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.
There are two types of dietary fiber: soluble (viscous) and insoluble. To receive the greatest health benefit, eat a wide variety of all high-fiber foods. Refined foods, like white bread, white pasta and enriched cereals are low in fiber. The refining process strips the outer coat (bran) from the grain, which reduces the amount of fiber that's left.
Including fish in your diet can increase HDL cholesterol in a short period of time. In a study published in February 2014 in the journal PLoS One, researchers concluded that a diet rich in foods including fish showed an increase in the size of HDL particles in the body, which could help improve cholesterol transport through the body. The researchers saw the positive effects of a diet that included fish in as little as 12 weeks.
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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.

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.
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.
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.
There is considerable controversy over whether high cholesterol is in itself a cause of heart disease (the lipid hypothesis), or a symptom of an inflammatory condition that is the true cause of heart disease (the inflammation hypothesis). According to the latter theory, chronically high levels of inflammation creates small lesions on arterial walls; the body sends LDL to heal those lesions, but it ultimately accumulates and oxidizes, causing blockages. From this perspective, the best lifestyle approach to lower cardiovascular disease risk is to lower inflammation in the body rather than LDL levels.
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.

Altering your diet is the easiest way to lower your elevated LDL cholesterol, and should be your first course of action, as every cholesterol-lowering strategy starts with your dietary habits. A balanced diet consisting of fruits, vegetables, whole grains, fish, and various plants will significantly help you lower your LDL cholesterol level. It’s best to limit the amount of red meat, eggs, and dairy you consume. Plant-based diets not only help lower your LDL, but they can also help clear plaque buildup from your arteries.


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.
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