What’s cholesterol balance and how to improve it

Cholesterol balance is a measure of good versus bad cholesterol in your blood and is connected to your heart health. It is measured by analysing various health markers in your blood (also known as biomarkers). However, we summarised all these biomarkers into a single health indicator score that’s easy to understand. Here's more on how cholesterol balance affects your health and ways to improve it.

You may have heard that cholesterol is bad for your heart’s health. However, it is just fat and there are many types of cholesterols, both good and bad. Low-density lipoprotein (LDL) and very-low-density lipoprotein (VLDL) cholesterols are considered bad as an excess of these block your arteries, which can then lead to heart diseases in the long run. On the other hand, high-density lipoprotein (HDL) cholesterol is considered good as they help in removing the bad cholesterols from your bloodstream.

How we calculate your cholesterol balance?

We measure your cholesterol balance by analysing two apolipoproteins—ApoA1 and ApoB. They hold the particles inside LDL and HDL together. While ApoA1 holds the “good” HDL, ApoB holds the “bad” LDL particles. So, looking at the ApoB to ApoA1 ratio gives an accurate measure of the “good” versus “bad” cholesterol balance in your blood. Other biomarkers that affect your cholesterol balance include total cholesterol, LDL-cholesterol, HDL-cholesterol, triglycerides and VLDL-cholesterol.

Biomarkers that affect cholesterol balance

ApoB, ApoA1, ApoB/ApoA1 ratio, total cholesterol, LDL-cholesterol, HDL-cholesterol, triglycerides, VLDL-cholesterol.

One-score summary

Blood values are difficult to understand without medical knowledge. My Nightingale, therefore, summaries all these biomarker results into one easy-to-understand score that maxes at 100. The higher you score, the better are your cholesterol values.

How to improve your cholesterol balance score

A combination of diet and exercise helps in maintaining a healthy cholesterol balance.


Studies say the quality of fats and carbohydrates you consume has a massive impact on your cholesterol balance.

When thinking of improving your cholesterol balance score with diet, scientific studies show that one needs to pay special attention to two things –– the quality of dietary fat and carbohydrates. Improving the quality of your fat intake is easy and you probably already know how –– cut down on saturated and trans fats (like butter, cheese, meat and fast food) and try replacing them with unsaturated fats (like fatty fish, nuts and plant-based oils).To improve the quality of carbohydrates in your daily diet, include a lot of fibre-rich foods and keep an eye on your simple sugar intakes like candy and soft drinks. An easy tweak to increase your fibre intake would be by favouring wholegrain options in all the grains or grain-based products (such as bread, pasta, rice, breakfast cereals, etc.) that are part of your everyday meals. So, for instance, if you tend to eat bread daily, make sure that the fibre content of the bread is more than 5%. You can get this information by checking the product packaging where it lists the nutritional breakdown. Also, some grains are better for heart health than others. For instance, research shows that oats, which are rich in β-glucan, can help in lowering bad LDL-cholesterol and therefore improve cholesterol balance.

Know more about a heart-healthy diet here.


Research recommends at least 2 to 3 hours of endurance sports every week.

In addition to diet, physical activity is important for heart health. While all kinds of physical activities are good, researchers have found that endurance activities are particularly good for your heart as it helps in increasing your good HDL-cholesterol numbers. Studies show that people who engage in endurance sports have healthier lipid profiles, including cholesterol balance, compared to individuals who mainly do resistance training. Endurance exercises are versatile and include many different things like brisk walking, running, cycling to swimming and cross-country skiing. For these activities to be most effective, studies recommend at least 2 to 3 hours of exercise every week. You can break this up into 30 minutes of training per day. The important part is sticking to the routine and doing it regularly.

Along with cholesterol balance, My Nightingale blood analysis gives you over 20 different health results from a single blood sample. It includes a health index that gives an overview of your health, 6 health indicator –– heart age, diabetes resistance, fatty acid balance, inflammation, cholesterol balance and blood sugar –– that provide one-score summaries of different aspects of your wellbeing and numerous other biomarkers (such as GlycA, omegas, glucose and BCAAs) that give an in-depth insight into your metabolic health.