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]


As if we needed another excuse to grab a second scoop of guac at the tailgate? Avocados are the poster child for the heart-healthy diet due to their rich abundance of monounsaturated fat, high fiber, and potassium. Monounsaturated fats from avocados, in particular, have been connected to an increase of HDL cholesterol and decreases of total cholesterol, LDL particles, and triglycerides, as shown in an Archives of Medical Research study. These can even be substituted for heart-harmful hydrogenated oils in baked goods as the fruit yields the same creamy texture and mouthfeel. Avocado brownies anyone?!

Where HDL is concerned, “you can’t be too thin,” Castelli says. One report found about a 1 percent rise in HDL for every pound of fat lost. This doesn’t mean you have to turn yourself into a toothpick, but that you should work on getting rid of excess flab as you add muscle. (Use a body-fat monitor rather than a scale to chart your progress.) Fortunately, fat loss is likely to go hand in hand with the exercise and dietary modifications that also raise HDL levels.
There are tons of natural remedies out there for how to lower cholesterol levels, often promising quick results with next to no effort required on your part. But while it’s true that there are tons of options to keep cholesterol levels in check, it can actually be as simple as swapping out a few foods in your diet for healthier options, switching up your workout routine or adding a supplement or two into the mix.
A study published in February 2016 in the journal PLoS One concluded as much. For nearly 11,000 adults, researchers found that low to moderate alcohol consumption (20 or fewer drinks a week for a man, 10 or fewer for a woman) led to higher levels of HDL cholesterol. It also helped get them to healthier overall cholesterol levels, decreasing triglycerides (blood fats in blood) and lowering LDL cholesterol.

Controlling your weight is an important part of getting to healthy cholesterol levels, so it’s crucial to know your portion sizes if you're trying to lower cholesterol. A portion of starchy carbohydrate, like potato or pasta, should be only about half the size of a baseball. A heart-healthy portion of meat should be about the size of a deck of playing cards, or about three ounces.


DAVID MONTGOMERY: The ways to reduce your bad cholesterol have a lot to do with your lifestyle. So your diet is really important. And although this kind of sounds trite, really one of the best and most effective ways to reduce cholesterol is by having a low fat diet, particularly saturated fat. We find saturated fat in eggs, dairy, and red meat. If you're able to reduce those, you reduce your bad fat, which reduces your bad cholesterol. Another really effective way that I use with my patients all the time to reduce your cholesterol is regular exercise. If you're doing aerobic type exercises, most days a week, four days a week, 30 minutes at a time, then you're doing your body the best amount of good, not just from lowering your cholesterol standpoint, but from so many different ways. There are other ways that we can reduce the fat. It may have to do with supplementations or medications. In some people, they are born with genetic conditions that predispose them to have very, very high cholesterol. And as a result of that, they have different problems like heart attacks or strokes. In those people, they really do benefit from cholesterol lowering drugs. But there are other things that you can get from over-the-counter, like omega fatty acids, omega-3 fatty acids in particular. They come in krill oil or fish oil. We've all heard of these before. And those help reduce parts of your cholesterol.

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]

Different foods lower cholesterol in various ways. Some deliver soluble fiber, which binds cholesterol and its precursors in the digestive system and drags them out of the body before they get into circulation. Some give you polyunsaturated fats, which directly lower LDL. And some contain plant sterols and stanols, which block the body from absorbing cholesterol.

