Why can't I get my HDL cholesterol to rise? Is intense exercise the only way?

[ZenAlex]

I don't drink, smoke, I was vegan for 8 years, so ate no cholesterol. But have been eating reasonable amounts of meat/dairy/eggs for the last 10 weeks.

I know low levels of exercise are linked to it and I cannot do more than just walking right now due to my issues, but I'm still walking for 2-3 miles a day or so.

But the main piece of advice the doctor gave to me about HDL cholesterol was increasing Omega 3 intake, which was around February. I started eating salmon 3x per week, so getting plenty of omega 3 now. I was taking a  supplement for DHA as a vegan + ala sources like seeds.

Despite good omega 3 intake, it hasn't budged. It was around 0.9 on another companies test in november, but I'd assume it may fluctuate a bit. My supplementation was regular. 

Below are my levels.

Is it purely lack of exercise causing low HDL? It's annoying that my 2021 tests didn't include cholesterol so I only have results over last 7 months while I've been having these issues. 

oct 2023

 

april 2024

 

Edited April 17 by ZenAlex

[undeather]

HDL-C and especially it's propensity to adapt in context of lifestyle-changes are genetically determined.
You might improve some points by adding more exercise, but If I had to bet - I would propably say it would stay rougle the same. 
The most dramatic changes in lipid markers are usually seen in overweight individuals who reduce bodyfat and build muscle.

That said, don't worry to much about it - having a low LDL-C is much more important! And you are doing fine in that regard.
Also, newer reserach seems to suggest that HDL-function seems to be as/if not more important than HDL-quantity.

Edited April 17 by undeather

[Michael569]

^ what the Doc said

In my limited clinical experience with cardiac/diabetic clients, HDL tends to improve as LDL gets better but only to some extend and then it sort of hits a certain level from where it is no longer moving. 

Eating more fibrous sources of of PUFA & MUFA like different assortment of nuts and seeds, even nut butters may help but only to the extend that they don't start making you fatter because then your LDL will creep up too

HDL seems more relevant where LDL and non-HDL are over healthy limits. Once your full lipid profile is optimal, HDL is nice to have but not the most essential of the LDL, HDL, non-HDL cholesterol, triglyceride picture. 

If you want to go deeper, pay attention to non-HDL and get your ApoB measured as well for total atherogenic particle count

Edited April 18 by Michael569

[sholomar]

It's largely genetic. My father would deny this but it's true. When I lived off chinese food (americanized chinese with lots of sugar and fat) I had a cholesterol of 150 with an HDL in the 50's to 60's... when I started to eat paleo/meditarranean the HDL did rise a bit but nothing super significant... my latest reading was 157 total cholesterol with HDL of 65.

I do zone 2 cardio, some weight training, eat meat, vegetables, eggs, and high fiber carbs.  Maybe reduce refined carbs to improve cholesterol readings. I believe refined carbs are the true villain to many people's diets who are prone to metabolic syndrome, just based on the way we evolved as a species.

I use a Polar H10 chest heart monitor and their app to maintain a zone 2 pace during my cardio. Maybe try that.. and less dietary carbohydrates, especially fructose.  When evolving humans did not have access to the high fructose ultra sweet genetically modified fruits of today.. they were seasonal and much more tart and smaller. Whether people want to admit it or not, our diet was paleo.... tubers, berries, meats, until around 10,000 years ago, which is when health started to decline...

Most of this guy's content is rather hit or miss, but this video is absolute gold...

Another good book I stumbled across on reddit is called "the thin prediabetic" .. written by someone of asian descent as they often have thin prediabetics in their culture.... the solution he mentions involves building type 2 muscle fibers to reduce insulin resistance, reducing carbs, and eating bitter foods like "bitter melon" along with a few other topics

https://www.amazon.com/dp/1095483773

Edited April 18 by sholomar