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]
Get Moving – Want healthy HDL levels? It’s time to lace up those sneakers and start exercising! Being physically active is essential for a healthy heart. Many types of exercise will help raise your HDL cholesterol, including high-intensity exercise, aerobic exercise, and strength training. Shoot to exercise most days out of the week for at least 30 minutes each session to experience the benefits.

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.
In a Canadian study, drinking a few glasses of orange juice every day for four weeks increased participants’ HDL by 21 percent, possibly due to a flavonoid called hesperidin that appears extremely HDL-friendly. Subsequent research found that tangerine juice may be even more effective. Unfortunately, that much juice will add hundreds of excess sugar calories to your diet. So stick to a glass a day and be satisfied with lesser results. Or you can buy hesperidin as a supplement, though it won’t replace the many beneficial nutrients of orange juice (and certainly won’t taste as good).
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.

A study of over 1 million US veterans showed a U-shaped relationship between HDL and total mortality, with 50mg/dL as the level associated with the lowest mortality. [7, 2] In addition, an analysis of the Framingham study demonstrated that LDL and triglyceride levels modify HDL’s predictive value; CHD risk was found to be higher when low HDL was combined with high LDL and/or triglycerides as compared with the presence of low HDL levels alone. [8, 2]  The relationship between HDL and CHD risk is also confounded by the presence of pro-atherogenic and inflammatory markers. [2]
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.
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)
If you’re one of the 73.5 million Americans who have unhealthy cholesterol levels, heart-healthy lifestyle changes are important ways to improve your cholesterol and prevent it from getting progressively worse. According to the Centers for Disease Control and Prevention (CDC), fewer than half of people with high LDL cholesterol (the type of cholesterol that puts you at risk for heart disease) are getting treated, and not even one in three have their high cholesterol under control.
And according to some powerful experiments by software engineer-turned-biohacker Dave Feldman, you can actually increase and decrease your cholesterol at will. It all depends on how much fat you eat — and, directly against mainstream dietary knowledge, the correlation is inverted. In other words, eating more fat will actually lower your cholesterol.
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