oxidative stress. Last but not least, it plays a role in the prevention of blood clots," explains Damien Denimal from the Center for Translational and Molecular Medicine in Dijon, France.

In simple terms, it can be said that if too much LDL cholesterol passes through the blood vessels, it starts to settle in them and create the so-called coating. Plaque build-up in blood vessels eventually causes them to narrow; the narrower the vessels, the harder it is for blood to reach the heart and other organs. This blocks blood flow, causing chest pain (angina), hardening of the arteries (atherosclerosis) and even heart attacks.

Which factors increase the risk of excess LDL cholesterol? Age and menu composition

The risk of high cholesterol increases with age. The older we get, the harder it is for our bodies to remove cholesterol, with a family history of high cholesterol increasing the risk rapidly. "You can't control aging or family predispositions, but there are situations where cholesterol levels can be balanced so that HDL is more than LDL, and not the other way around," explains healthline therapist Alana Biggers from Healthline. There are a number of risk factors.

For example, obese individuals and diabetics (type 2 diabetes) are extremely prone to an excess of bad cholesterol.

Other risk factors contributing to a drop in HDL cholesterol include:

• smoking,
• a diet with a high content of saturated fat,
• lack of movement,
• excessive drinking of alcohol,
• excessive intake of sugar (sugar turns into fat in the body),
• stress,
• excessive salting of food.

How to lower LDL cholesterol? Changing your lifestyle and adding healthy foods to your menu will help

Ami B. Bhatt, director of the Congenital Heart Disease Program, says a good first step to lowering LDL cholesterol is "a low-fat diet, aerobic exercise, maintaining an optimal weight and a smaller waistline." In some cases, lifestyle changes are not enough and your doctor will prescribe cholesterol-lowering drugs such as statins. "Rarely, tendencies towards high LDL cholesterol are passed on genetically in the form of so-called familial hypercholesterolemia," adds Bhattová.

"It is caused by a genetic mutation reducing the ability of the liver to remove excess cholesterol. The disease is all the more dangerous because it leads to high levels of LDL cholesterol with the risk of heart attack or stroke at a very young age." Remember, adopting a healthy lifestyle and incorporating these tips into your daily routine is a good first step.

Enjoy olive oil regularly

Olive oil is one of the healthiest fats ever. It reduces the risk of heart disease and increases the level of healthy HDL cholesterol because it contains antioxidants called polyphenols. In addition, it strengthens the anti-inflammatory and antioxidant properties of HDL cholesterol.

Follow a low-carb and/or keto diet

A low-carbohydrate diet and a keto diet have a positive effect on weight loss, lowering blood sugar levels and increasing HDL cholesterol values. Scientific studies even show that in addition to increasing HDL cholesterol, a low-carbohydrate diet can reduce the amount of triglycerides and thus the risk of developing heart disease.

Treat yourself to regular light exercise at least twice a week

Regular exercise contributes to heart health. Many studies have shown that aerobic exercise effectively increases HDL cholesterol levels. "The greatest increase in HDL usually occurs during intense short exercise," advises endocrinologist Marina Basinová. However, even lower intensity exercise appears to increase HDL's anti-inflammatory and antioxidant capabilities.

Have your cholesterol level checked at least twice a year, an overview of progress in lowering LDL is important 

Experts recommend having your fat metabolism checked or lipid profile at least twice a year. If you want to track your progress in reducing your bad cholesterol, you can purchase a self-pay cholesterol test and take it as often as you like. The VZP website states that "cholesterol screening is carried out at the age of 18 during the first preventive check-up with a general practitioner for adults and then during the general preventive check-up at the age of 30, 40, 50 and 60". Given that HDL cholesterol is primarily processed by the liver, it is necessary to undergo a liver test at least once a year.

With cholesterol, remember that it is good to have more HDL (good cholesterol) than LDL (bad cholesterol). HDL ensures that cholesterol is removed from the blood, while LDL clogs blood vessels and increases the risk of developing hardening of the arteries. Don't forget to get your cholesterol checked at least twice a year, if you are a self-payer, feel free to get tested several times a year.