A: Before I answer that question, why bother to increase HDL cholesterol at all? Many studies have found that people with low levels of HDL are at increased risk for heart attacks, strokes, and other complications of arteries diseased by atherosclerosis: that's why we call HDL the "good" cholesterol. Given that, you'd think that raising HDL levels would reduce a person's risk for atherosclerosis. Unfortunately, despite a lot of research, we don't yet know if that's true, nor how best to raise HDL levels.
A: Before I answer that question, why bother to increase HDL cholesterol at all? Many studies have found that people with low levels of HDL are at increased risk for heart attacks, strokes, and other complications of arteries diseased by atherosclerosis: that's why we call HDL the "good" cholesterol. Given that, you'd think that raising HDL levels would reduce a person's risk for atherosclerosis. Unfortunately, despite a lot of research, we don't yet know if that's true, nor how best to raise HDL levels.
Flavor foods with herbs and spices whenever you can. It’ll help you cut back on condiments high in saturated fat while maximizing flavor. Spices and herbs also pack antioxidants, which can help improve cholesterol levels when combined with veggies. Ones we love: Basil, cilantro, rosemary, sage, ginger, garlic, tarragon, black and red chili pepper, mint, and oregano.
If you want to increase the benefits of the fats you eat, work out before you chow down. A study at the University of Missouri found that regular exercise prior to high-fat meals produces a large hike in HDL. I’m not suggesting that your excuse for indulging in high-fat meals ought to be a pre-meal workout, merely that exercise before a meal works to your heart’s advantage.
While this belief is still thought to be almost always true, in recent years a fly has been found in the ointment. Drug companies have spent billions of dollars developing drugs that increase HDL cholesterol levels. However, to the dismay of all, these drugs have failed to reduce cardiac risk—despite the fact that they make HDL levels go up. Development of at least two of these drugs has now been halted. (More on this below.) So the HDL story is more complex than scientists originally had hoped.
Too much cholesterol in the blood builds up on artery walls causing hardening of the arteries (atherosclerosis). The buildup of cholesterol narrows arteries, slowing or blocking the flow of oxygen-carrying blood to the heart, which can manifest as chest pain. If blood flow to the heart is cut off because of clogged arteries, the result is damage to the heart muscle – a heart attack.

Lentils are pulses, a.k.a. the dry edible seeds of certain crops (like beans, chickpeas, and peas). Pulses are just everywhere these days because they’re packed with plant-based protein and fiber, not to mention antioxidants, minerals, and B vitamins. All of those compounds help protect you from plaque buildup while optimizing blood flow and assisting your body in efficiently using the nutrients you consume.
Avoid trans-fatty acids. These heart-damaging fats can reduce HDL (“good”) cholesterol levels and raise levels of LDL (“bad”) cholesterol. The tip-off that trans-fatty acids are present in foods is the listing of “partially hydrogenated oil” on a food’s ingredient list. Trans-fats are found in many brands of margarine and in most heavily processed foods, as well as in snack foods such as chips, crackers and cookies, and in the oils used to cook fast-food French fries, doughnuts and movie popcorn.
Olive oil is a plant-based fat, so it's a better choice when you're trying to lower your "bad" cholesterol than fats that come from animals. It’s great mixed with red wine vinegar, a minced garlic clove, and a little ground pepper for a salad dressing. For something different, try braising vegetables like carrots or leeks. Just drizzle 3 tablespoons of oil over vegetables in a snug baking dish, scatter some herbs, cover with foil, and put in a 375-degree oven for about 45 minutes.
Rich in omega-3 fatty acids and all-around delicious, walnuts have also been shown to improve the HDL-to-total cholesterol ratio, according to a study published in the American Diabetes Association’s peer-reviewed journal, Diabetes Care. This ratio is used by physicians to assess overall cardiovascular risk and can provide more information than just one value alone. A desirable ratio is anything below 5:1, but a ratio of 3.5:1 indicates very minimal cardiovascular risk.
Ivan V. Pacold, MD, a cardiology professor at Loyola University’s Stritch School of Medicine in Chicago, says that lifestyle choices matter, and “even if these changes don’t show up directly in your cholesterol numbers, they can be lowering your risk for heart disease.” So if you haven’t made the change to a heart-healthy lifestyle, here are nine ways to get started.
Because increasing HDL levels is thought to be such a beneficial thing, and because there is no easy or reliable way to do so, developing drugs that substantially raise HDL levels has become a major goal for several pharmaceutical companies. And indeed, several of these drugs have been developed, and have led to clinical trials to demonstrate their safety and efficacy. 

