Higher HDL levels are generally associated with decreased risk for heart disease because of its role in transporting cholesterol away from macrophages within the artery wall back to the liver for recycling. However it seems that the amount of HDL is not the primary driver of improvement in this area. HDL Efflux appears to be the main driver and refers to how good HDL is at ‘sucking’ up cholesterol. You can have HDL C levels above 2.0 mmol but if your Efflux is low the hoover just ain’t picking up the bits. This may explain why very high levels of HDL dont seem to be better than just above average levels.
How can we improve HDL Efflux, well it seems the good old Med’ diet comes to fore once again along with a moderate (glass with a meal) amount of red wine. More controversially for me and other more expert in the field is the advocacy of extra virgin olive oil. Nothing seems to split the heart health community like this ingredient. Some research swear by it whilst others clearly show it creates endothelial disfunction. My feelings are that when confronted with split opinions like this I prefer to leave it out of my diet especially when its non essential. I will stick with a med’ based diet and a handful of nuts each day.