Let’s face it, cholesterol readings can be confusing. Not only is there total cholesterol, HDL, and LDL, there’s also non-HDL cholesterol.
What exactly is non-HDL cholesterol, how is it different to the other cholesterol readings, and what do you need to know about it?
As you probably know, not all cholesterol is bad. Your body needs some cholesterol in order to function properly. But you don’t want too much of it, particularly the bad kind.
Non-HDL cholesterol is a way of measuring how much of the bad kinds of cholesterol you have in your blood. It’s also a helpful way for your doctor to evaluate your risk for heart disease.
Keep reading to learn more about what makes up your non-HDL cholesterol number, how it affects heart health, and how you can reduce this type of cholesterol.
To determine your cholesterol levels, you need a blood test called a lipid panel. The results will show your total cholesterol level. But that total doesn’t tell the whole story.
To better understand your heart disease risks, total cholesterol is broken down into:
Let’s take a closer look at each type of cholesterol and what it means.
HDL is commonly referred to as the “good” cholesterol. That’s because it transports non-HDL cholesterol from the bloodstream to the liver, which removes it from the body.
This helps prevent plaque from building up in your arteries. Having high HDL naturally is beneficial. Studies of medications, such as niacin, which raise your HDL, have not shown to be beneficial in preventing heart attacks.
LDL is sometimes called “bad” cholesterol. If you have too much, it can clog your arteries and restrict blood flow. This can lead to a heart attack or stroke. You want your LDL cholesterol to be as low as possible.
Triglycerides are a kind of fat you get from food. Extra triglycerides can pile up when you eat more calories than you burn off. High triglyceride levels in the blood are linked to heart disease. Like LDL, the goal is to keep triglyceride levels low.
There’s also a very-low-density lipoprotein (VLDL) that comes from the liver. VLDL won’t show up on your report because there’s no way to accurately measure it. It’s typically estimated as a percentage of the triglyceride value. This is important because VLDL transports triglycerides. Over time, VLDL can turn into LDL cholesterol.
As the name implies, non-HDL cholesterol, is basically your HDL (good) cholesterol number subtracted from your total cholesterol number. So, in other words, it’s all the “bad” types of cholesterol. Ideally, you want this number to be lower rather than higher.
The higher your non-HDL cholesterol, the higher your risk of heart disease.
A study published in 2018 involved more than 36,000 people with a low 10-year risk of cardiovascular disease. A long-term follow-up found LDL and non-HDL readings of more than 160 mg/dL were each linked with a 50 to 80 percent increased relative risk of cardiovascular disease mortality.
For other cholesterol readings, the following guidelines apply if you don’t have heart or blood vessel disease.
Your LDL cholesterol reading is:
- optimal if less than 100 mg/dL
- above optimal/borderline high if between 100 and 129 mg/dL
- mildly high if 130 to 159 mg/dL
- high at 160 to 189 mg/dL
- very high at 190 mg/dL or above
Your HDL cholesterol reading is:
- optimal (able to reduce your risk of heart disease) if it’s 60 mg/dL or above
- low (may increase your risk of heart disease) if it’s 40 mg/dL or lower
Your triglyceride reading is:
- optimal if less than 100 mg/dL
- borderline high at 100 to 149 mg/dL
- high if 150 to 499 mg/dL
- very high if higher than 500 mg/dL
Your doctor may have different goals for you if you’re at high risk of heart disease or have already had heart disease.
The risk of heart disease may be even greater if you:
Studies are beginning to highlight the importance of non-HDL in assessing cardiovascular risk.
For example, in a 2016 study, researchers looked at data from nine clinical trials involving people with coronary disease. They found that achieved non-HDL cholesterol was more strongly associated with disease progression than LDL.
A 2017 study involved more than 4,800 men and included a 22-year follow-up. The researchers concluded that when it comes to predicting cardiovascular disease mortality, non-HDL cholesterol may be more significant than LDL.
You get all the cholesterol you need from your liver. You also get some from foods like meat, poultry, dairy products, and saturated oils used in baked goods. These foods also prompt your liver to make more cholesterol.
To reduce your overall cholesterol levels, limit your intake of saturated fats. That means going light on fatty meat and full-fat dairy products.
It’s also important to avoid trans fats, which you may find listed as partially hydrogenated vegetable oil in:
- baked goods like store-bought cookies, cakes, pastries, and frozen pies
- snack foods like crackers, microwaveable popcorn, frozen pizza crusts, and meat pies
- fried fast foods like fried chicken, french fries, fried noodles, and battered fish
- vegetable shortening which is often used in baked goods as a cheap alternative to butter
- stick margarine which is made from hydrogenated vegetable oils
- non-dairy coffee creamers used as a substitute for milk and cream in coffee, tea, and other hot beverages
Instead of eating processed foods, try to focus on eating more whole foods, like fresh fruits and vegetables, nuts, seeds, whole grains, and healthy sources of protein, like fish, skinless chicken, and lean red meat.
Some foods that may help improve LDL cholesterol include:
- oatmeal and oat bran
- kidney beans
- brussels sprouts
- apples, pears
Some foods that may help lower triglycerides include:
- fish high in omega-3 oils, like salmon, mackerel, herring, tuna, and trout
- flaxseed oil
- canola oil
Other ways to improve your cholesterol include:
- exercising at a moderate level of activity for at least 30 minutes a day, 5 times a week
- not smoking
- limiting alcohol intake
- maintaining a healthy weight
If lifestyle changes aren’t enough, your doctor may prescribe cholesterol-lowering medications.
High HDL cholesterol is helpful, but high non-HDL cholesterol may mean you’re at an increased risk of heart disease.
Fortunately, certain lifestyle changes involving diet, exercise, and not smoking may be able to get your non-HDL back in line. If that doesn’t work, there are effective medications to help control cholesterol. If you don’t know your cholesterol numbers, talk to your doctor about getting tested.