Trans fats increase your LDL cholesterol, reduce your HDL levels and raise your risk of developing heart disease, stroke, diabetes and other chronic conditions. Trans fats lurk in fried foods, stick margarine, cookies, crackers, cakes, pie crusts and frozen pizza. Today, some food manufacturers are removing them from their products, but the only way to tell if a product is trans fat-free is to read labels while you’re shopping. Avoid products that list “partially hydrogenated oil” in the ingredients, since this is just a sneaky name for trans fats.
When it comes to cholesterol, not all types are created equal, and it is important to understand how lifestyle choices significantly impact cardiovascular health. High-density lipoprotein, or HDL, is known as the “healthy” or “good” type of cholesterol due to the fact that it scavenges and removes the “bad” type of cholesterol (low-density lipoprotein or LDL) known to clog arteries. A desirable HDL level is anything greater than 60 milligrams per deciliter (mg/dL).
Hyperalphalipoproteinemia (HALP) may be familial, including primary (without CETP deficiency) and otherwise (with CETP deficiency), or secondary. [15] Familial HALP (aside from the primary form) is a well-documented genetic form of hypercholesterolemia characterized by a deficiency of CETP, a key protein in the reverse cholesterol transport (RCT) system that facilitates the transfer of cholesteryl esters from high-density lipoprotein (HDL) to beta lipoproteins. Primary HALP is a term used for familial elevated HDL cholesterol levels that are not due to CETP deficiency and for which the cause is unknown. Secondary HALP is due to environmental factors or medications.
All cherries are delicious, but there's something extra special about this sour variety. "I love snacking on dried Montmorency tart cherries not only because they have a sour-sweet flavor, but because they also have fiber," Gorin says. "Plus, you get other heart-helping benefits, too. Anthocyanins, a type of antioxidant found in purple and dark red fruits and vegetables, may help decrease the risk of heart attack in women."
Perhaps most disappointing of all, a new class of drugs (the so-called CETP-inhibitors), which several pharmaceutical companies have been enthusiastically developing for several years to raise HDL levels, has become a great disappointment. While these drugs do indeed increase HDL levels, they have not demonstrated an ability to improve cardiac risk — and on the contrary, studies appear to show a worsening in cardiac risk with some of these drugs. It is unclear today whether any CETP-inhibitors will ever reach the market.
HDL serves as a chemical shuttle that transports excess cholesterol from peripheral tissues to the liver. This pathway is called the RCT system. In this system, plasma HDL takes up cholesterol from the peripheral tissues, such as fibroblasts and macrophages. (A study by El Khoury et al indicated that in persons with HALP, macrophages have an increased plasma cholesterol efflux capacity. [18] ) This may occur by passive diffusion or may be mediated by the adenosine triphosphate (ATP)–binding cassette transporter 1. The latter interacts directly with free apo A-I, generating nascent, or so-called discoidal, HDL. Cholesterol undergoes esterification by lecithin-cholesterol acyltransferase (LCAT) to produce cholesteryl ester, which results in the production of the mature spherical HDL. Cholesterol is also taken up from triglyceride-rich lipoproteins in a process mediated by a phospholipid transfer protein (ie, CETP). [19, 20, 21, 22]
Typically, a fasting plasma lipid profile is ordered to measure LDL, HDL, total cholesterol, and triglyceride levels. Lipids in plasma and in isolated lipoprotein fractions are quantified by enzymatic methods. Prior consumption of food has little effect on the determination of HDL, with postprandial blood samples usually yielding results that can be well interpreted. [14, 2] Current clinically available techniques can determine the cholesterol content, but not the biologic function, of HDL particles. [2]
Starting a simple exercise routine is another way to help lower your elevated LDL cholesterol level. And if you compound working out with the dietary tips listed above, you could potentially lower your LDL level by over 37 percent and increase your HDL cholesterol by over 5 percent in just two months. Not to mention the added benefits of losing weight, decreased stress, and higher energy, exercising is an all-around great activity to incorporate into your life. Aim for 30 minutes of physical activity, four to five times each week, and you’ll be well on your way.

Foods high in monounsaturated fats (such as olive oil, nuts, and the oils in many salad dressings) seem to boost HDL best; it’s likely that foods high in omega-3 fatty acids (such as cold-water fish) do so as well. Saturated fats, the kind in meat and dairy foods, are likely to drive up harmful LDL, so take this opportunity to cut way back. Worst of all are trans-fatty acids, the hardened oils often found in margarine, crackers and other snack foods-a substance Harvard Medical School nutrition expert Walter C. Willett, M.D., author of Eat, Drink, and Be Healthy, calls “uniquely bad.” These foods can do exactly the opposite of what you want, lowering HDL while raising LDL.

