Even small amounts of alcohol can increase triglycerides. So if high triglycerides are a problem for you, it would be a good idea to cut down on alcohol as much as possible.
HDL cholesterol is called “good” cholesterol because higher levels protect against coronary heart disease by carrying cholesterol away from the arteries and back to the liver where it is disposed of. A low level of HDL cholesterol is associated with an increased risk of coronary heart disease.
When triglyceride levels are elevated, HDL cholesterol levels begin to fall. So when you make changes to improve your triglycerides, this may also lead to an improved HDL cholesterol level. However, low HDL cholesterol may also be present in the absence of high triglycerides. This is called isolated low HDL cholesterol and is attributed to many of the same factors that may promote high triglycerides, including overweight and obesity, physical inactivity, cigarette smoking, very high carbohydrate intake (more than 60% of calories), Type 2 diabetes, and genetic factors.
All the lifestyle changes covered in this article are essential components of HDL cholesterol management. In particular, losing weight or maintaining a healthy weight, being physically active most days of the week, and not smoking can increase your HDL cholesterol. In addition, maintaining a low intake of saturated fat and trans fat, avoiding processed carbohydrates, and consuming an adequate amount of monounsaturated and polyunsaturated fats all promote a healthy level of HDL cholesterol.
Special considerations for diabetes
The combination of high triglycerides and low HDL cholesterol is common among people with diabetes (especially Type 2 diabetes) and is often referred to as diabetic dyslipidemia or atherogenic dyslipidemia. Abnormalities in blood lipids, high blood pressure, high blood glucose, insulin resistance, and other factors also contribute to the increased risk of coronary heart disease among people with diabetes.
Just having diabetes is considered a coronary heart disease “risk equivalent.” This means that the lipid management goals for people with diabetes are the same as for people who have established coronary heart disease. A change in lifestyle should always be part of a plan to lower lipid levels, but doctors may also prescribe lipid-lowering drugs to further reduce the risk — even if lipid goals are met through lifestyle changes alone. To keep track of your lipid levels, annual testing is recommended. And because nutrition can be complex, it is also recommended that people with diabetes meet with a registered dietitian to devise individualized strategies for meeting their dietary goals.
Improving your lipid levels may not be easy and may take time, but significant change is possible. An estimated LDL cholesterol reduction of 8% to 10% can be achieved by cutting intake of saturated fat to less than 7% of calories. An additional reduction of 3% to 5% can be achieved by cutting cholesterol intake to less than 200 mg per day. A 10-pound weight loss could mean as much as a 5% to 8% decrease in LDL cholesterol. The addition of plant sterol and stanol esters to your diet could reduce LDL cholesterol even further, by up to 15%. And consuming more soluble fiber can reduce it up to 5% more. This adds up to a possible 30% reduction in LDL cholesterol through lifestyle changes alone.
These lifestyle modifications may not only improve lipids, but also have a ripple effect: Blood glucose control and blood pressure may also improve as a result. The best way to start is to talk with your doctor. Review your lipid levels with him, set lifestyle change goals, and set a date to follow up and track your progress.