Dear Mark: What Does High HDL Mean? and Is Exercise Good or Useless for Weight Loss?

Inline_Dear_Mark_HDLToday’s edition of Dear Mark is a relatively brief two-parter, but it’s a good one. First, I answer a question about HDL. Is higher good? Is higher (sometimes) bad? How does a person make sense of all the seemingly conflicting information? Then I explain how two statements about exercise and weight loss can be simultaneously correct and apparently contradictory. Is weight loss effective or useless for weight loss, or what?

Let’s go:

I’m not sure I understand the HDL one. So higher HDL could lead to cardiovascular issues, but higher HDL is a byproduct of a healthy lifestyle? I think I’m missing something. Does anyone understand this to explain it?

Allow me to provide more details.

Higher HDL is complicated, and before we can interpret its health implications we must understand the many roles it plays in immune and cardiovascular health.

HDL reduces and neutralizes oxidative, inflammatory agents that damage LDL particles and lead to atherosclerotic lesions in our arteries. They can even clear oxidized LDL particles themselves, shuttling them to the liver for processing.

HDL can also attack and destroy pathogens and their toxins. In some cases, HDL particles carry antimicrobial poisons and trick pathogens into consuming them. HDL also “grabs” bacterial endotoxins and neutralizes their toxicity.

Sometimes, high HDL indicates an ongoing inflammatory assault or infection. For instance, high omega-6/omega-3 ratios have been shown to increase HDL cholesterol, but they do not suppress atherosclerosis. How can this be?

Perhaps the high omega-6/low omega-3 intake is increasing the susceptibility of LDL to oxidative damage. That’s what other studies show, generally—eating more dietary omega-6 (linoleic acid) makes your lipoproteins more polyunsaturated, unstable, and prone to oxidative damage. And since one of HDL’s primary jobs is to clean up oxidized LDL and the agents that oxidize it, the body might ramp up HDL production as a response to increased omega-6s.

High HDL can be “bad” if it indicates an infection or high oxidative stress. But it’s also “good” because it means a person’s body is producing more HDL to deal with the infection or inflammation.

Previous attempts to brute-force high HDL via drugs like torcetrapib have failed miserably. Actually, they succeeded in boosting HDL to incredible heights, but they failed by killing the people who experienced the HDL boosts.

HDL testing could use some updating, I think. The HDL measurement we get at the doctor generally refers to the weight of the HDL. If your HDL has picked up toxins, it will weigh more and come up higher than a person whose HDL has not—even if you have the same number of HDL particles. Far more illuminating is the HDL particle number. When HDL particle testing becomes more routine, I think we’ll have a better idea of what’s going on.

Thanks for the question!

I’m taking the Primal Health Coaching Certification course and I just started Key Concept #7 this morning, titled Exercise is ineffective for weight management. Imagine my surprise when I read #10 above: Exercise is important for weight loss. Looking forward to reading more about this and getting some resolution around this topic so that I have a clear message for my clients.

Great question!

Note the slight nuance: exercise can be both ineffective for weight management and important during weight loss.

Exercise is a major factor in Primal Health Coaching after all. If it weren’t important, we wouldn’t mention it. It’s just not enough for weight loss.

What we were trying to emphasize is that clients not rely on exercise for weight loss. Doing so leads to many negative outcomes:

  1. Promotes an “earn it, burn it” mindset, where bad food choices can be “paid off” by cranking out another hour or two on the treadmill or on the bike. This only encourages people to make those bad food choices.
  2. Introduces guilt. If exercise is the major determinant of weight loss and you’re not losing weight, it necessarily follows that you’re a lazy, good-for-nothing layabout who just needs to work harder. A small subset of people respond to this kind of motivation positively. Most will retreat into junk food and withdraw completely.
  3. Leads to burn-out, especially in women. You don’t want to get into the exercise rat race, where exercise becomes a miserable job you clock into day in and day out. Exercise should be joyous, intense, and, yes, challenging. It shouldn’t be drudgery. It shouldn’t be mind-numbing. It should be acutely stressful but not chronically so.
  4. Doesn’t really work all that well. Exercise can certainly enhance weight loss alongside diet and make weight gain harder, but as a standalone intervention it falls short. There are millions of examples of people who try to exercise their way to weight loss (watch for a bunch coming this January!) and fail miserably.

That’s different from using exercise to enhance and improve weight loss, however. Alongside a good diet, exercise can:

  • Help you preferentially lose fat and retain/gain muscle. Diet helps you lose weight. Exercise affects what type of weight you lose.
  • Create a glycogen debt and increase non insulin-dependent glycogen storage, so you can eat (post-workout) carbs without altering insulin levels by much and shutting off fat loss.

Those are the two most important roles exercise plays in fat loss, but there’s also more. If you want to know how exactly exercise can enhance fat loss, check out the post I wrote earlier this year. It contains lots of information you can use to improve your client outcomes.

Thanks for your question, by the way! It’s an important distinction that has to be made.

