HDL is more tightly controlled by genetic factors than are the other lipoproteins (ie, LDL, very–low-density lipoprotein (VLDL), intermediate-density lipoprotein [IDL], chylomicrons). For example, in certain families, especially some families with Japanese ancestry, a genetic deficiency of cholesteryl ester transfer protein (CETP) is associated with strikingly elevated HDL-C levels. 
Why is one form of cholesterol considered good and another bad? There are actually as many as 18 kinds of cholesterol, but to save confusion, doctors divide them into two categories: LDL (bad) and HDL (good). Your liver manufactures most of your cholesterol, and small amounts of it go toward a variety of healthy purposes, including creating hormones that help turn food and exercise into muscle. Serving as cholesterol chauffeurs are fat/protein bunches called lipoproteins, and that’s where the fun begins: Low-density lipoproteins tend to deposit cholesterol on artery walls, where it builds up and eventually interferes with blood flow. But the high-density variety seems to take cholesterol back to the liver, where it can be eliminated from the body.
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.
With apologies to the American Heart Association, which discourages doctors from telling their patients about the advantages of alcohol: one or two drinks per day can significantly increase HDL levels. More than one or two drinks per day, one hastens to add, can lead to substantial health problems including heart failure. And unfortunately, there are many people who are simply incapable of limiting their alcohol intake to one or two drinks per day. Here's more on alcohol and the heart.
How much do you know about your cholesterol? You probably know that there are two different kinds – high-density lipoprotein (HDL), which is the “good” cholesterol, and low-density lipoprotein (LDL), also known as the “bad” cholesterol. High HDL levels help carry cholesterol from your arteries to your liver and also possess antioxidants and anti-inflammatory properties, which are linked to a reduced risk of heart disease.
Fish can be fatty or lean, but it’s still low in saturated fat. Eat at least 8 ounces of non-fried fish each week, which may be divided over two 3.5- to 4-ounce servings. Choose oily fish such as salmon, trout and herring, which are high in omega-3 fatty acids. Prepare fish baked, broiled, grilled or boiled rather than breaded and fried, and without added salt, saturated fat or trans fat. Non-fried fish and shellfish, such as shrimp, crab and lobster, are low in saturated fat and are a healthy alternative to many cuts of meat and poultry.
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.
Who doesn't love avocados? They not only taste amazing but also can help lower your cholesterol. Avocados are high in healthy monounsaturated fat, which helps lower "bad" LDL cholesterol. They also contain fiber, antioxidants and phytosterols, such as beta-sitosterol, which have also been shown to lower cholesterol. Don't hog the entire bowl of guacamole, though! One serving is just a quarter of a Hass avocado, which delivers 57 calories. Spread a few slices of avocado on your sandwich instead of mayo, or dip some veggies into a bowl of fresh guacamole.
Are you pouring up a glass of OJ in the morning? Is your daily caffeine fix a fountain coke at the local gas station? What about that fruity cocktail tempting you at happy hour? Eliminating sweetened beverages from the daily routine is one of the easiest ways to cut thousands of calories or more per week, but will also put years on your life. Water is the best form of hydration and can be flavored with citrus, tropical fruits, and herbs to create a refreshing spa-like oasis that will increase HDL levels when it replaces your typical sugar-sweetened beverages.
HDL particles are heterogeneous. They can be classified as a larger, less dense HDL2 or a smaller, denser HDL3.  Normally, most of the plasma HDL is found in HDL3.  To add to the complexity of HDL classification, HDL is composed of 4 apolipoproteins per particle. HDL may be composed of apo A-I and apo A-II or of apo A-I alone. HDL2 is usually made up only of apo A-I, while HDL3 contains a combination of apo A-I and apo A-II. HDL particles that are less dense than HDL2 are rich in apo E.
Heart-healthy eating. A heart-healthy eating plan limits the amount of saturated and trans fats that you eat. It recommends that you eat and drink only enough calories to stay at a healthy weight and avoid weight gain. It encourages you to choose a variety of nutritious foods, including fruits, vegetables, whole grains, and lean meats. Examples of eating plans that can lower your cholesterol include the Therapeutic Lifestyle Changes diet and the DASH eating plan.
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.
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.)
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It’s a very common misconception that cholesterol is generally bad and high levels are always cause for serious concern. But what if I told you that there is a type of cholesterol that’s not only good at higher levels, but also decreases your risk of major health issues like heart disease? I have great news: This type of cholesterol really does exist. It’s called HDL cholesterol, and it’s our “good” cholesterol.
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.
The National Cholesterol Education Program recommends you take in 2 grams of plant sterols and stanols each day. The FDA allows an approved health claim on phytosterols stating, "Foods containing at least 0.65 gram per serving of vegetable oil plant sterol esters, eaten twice a day with meals for a daily total intake of at least 1.3 grams, as part of a diet low in saturated fat and cholesterol, may reduce the risk of heart disease."
Hayek T, Chajek-Shaul T, Walsh A, Agellon LB, Moulin P, Tall AR, Breslow JL. An interaction between the human cholesteryl ester transfer protein (CETP) and apolipoprotein A-I genes in transgenic mice results in a profound CETP-mediated depression of high density lipoprotein cholesterol levels. J Clin Invest. 1992 Aug;90(2):505–510. [PMC free article] [PubMed]
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.