In randomly screened children aged 6-19 years who had age-, race-, and sex-specific total plasma cholesterol levels greater than or equal to 95th percentile levels, 7.8% of white males, 12.8% of white females, 25% of black males, and 17.2% of black females had hypercholesterolemia due to elevated high-density lipoprotein [HDL] cholesterol levels (but not due to elevated low-density lipoprotein [LDL] cholesterol levels) greater than age-, sex-, and race-specific 95th percentile levels. That is, they had HALP.
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.
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.
Other supplements that have been suggested for cholesterol have less evidence of being useful. In the case of red yeast rice, there is a potential danger because it contains a naturally-occurring form of lovastatin, a prescription drug. Garlic has now been shown to be ineffective for lowering cholesterol. Other supplements and food you may see touted include policosanol, coenzyme Q10, green tea, and soy.

Although your cholesterol levels are partially determined by your genetics, these tips above can help you increase your HDL levels naturally! Also, don’t forget to visit your doctor every few years to have your cholesterol checked and have a blood panel conducted. Your doctor can use this information to treat any early conditions you may have. After all, high cholesterol levels don’t show any symptoms!


"These fish are best for cholesterol, but any fish is better than red meat," says Pacold. “Every time you have fish as a protein source instead of red meat, you are doing your heart a favor.” If you don't eat fish, you can get your needed dose of omega-3s in the form of a diet supplement pill, he suggests. Flaxseeds, walnuts, and even mixed greens are plant-based options to get more omega-3s in your diet.
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While cholesterol is normally kept in balance, an unhealthy diet high in hydrogenated fats and refined carbohydrates can disrupt this delicate balance, leading to increased cholesterol levels. This imbalance is manifested in elevated LDL (bad cholesterol) and low HDL (good cholesterol), which increases the risk of heart attack or stroke. Other causes can include physical inactivity, diabetes, stress and hypothyroidism.
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.
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.

Stick to a Low-Carb Diet – Also known as a ketogenic diet, a low-carb diet can lead to several health benefits, including weight loss, reduced blood sugar levels, and, of course, an increase in your HDL cholesterol. This is great for those who suffer from diabetes, metabolic syndrome, or obesity, but in truth, anyone can benefit from this type of diet!
Treatment of high cholesterol usually begins with lifestyle changes geared toward bringing levels down. These include losing weight if you’re overweight, and changing your diet to emphasize vegetables and fruits, fish, particularly cold water fish such as wild Alaskan salmon, mackerel, herring and black cod that provide heart healthy omega-3 fatty acids. If lifestyle changes don’t help or if you’re unable to make the changes your doctor recommends, cholesterol-lowering drugs may be prescribed. These include statins, which effectively lower LDL cholesterol; bile acid sequestrants that may be prescribed along with statins to lower LDL; nicotinic acid to lower LDL cholesterol and triglycerides and raise HDL; drugs called fibrates that may be prescribed to lower cholesterol and may raise HDL; and a drug called Ezetimibe to lower LDL by blocking the absorption of cholesterol in the intestine.
However, environmental factors also have a significant impact on HDL levels. Factors that elevate HDL concentrations include chronic alcoholism, treatment with oral estrogen replacement therapy, extensive aerobic exercise, and treatment with niacin, statins, or fibrates. [11, 12, 13] On the other hand, smoking reduces levels of HDL-C, while quitting smoking leads to a rise in the plasma HDL level.

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.
Nuts are high in polyunsaturated fatty acids, so almonds, walnuts, or pistachios can help reduce your LDL levels. Try sprinkling them on your salad, or eat them right out of hand as a snack. Just be sure to choose the low-salt option, and keep it to about 1.5 ounces a day -- nuts are also high in calories. For almonds, that’s about 30 almonds or 1/3 cup.
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.
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.
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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.
Most of us do not get enough fiber in our diet. The recommended amount is 25-35 grams of dietary fiber per day. Dietary fiber is a type of carbohydrate that the body cannot digest. As fiber passes through the body, it affects the way the body digests foods and absorbs nutrients. Fiber can help reduce your LDL cholesterol level. A fiber-rich diet can also help control blood sugar, promote regularity, prevent gastrointestinal disease and help you manage your weight.

Aside from the inconvenience of taking niacin, two recent, highly-anticipated clinical trials have suggested that raising HDL levels with niacin failed to demonstrate any improvement in cardiovascular outcomes. Furthermore, treatment with niacin was associated with an increased risk of stroke and increased diabetic complications. At this point, most doctors are very reluctant to prescribe niacin therapy for the purpose of raising HDL levels.

I very simply lowered my cholesterol 57 points in 6 month (257 to 200) and my ldl from 158 to 132 by not eating meat. It has now been a year since I stopped eating meat, I cannot exercise due to major surgery but lost 50lbs and will have my cholesterol retested in September for my annual checkup. I’m also planning on going back to the gym soon. High cholesterol runs in my family and I was determined not to go on medication like my mom. I gained 30lbs when I was injured, I did not intend to go back to my weight as a teenager when I stopped eating meat, just lower my cholesterol, that was just a perk. I never deprive myself of food, I eat fish and I don’t miss meat from my diet at all. It was a conscience choice I made to try and lower my cholesterol, no one told me to or advised me but it worked and I’m happy I took the path. Good luck to all and stay healthy!