That’s it for this week, everyone. I hope you all had a fantastic holiday. Thanks for reading!


About the Author

Mark Sisson is the founder of Mark’s Daily Apple, godfather to the Primal food and lifestyle movement, and the New York Times bestselling author of The Keto Reset Diet. His latest book is Keto for Life, where he discusses how he combines the keto diet with a Primal lifestyle for optimal health and longevity. Mark is the author of numerous other books as well, including The Primal Blueprint, which was credited with turbocharging the growth of the primal/paleo movement back in 2009. After spending three decades researching and educating folks on why food is the key component to achieving and maintaining optimal wellness, Mark launched Primal Kitchen, a real-food company that creates Primal/paleo, keto, and Whole30-friendly kitchen staples.

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19 thoughts on “Dear Mark: What Does High HDL Mean? and Is Exercise Good or Useless for Weight Loss?”

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  1. The 4 negative factors of relating exercise to weight loss are so important! While exercise is a crucial part of a healthy lifestyle, it becomes problematic to believe it is the only thing that matters. As you note, this can lead to a lot of feelings of guilt and, in extreme cases, lead to over exercising.

  2. “Is weight loss effective or useless for weight loss, or what?”
    is this a trick question?

  3. Very interesting Mark; and here I thought I knew all there’s to know about HDL.

    Your points on exercise and weight loose is well taken and yet, isn’t the “MAF” method the exception? Thanks!

  4. I have another question that I should perhaps forward to you but here it is (-:

    What do you thinks of Dr. Thomas Cowan views (human heart cosmic heart) on CVD? Namely, that hearth disease is caused by acidosis (fermentation of lactate that unlike that caused during exercise can’t exit the heart) and less by narrowing of the arteries. Since if this was the case, other blood vessels would have calcified as well. Thanks again.

  5. The exercise thing can be so confusing. I see people who seem to be working out non-stop (cardio) and never lose weight. In many cases, I see those same people eating all kinds of processed, packaged snacks, probably because they are starving. Lately I try to look at exercise as something to keep my body toned, flexible and healthy. As long as I stick to a mostly primal way of eating, my weight is very healthy regardless of how much exercise I get.

    1. That is largely due to the fact that the “cardio” methods people use to lose weight (fat) are some of the worst ways to actually achieve it. Hours on the treadmill do not a ‘fit’ body make.

      1. I just read a ridiculous click bait article called “Is your Fitbit making you fat?” After reading the article what was happening is these goofs would reward themselves with pizza, carbs, junk food and bigger portions because they achieved their 10,000 step goal. It was the classic mindset that you exercise to burn off bad eating habits and that with enough exercise you can neutralize the worst diet.

  6. Wondering if taking fish oil in the capsules (that tastes rancid if you open them and taste the liquid inside) leads to problems with HDL, given what Mark said about oxidative damage? I take a liquid fish oil that is stored in the fridge and tastes good – I know it’s not rancid, but I’m guessing that the vast majority of people take capsules that are already rancid/oxidized.

    1. There was a big hubbub awhile back about the brand Green Pasture that was accused of selling fake and rancid ferment cod liver oil which was promoted by Weston A Price. They said the lab DNA test resulted in a different fish. So one have to be careful with buying fish oils.

      Sea food fraud is a rampant issue everywhere. For now I will stick with krill oil if I’m in the mood.

      1. Chris Masterjohn wrote on that. Labels like “rancid” are somewhat unscientific, imprecise, and probably indicate ulterior/monetary motives, like the recent study from Harvard that is basically promoting prescription n-3.

  7. My take on this is:
    It is not effective. I used to subscribe to the dogma that what you eat is 80% and exercise is 20%. Now I think it is 90 and 10.
    And that is all I have to say about exercise and weight loss 🙂

  8. Exercise “doesn’t work” for the same reason “diets don’t work.” People lie and don’t put in effort. Putting health aside, a disciplined and motivated lifter can have an excellent physique despite a bad diet. The inverse is extremely rare.

  9. Another issue (which I don’t have studies for but I have read about it (Miriam Nelson?) and discussed it multiple times, feel free to rebut) is that, when you lose weight (especially if it’s not very slow), you will lose fat, muscle, and bone. You addressed the issue of exercising to make sure that you don’t lose muscle with diet changes that cause weight loss. But bone is important too, for both men and women but especially women. Exercise that increases bone: weight training and impact exercise.

  10. I’m kind of surprised people still debate whether exercise alone can overcome poor lifestyle habits, especially diet. It just feels like the inability to lose weight, aside from serious health issues, usually comes down to laziness and lack of discipline. It’s simple people – like anything else in life, if you do 80% of what you’re supposed to, you’ll see most of the results. The rest of us don’t need to perfect a diet because we aren’t trying to become bodybuilders.

  11. Not only one should focus on exercise but there are various other factor that comes to count. If you want to loose weight, your diet matters.

  12. I personally a healthy diet can prevent us from all the bad things like HDL and other heart problems.