Consistently low HDL level

Medical Q&A [Moderated]
1

Hi
I’ve just had my blood lipids tested and wanted to know whether I should be concerned with low HDL levels, as I know they seem to be correlated with increased risk of CV diseases/events. I’m overall healthy, 27 year old 5’9" 75kg (165lb) male. I’ve been an active lifter for a few years now, my waist circumference is about 80cm (~31 inches) at the moment, I would say I’m rather muscular. I’m trying my best to meet dietary guidelines, however I tend to not eat a whole lot of fruits/veggies and I often eat at fast food restaurants as my main meals, processed snacks are also not a rarity. I’ve tracked saturated fats for a few sample days and to my calculations they did not exceed 10% of daily calorie intake. I do eat a lot of protein daily, mostly from various meat sources and WPC.

Here’s my lipid panel taken today:

Total cholesterol: 121
LDL: 75
HDL: 26
Triglycerides: 102

And below are the results of a test taken about 2 years ago, I was a little less lean at the time, around 80kg (176lb) and probably about 1 or 2 inches wider compared to current day. My dietary pattern was similar back then to what it is now.

Total cholesterol: 143
LDL: 87
HDL: 41
Triglycerides: 74

Even though I’m leaner now, HDL dropped even lower, when it’s supposed to be at around 60 as far as my research goes to avoid any CV associated risks. Do you think I should try to make some diet interventions and be overall concerned about the HDL levels being low with a tendency to drop over time?

Not sure if relevant, but my blood pressure was 124/75 today (did not really rest for any significant period, I just sat there and had it checked immediately by the nurse, perhaps it could be a little lower after a few minutes).

2

Yes, I would recommend making dietary modifications to increase your intake of vegetables, fruits and other fibrous plant-based foods (legumes, berries, nuts), while decreasing intake of fast food and other highly processed/refined/hyperpalatable foods.

3

Thank you for the quick response. Will try my best to adhere better to a health promoting dietary pattern. But just hypothetically (assuming it’s a realistic scenario), if my blood panel looked exactly the same even though my diet would meet all the requirements to being healthy, would you recommend any behavioral/lifestyle changes or treating/supplementation or whatever just to try and bring up the HDL? What I mean is, should that exact results alone be of any concern to an individual that meets all the health promoting guidelines?

4

No interventions that specifically/directly raise HDL-C have ever been shown to actually result in better outcomes or lower risk, so there is nothing specific that I would recommend at that point, assuming you are checking off all the other “lifestyle” boxes.

The current thinking is that low HDL-C is a marker for CV risk (often related to things like insulin resistance, obesity, other chronic diseases), but is not itself causal of cardiovascular disease.