HDL is actually more complex than we once thought. Rather than being a single kind of particle, HDL is is now considered a family of different particles. All HDL contains lipids (fats), cholesterol and proteins (called apolipoproteins), but some types of HDL are spherical while others are shaped like a doughnut. Some HDL types remove bad cholesterol from the blood while other types are indifferent to cholesterol. Or even worse, some HDL transfers cholesterol the wrong way (into LDL and cells) or protects LDL in a way that makes it more harmful to the arteries.
Plasma HDL is a small, spherical, dense lipid-protein complex that is half lipid and half protein. The lipid component consists of phospholipids, free cholesterol, cholesteryl esters, and triglycerides. The protein component includes apo A-I (molecular weight, 28,000) and apo A-II (molecular weight, 17,000). Other minor, but important, proteins are apo E and apo C, including apo C-I, apo C-II, and apo C-III.
The lipid profile blood test reports the levels of cholesterol and triglycerides in the bloodstream. Healthcare organizations have established a set range for total, bad LDL and good HDL cholesterol as well as triglycerides, but the most important thing to consider when looking for how to lower cholesterol naturally is the ratio of LDL to HDL cholesterol, which should be around 2:1. (1, 2)
Pasta and heart health together in one sentence seems to be an oxymoron, however with one small tweak spaghetti can become a cholesterol-busting meal. Instead of opting for white, refined noodles, choose the less-processed, vitamin-enriched counterpart: whole grain pasta. Barilla makes one that has 7 grams of fiber per serving, and — what’s more — none of the stress-fighting B-vitamins have been removed. A B vitamin known as niacin has been found to decrease LDL levels and increase HDL when taken in doses above your vitamin requirement, according to a guide to lowering your cholesterol by the U.S. Department of Health and Human Services.
A study published in January 2016 in the journal Nutrients found that an antioxidant-rich diet raises HDL cholesterol levels in relation to triglycerides, and might be associated with a reduced risk of stroke, heart failure, and inflammatory biomarkers. Antioxidant-rich foods include dark chocolate, berries, avocado, nuts, kale, beets, and spinach.
If you smoke, it’s time to pack it in. According to the American Heart Association, smoking reduces your HDL cholesterol levels, while increasing your risk of heart disease, high blood pressure and diabetes. If you’re a smoker, you need to quit. Once you stop smoking, you can significantly improve your HDL cholesterol level very quickly and start protecting your heart. And if you’re a non-smoker, you need to avoid exposure to second-hand smoke to prevent your health from going up in smoke.
If you’re getting worked up over high cholesterol, then start working out. Daily exercise can help raise your HDL cholesterol levels and reduce your LDL cholesterol, while protecting you from many health conditions. Begin by choosing an activity that sounds like fun to avoid “workout burn-out.” Consider jogging, brisk walking, cycling, tennis, swimming or hitting the gym. Find an exercise partner to make the activity more enjoyable and help you stay on track. And while exercise can lower your cholesterol, it can also reduce your stress and anxiety. So working up a sweat can also save you from sweating the small stuff.
Eating seafood twice per week is a surefire way to reduce your risk of cardiovascular disease. Fatty fish like salmon yields some of the greatest anti-inflammatory and heart-healthy benefits, as a Journal of Nutrition study found salmon protein to significantly increase the proportion of HDL cholesterol. One tip: fish should be purchased wild and sustainably caught. For a consumer guide on how to make informed choices you can check out the consumer guides provided by the Monterey Bay Aquarium Seafood Watch.
This healthy recipe pairs well with just about anything -- salmon, chicken, or game meat like bison and venison. It's also a superb go-to for quick-fix lunches or snacks. Ladle some into whole-wheat tortillas stuffed with crunchy veggies. Pour a cup or two into some chicken or vegetable stock for an easy soup. Or blend a big scoop of your beans and rice with a big bowl of lettuce greens and sliced tomatoes for a filling lunch salad.
HDL cholesterol is “good” because elevated blood levels have been associated with a lower risk of cardiovascular disease. However, clinical trials with experimental medications aimed at increasing HDL cholesterol levels, so far, have been largely disappointing. HDL researchers have gone back to the drawing board to figure out what it is about HDL that may reduce the risk of heart disease.
