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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.
Dr. Pacold notes that exercise has a greater effect on raising HDL cholesterol, which protects you from heart disease, than on lowering the LDL cholesterol that puts you at risk. It's good to know that even if you don’t see the numbers changing right away, regular exercise strengthens your heart and protects you from heart disease. If you’re not a big fan of exercise and not in great shape to begin with, remember that all you need to do to start reaping the heart-healthy benefits of exercise is 30 minutes of walking at a moderate pace every day. If you have a heart condition, talk with your doctor first about how much exertion is right for you when you begin, and then work your way up to your fitness goals for heart health.
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
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.
So if there is a cholesterol that is actually good for us, how can we naturally increase its levels? The short answer is lifestyle. Your lifestyle actually has the single greatest impact on your HDL cholesterol level. So making changes to daily and completely controllable habits like diet and exercise can equate to healthier HDL cholesterol levels, which can lower your risk for life-threatening health issues.
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. 
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.  ) 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]
If you have been looking high and low for ways to lower your cholesterol, you’re not alone. High cholesterol is one of the most common health problems today. So what is cholesterol? There is LDL (bad) cholesterol and HDL (good) cholesterol. LDL cholesterol encourages a waxy plaque to build up in your arteries, which can lead to heart disease and other conditions. HDL cholesterol clears this plaque from your arteries and removes it from your body, which reduces your risk of these problems. Together, these form your “total” cholesterol levels. The way to improve your overall cholesterol is make changes that lower your LDL levels and raise your HDL levels.
HDL levels below 40 mg/dL are associated with an increased risk of CAD, even in people whose total cholesterol and LDL cholesterol levels are normal. HDL levels between 40 and 60 mg/dL are considered "normal," and do not very much affect the risk of CAD one way or the other. However, HDL levels greater than 60 mg/dL are actually associated with a reduced risk of heart disease.
The lipid profile blood test reports the levels of cholesterol and triglycerides in the bloodstream. Healthcare organizations have established a set range for total, bad LDL and good HDL cholesterol as well as triglycerides, but the most important thing to consider when looking for how to lower cholesterol naturally is the ratio of LDL to HDL cholesterol, which should be around 2:1. (1, 2)