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
Catapano AL, et al. 2016 ESC/EAS guidelines for the management of dyslipidaemias: The task for the management of dyslipidaemias of the European Society of Cardiology (ESC) and European Atherosclerosis Society (EAS) developed with the special contribution of the European Association for Cardiovascular Prevention & Rehabilitaiton (EACPR). Atherosclerosis. 2016;253:281.
Sugar and spice and everything nice… except for the fact that recent data has shown that added sugar is not so nice for our cardiovascular health or waistlines. In fact, a study published in Circulation found that people with the highest consumption of added sugars show significantly lower HDL levels. To cut back on your added sugar intake and increase HDL levels, consider replacing sugar with dates when you’re making baked goods like homemade granola bars, cookies, and cakes. It’s one way to slice total added sugars in half and will also give your sweet treat extra fiber, vitamins, and minerals.
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. 
Foods naturally rich in soluble fiber have proven particularly good at lowering cholesterol. Excellent sources include oats, oat bran, barley, peas, yams, sweet potatoes and other potatoes, as well as legumes or beans, such as pinto beans, black beans, garbanzo beans, and peas. Vegetables rich in soluble fiber include carrots, Brussels sprouts, beets, okra, and eggplant. Good fruit sources are berries, passion fruit, oranges, pears, apricots, nectarines, and apples.
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.
115 my triglycerides being 456 and my HDL cholesterol that I 35 and then my LDL direct is 256 my family is known for heart disease and plaque buildup nine really don’t want that to happen so any advice would be appreciated I already limit my diet really well with vegetables and fruits and I eat a lot of pork and chicken and I’m allergic to fish so I can eat fish is there anything I can do to replace that thank you for your time have a wonderful day
Soy isoflavones significantly decreased serum total cholesterol by 0.10 mmol/L (3.9 mg/dL or 1.77%; P = 0.02) and LDL cholesterol by 0.13 mmol/L (5.0 mg/dL or 3.58%; P < 0.0001); no significant changes in HDL cholesterol and triacylglycerol were found. Isoflavone-depleted soy protein significantly decreased LDL cholesterol by 0.10 mmol/L (3.9 mg/dL or 2.77%; P = 0.03). Soy protein that contained enriched isoflavones significantly decreased LDL cholesterol by 0.18 mmol/L (7.0 mg/dL or 4.98%; P < 0.0001) and significantly increased HDL cholesterol by 0.04 mmol/L (1.6 mg/dL or 3.00%; P = 0.05). The reductions in LDL cholesterol were larger in the hypercholesterolemic subcategory than in the normocholesterolemic subcategory, but no significant linear correlations were observed between reductions and the starting values. No significant linear correlations were found between reductions in LDL cholesterol and soy protein ingestion or isoflavone intakes.
It’s harder to increase HDL or "good" cholesterol than it is to lower LDL or total cholesterol. It’s estimated that up to 80 percent of the variation in HDL from person to person is due to genetic factors. But the following steps have been shown to boost HDL—and they are worth taking because they also lower total cholesterol and help protect the heart in many ways beyond their effect on HDL.
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.
If you want to increase the benefits of the fats you eat, work out before you chow down. A study at the University of Missouri found that regular exercise prior to high-fat meals produces a large hike in HDL. I’m not suggesting that your excuse for indulging in high-fat meals ought to be a pre-meal workout, merely that exercise before a meal works to your heart’s advantage.
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.
Along with exercising, eating a healthy diet is one of the most important things you can do to reach and maintain healthy cholesterol levels. Learn how to read nutrition labels and know the difference between healthy and unhealthy fats. Calories, calories from fat, total fat, saturated fat, and trans fat numbers are all right there on the nutrition facts label to help you make heart-healthy choices.
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.
Before you begin dramatically changing your diet or taking any supplements, you should talk with your doctor and dietitian. Food is an outstanding and all-natural way to deliver more heart-healthy vitamins, minerals, and nutrients to your body. However, certain foods and supplements are off-limits because of their possible interactions with medications or prescriptions.
As if we needed another excuse to grab a second scoop of guac at the tailgate? Avocados are the poster child for the heart-healthy diet due to their rich abundance of monounsaturated fat, high fiber, and potassium. Monounsaturated fats from avocados, in particular, have been connected to an increase of HDL cholesterol and decreases of total cholesterol, LDL particles, and triglycerides, as shown in an Archives of Medical Research study. These can even be substituted for heart-harmful hydrogenated oils in baked goods as the fruit yields the same creamy texture and mouthfeel. Avocado brownies anyone?!