According to the Mayo Clinic, ideal HDL levels for both men and women are 60 milligrams of cholesterol per deciliter of blood. If a man’s HDL level is below 40 milligrams of cholesterol per deciliter of blood or a woman’s HDL level is below 50 milligrams of cholesterol per deciliter of blood, then disease risk, specifically heart disease, is considered to be heightened. Even if your HDL level is above the at-risk number (but below the desirable number), you still want to work on increasing your HDL level so you can decrease your heart disease risk. (9)
HDL plays an important role in transporting cholesterol from the peripheral tissues to the liver, where it can be excreted; this process is known as reverse cholesterol transport (RCT). (The liver is the main organ for excretion of cholesterol, doing so either directly or by converting cholesterol into bile acids.) It is important to remember that most HDL measured in the blood is derived from the liver and intestine. Therefore, the concentration of HDL in plasma does not reflect cholesterol efflux from blood vessels or the efficiency of RCT. Moreover, HDL function in RCT is not mirrored by HDL measurements. [2]
No, carbohydrates are not the enemy to fitness goals. Plus, when it comes to heart health, oatmeal is a humble workhorse. One of the highest fiber-per-dollar foods on the market, oatmeal is an inexpensive and hearty addition to any breakfast time routine. While not raising HDL levels directly, oatmeal lowers total cholesterol and LDL cholesterol levels even more, according to an American Journal of Lifestyle Medicine review, which in turn increases your HDL levels as a percentage of total cholesterol. Make weekend brunch fun for the whole family by serving up an oatmeal bar concept with a wide array of toppings and mix-ins such as chia seeds and raspberries.

Tree nuts, such as walnuts, pistachios and pecans, have been shown to lower both total cholesterol and "bad" LDL cholesterol. Nuts are high in heart-healthy monounsaturated fat, fiber and several vitamins and minerals that are good for heart health. Nuts also contain plant sterols, which are natural compounds that block the cholesterol you eat from entering your bloodstream. While nuts are awesome to eat, don't go crazy. Portion control is still important—there are 163 calories in just 1 ounce of almonds. Add a small handful to oatmeal, top toast with nut butter or make a DIY trail mix with dried fruit and nuts.
Could one of your current prescriptions be a cause of your low HDL levels? Possibly! Medications such as anabolic steroids, beta blockers, benzodiazepines and progestins can depress HDL levels. If you take any of these medications, I suggest talking to your doctor and considering if there is anything you can do that could take the place of your current prescription.
What causes high cholesterol? High cholesterol is a risk factor for heart attacks and coronary heart disease, because it builds up in the arteries, narrowing them. It does not usually have any symptoms, and many people do not know they have it. We look at healthy levels and ranges of cholesterol, at ways to prevent it, and medications to treat it. Read now
Many fruits contain soluble fiber, which is important for lowering cholesterol, but apples have a leg up on other fruits. Apples (especially the skins) contain pectin, a type of soluble fiber that latches onto the "bad" cholesterol and guides it through your digestive system and out of your body, effectively lowering your LDL-cholesterol levels. Citrus fruits are also high in pectin, but since it's mostly in the pulp, you'll have to eat your fruits to get the benefits, rather than juice them. Luckily, apples are a little easier to pucker up to than lemons. Apples are also high in polyphenols, powerful antioxidants that help reduce inflammation.

Trans fats are a byproduct of the chemical reaction that turns liquid vegetable oil into solid margarine or shortening and that prevents liquid vegetable oils from turning rancid. These fats have no nutritional value — and we know for certain they are bad for heart health. Trans fats increase LDL cholesterol and triglyceride levels while reducing levels of HDL cholesterol.
Could one of your current prescriptions be a cause of your low HDL levels? Possibly! Medications such as anabolic steroids, beta blockers, benzodiazepines and progestins can depress HDL levels. If you take any of these medications, I suggest talking to your doctor and considering if there is anything you can do that could take the place of your current prescription.
Niacin (vitamin B3) is believed to block cholesterol production in the body. Although niacin in prescription supplement form appears to be most effective in increasing HDL, it may have side effects such as flushing, itching, and headache, so you may want to consider adding niacin-containing foods to your diet first. Niacin is found in high concentrations in crimini mushrooms, chicken breast, halibut, tomato, romaine lettuce, enriched bread, and cereals.
The most important mechanism by which HDL exerts its antiatherogenic role is the removal of excess cholesterol from peripheral cells and its transport to the liver, a process commonly termed the reverse cholesterol transport system (RCT). Several proteins are involved in this process, including ATP-binding cassette transporter 1, LCAT, CETP, and hepatic triglyceride lipase (see Pathophysiology). [25]
What is the difference between HDL and LDL cholesterol? The body needs cholesterol, but too much bad cholesterol can be harmful and is a major risk factor for heart disease and stroke. In this article, learn about the difference between HDL and LDL — “good” and “bad” — cholesterol, as well as how they are measured. What steps can you take to lower LDL and increase HDL? Read now
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