Part of the “French paradox”-lower heart-disease rates in butter-and-cream-feasting France-may stem from the HDL benefits of wine consumption. For some people, however, alcohol causes more troubles than it cures. “Men should limit themselves to one or two drinks a day,” Willett says. “After that, you start worrying about adverse consequences.” While any alcoholic beverage will do, the antioxidants in red wine or dark beer may give you an added benefit.
An under-valued element of bone and cardiovascular health is the role of Vitamin K2, which many individuals are unknowingly deficient in. Found in the Japanese breakfast delicacy “natto” (fermented soybeans), vitamin K2 not only helps remove calcium from the arteries and soft tissues to prevent atherosclerosis, but it also draws calcium into the bones to prevent the risk of fracture. Nattokinase, an enzyme found in natto, may help to increase HDL levels while lowering total cholesterol and LDL cholesterol levels, according to an Asia Pacific Journal of Clinical Nutrition study.
Resistance training is a form of physical activity that forces your muscles to contract, building up strength and endurance. Some research also shows that resistance training could have beneficial effects on heart health as well and may decrease total and LDL cholesterol. (31) Weight lifting and bodyweight exercises like squats or lunges are some examples of resistance training that you can add to your routine.
A 2014 study published in the journal PLoS One found that a diet rich in foods including fish, especially fatty fish, increased the size of HDL particles, which may help improve cholesterol transport throughout the body. The American Heart Association recommends eating fish at least twice a week, especially varieties that contain omega-3 fats, such as salmon, trout, and herring. A serving is considered 3.5 ounces cooked.
Foods like oatmeal, apples, prunes, and beans are high in soluble fiber, which keeps your body from absorbing cholesterol. Research shows that people who ate 5 to 10 more grams of it each day saw a drop in their LDL. Eating more fiber also makes you feel full, so you won’t crave snacks as much. But beware: Too much fiber at one time can cause abdominal cramps or bloating. Increase your intake slowly.
I just moved and had to go to a new doctor. At my first annual exam and lipid panel, she called me back for a consult because she wanted to put me on a statin due to “high” ldl cholestoral levels. I am female, 54, height 5’4” and weigh 130 lbs. My ldl was 123 – my triglycerides were 58. My hdl was 68. I had basically the same lipid panel 2 years ago at my last annual exam (before moving) and my doc there was not concerned other than suggesting I start a CoQ10 and Omega 3 regimen. I don’t smoke, I exercise at least 45 minutes a day (running, cycling, golf, walking, etc.) – my major weakness is sweets. Plus no heart disease in immediate family (both parents still alive at 79 & 80 – no history of stroke, etc.)
What is cholesterol ratio and why is it important? There are two types of cholesterol. One is harmful, and builds up in the arteries, but the other can actually benefit the body. In this MNT Knowledge Center article, learn about the difference between 'good' and 'bad' cholesterol. How do they affect the body? How can you manage high cholesterol? Read now
First, a quick explainer: Cholesterol is a waxy substance that travels through your bloodstream, but not all of it is bad. HDL cholesterol (a.k.a. "good" cholesterol) actually sweeps away LDL cholesterol, or the "bad" kind. A high LDL level puts you at risk for heart attacks and strokes because it can clog arteries with plaque, a condition called atherosclerosis. A blood test can determine whether you have high cholesterol, and your doctor may recommend exercise or medication in addition to a healthier diet.

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.

Along with exercising, eating a healthy diet is one of the most important things you can do to reach and maintain healthy cholesterol levels. Learn how to read nutrition labels and know the difference between healthy and unhealthy fats. Calories, calories from fat, total fat, saturated fat, and trans fat numbers are all right there on the nutrition facts label to help you make heart-healthy choices.
While diet and exercise should be your two main options for fighting off LDL cholesterol, you can also look into the various dietary supplements that are on the market today. Consider omega-3 fish oils, artichoke extract, and green tea extract. Keep in mind that these natural products have not been fully proven to reduce your level of LDL cholesterol, but they may be able to help along the way.
Part of the “French paradox”-lower heart-disease rates in butter-and-cream-feasting France-may stem from the HDL benefits of wine consumption. For some people, however, alcohol causes more troubles than it cures. “Men should limit themselves to one or two drinks a day,” Willett says. “After that, you start worrying about adverse consequences.” While any alcoholic beverage will do, the antioxidants in red wine or dark beer may give you an added benefit.

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.

8. Foods fortified with sterols and stanols. Sterols and stanols extracted from plants gum up the body's ability to absorb cholesterol from food. Companies are adding them to foods ranging from margarine and granola bars to orange juice and chocolate. They're also available as supplements. Getting 2 grams of plant sterols or stanols a day can lower LDL cholesterol by about 10%.
Chocolate fans rejoice! You might have heard that chocolate is good for you, and it's true. Dark chocolate and cocoa powder contain powerful antioxidant compounds called flavonoids, which help lower cholesterol. Milk chocolate has less cocoa solids, and thus lower flavonoid levels, and white chocolate is even lower in the good stuff. Reach for small portions of dark chocolate, preferably with a high cocoa content. Or try a sprinkle of cocoa powder in your smoothie or on yogurt to reap chocolate's cholesterol-lowering benefits.
Part of the “French paradox”-lower heart-disease rates in butter-and-cream-feasting France-may stem from the HDL benefits of wine consumption. For some people, however, alcohol causes more troubles than it cures. “Men should limit themselves to one or two drinks a day,” Willett says. “After that, you start worrying about adverse consequences.” While any alcoholic beverage will do, the antioxidants in red wine or dark beer may give you an added benefit.

Barley, oatmeal and brown rice have lots of soluble fiber, which has been proven to lower LDL cholesterol by reducing the absorption of cholesterol into your bloodstream. Try switching out your regular pasta for the whole-grain version, or use brown rice instead of white. To give an added cholesterol-busting kick, top your morning oatmeal with high-fiber fruit like bananas or apples.
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