But keep in mind that not all cholesterol is created equally. LDL cholesterol, also known as “bad cholesterol,” is the form that can build up on the artery walls and increase your risk of heart disease. HDL cholesterol, on the other hand, is often dubbed “good cholesterol” because it travels through the bloodstream, removing harmful cholesterol from the arteries to help enhance heart health.
The good news is that changing your cholesterol levels is well within your control as some of the smallest lifestyle tweaks can yield a profound impact. A fast track to boosting HDL includes quitting smoking and increasing physical activity. The American Heart Association recommends 30 minutes of moderate physical activity at least 5 times per week with two sessions of resistance training. Your choices at mealtimes, however, may prove to be an easier more attainable way to make lasting change. Here are the foods that raise HDL cholesterol.
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.
Grabbing a plum to snack on during the day is a sweet way to keep your cholesterol levels in check: The fruit contains anthocyanins — a.k.a. antioxidants — that help out your heart by lowering blood pressure and cholesterol. According to one study, eating three or more servings of anthocyanin-rich fruit each week can lower your heart attack risk by 34 percent.
HDL cholesterol carries excess cholesterol to your liver so it doesn’t build up in your bloodstream. But when LDL cholesterol moves cholesterol throughout your body, it can build up in the walls of the arteries, making them hard and narrow. If you have too little HDL cholesterol and too much LDL, you may be diagnosed with high cholesterol, a condition that can lead to atherosclerosis, angina (often experienced as chest pain), heart attack, and stroke.
George T Griffing, MD is a member of the following medical societies: American Association for the Advancement of Science, International Society for Clinical Densitometry, Southern Society for Clinical Investigation, American College of Medical Practice Executives, American Association for Physician Leadership, American College of Physicians, American Diabetes Association, American Federation for Medical Research, American Heart Association, Central Society for Clinical and Translational Research, Endocrine Society
High levels of HDL cholesterol, often called "good" cholesterol, are associated with a reduced risk of coronary artery disease (CAD). It appears that HDL particles "scour" the walls of blood vessels, cleaning out excess cholesterol that otherwise might have been used to make the plaques that cause CAD. The HDL cholesterol is then carried to the liver, where it is processed into bile, and secreted into the intestines and out of the body.
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.
Thanks everyone for all of your comments. If you have specific inquiries, please feel free to contact us at info@thefhfoundation.org. While we cannot give you medical advice, we may be able to help you find an FH specialist. Otherwise, continue to check back to our discussions, or consider joining our FH Support Group here: https://community.thefhfoundation.org/welcome
In both studies, mega-doses of statins (a doubling and tripling of regular doses) drove LDL levels way down. But in both studies, mega-doses also caused problems. Suffering from adverse side effects like muscle pain, memory loss, and elevated liver enzymes, patients on the high doses stopped taking their medications at twice the rate of patients on regular doses.
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]
Ask for tomato sauce with your pasta if you want to keep your cholesterol under control. Tomatoes are a significant source of a plant compound called lycopene, which reduces levels of LDL cholesterol. Research shows that the body absorbs more lycopene if the tomatoes are processed or cooked, so drink tomato juice and add tomatoes to your minestrone soup as well.
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).
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."
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.
But keep in mind that not all cholesterol is created equally. LDL cholesterol, also known as “bad cholesterol,” is the form that can build up on the artery walls and increase your risk of heart disease. HDL cholesterol, on the other hand, is often dubbed “good cholesterol” because it travels through the bloodstream, removing harmful cholesterol from the arteries to help enhance heart health.

More long-term studies are needed in order to determine whether or not it is the actual loss of weight or the diet and exercise that go along with it that causes the reduction in LDL levels. It is also possible that LDL cholesterol can eventually return to original levels, even when weight loss is maintained. Nonetheless, the prospect makes weight maintenance and good nutrition worthy goals to have.


Some companies sell supplements that they say can lower cholesterol. Researchers have studied many of these supplements, including red yeast rice, flaxseed, and garlic. At this time, there isn't conclusive evidence that any of them are effective in lowering cholesterol levels. Also, supplements may cause side effects and interactions with medicines. Always check with your health care provider before you take any supplements.
Can my HDL be too high? It is well known that not all cholesterol is bad for you. Of HDL and LDL cholesterol, HDL packs some great benefits. This MNT Knowledge Center article examines when high HDL cholesterol is good, and whether higher is always better? Learn how to find the right balance along with some healthful ways to achieve high HDL. Read now

George T Griffing, MD is a member of the following medical societies: American Association for the Advancement of Science, International Society for Clinical Densitometry, Southern Society for Clinical Investigation, American College of Medical Practice Executives, American Association for Physician Leadership, American College of Physicians, American Diabetes Association, American Federation for Medical Research, American Heart Association, Central Society for Clinical and Translational Research, Endocrine Society


Salmon is rich in omega-3 fatty acids, which are healthy fats that can help reduce blood pressure. Eating salmon can improve your "good" HDL cholesterol, but it won't lower your "bad" LDL cholesterol. HDL cholesterol helps sweep cholesterol off your artery walls, preventing dangerous plaque from forming. The American Heart Association recommends eating fatty fish like salmon at least twice per week for heart-healthy benefits. Other fish that contain omega-3s, such as mackerel, tuna and sardines, can also help.
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