Cholesterol ratios can be useful in the prediction of heart disease. Ratios show us the whole picture rather than just one number. A “total cholesterol” gives one number and doesn’t provide information about each individual type of cholesterol that makes up the total cholesterol value.
One type of cholesterol is considered to be good the HDL cholesterol (or high-density lipoprotein). This type of cholesterol transports cholesterol from the arteries and tissues back to the liver.
LDL cholesterol, on the other hand, is considered to be the “bad” cholesterol as it is transported from the liver to the rest of the body, and at elevated levels it can deposit cholesterol in arteries.
Total cholesterol to HDL cholesterol ratio
The total cholesterol HDL ratio (Total / HDL) is calculated by dividing total cholesterol by HDL cholesterol. i.e.
Total cholesterol/HDL Ratio = [Total Cholesterol/HDL Cholesterol]
A desirable ratio is 5:1 or under. According to the American Heart Association the optimum total / HDL cholesterol ratio should be 3.5:1.
If the ratio is higher, then the risk of heart disease is greater. A low HDL cholesterol and high total cholesterol value increases the total/HDL cholesterol ratio. If a person is found to have a higher reading, they can then take measures to lower the ratio.
On the other hand the lower ratios are more ideal and predict a lower heart disease risk. A high HDL cholesterol will reduce the ratio. This is healthier for us because HDL cholesterol is the “good” cholesterol.
The LDL/HDL Ratio is calculated by dividing the LDL cholesterol value by the HDL cholesterol value. i.e.
LDL/HDL ratio = [LDL Cholesterol / HDL Cholesterol]
The more direct ratio of LDL/HDL is considered more helpful by some healthcare professionals, who see is as more of a “pure” ratio than that of the total/HDL ratio.
Regardless of whether the LDL/HDL or total/HDL cholesterol ratio is used, cholesterol ratios as a whole provide more insight into heart disease risk than a total cholesterol value alone. Many health professionals these days are taking cholesterol ratios into account for predicting heart disease risk in patients.
Tips to improve cholesterol ratios
1. Avoid trans fat. Trans fat increase LDL (bad) cholesterol and reduce HDL (good) cholesterol.
2. Minimise saturated fats. These fats raise LDL (bad) cholesterol.
3. Increase dietary fibre, particularly soluble or viscous fibres which can reduce LDL cholesterol levels.
4. Consider the use of plant sterol fortified food products (2-3g per day is ideal).
5. Consume omega 3 fats on a daily basis.
6. Choose poly and monounsaturated fats in place of saturated fats.
7. Obtain adequate amounts of exercise (which can increase HDL and reduce LDL cholesterol). Check with your Doctor before starting any new exercise regime, to ensure it is safe to do so.