Understanding and effectively influencing cholesterol levels
The terms LDL and HDL appear in almost every (proper) blood test, yet for many men they are nothing more than cryptic abbreviations. However, these two cholesterol fractions provide crucial information about your vascular health, your risk of heart attack, and your hormonal balance .
Cholesterol itself is not bad: it is a vital building block for cell membranes, vitamin D synthesis, and the production of male hormones such as testosterone . Cholesterol only becomes problematic when it is unevenly distributed , and this is where LDL and HDL come into play.
LDL: The “bad” cholesterol
LDL (low-density lipoprotein) is responsible for transporting cholesterol from the liver to the body's cells. This sounds harmless at first, since every cell needs cholesterol. However, if too much LDL is transported, it can accumulate in the walls of blood vessels. There, it oxidizes and contributes to atherosclerosis (hardening of the arteries) – a gradual disease that increases the risk of:
- heart attack
- stroke
- Erectile dysfunction
- and peripheral vascular diseases
significantly increased.
The LDL level is therefore particularly critical when it coincides with other risk factors - such as abdominal fat, insulin resistance, high blood pressure or smoking.
HDL: The “good” cholesterol
HDL (high-density lipoprotein) works in the opposite way to LDL: it collects excess cholesterol in the tissues and transports it back to the liver, where it is broken down. HDL thus actively protects the blood vessels from deposits – provided it is present in sufficient quantity and functioning properly .
A good HDL level can reduce the risk of cardiovascular disease, especially when LDL is kept low at the same time. A favorable LDL/HDL ratio is often more informative than the individual values.
LDL/HDL: What is considered healthy?
Most laboratories use the following target values as a guideline:
- LDL: below 100 mg/dL (optimal), above 160 mg/dL critical
- HDL: above 40 mg/dL in men, above 60 mg/dL is considered particularly protective
- LDL/HDL ratio: ideally below 3.5
Caution: Even with "normal" total cholesterol, an unfavorable ratio can indicate an increased risk.
What do LDL and HDL depend on?
Lipid distribution is not exclusively genetically determined - in many cases it can be positively influenced by lifestyle:
Among other things that increase LDL cholesterol are:
- high-sugar diet
- Trans fats (especially in fast food)
- Lack of exercise
- chronic stress and sleep deprivation
HDL can be improved:
- regular physical activity, especially strength and interval training
- healthy fats (olive oil, nuts, avocado, omega-3)
- moderate alcohol consumption (e.g. 1 glass of red wine)
- Quit smoking
Of particular importance: Insulin resistance and visceral fat promote an unfavorable LDL composition – even at a normal weight. Therefore, blood lipid levels should not be considered in isolation , but always in the context of metabolism, hormones, and inflammation .
