What is cholesterol ratio and why is it important? There are two types of cholesterol. One is harmful, and builds up in the arteries, but the other can actually benefit the body. In this MNT Knowledge Center article, learn about the difference between 'good' and 'bad' cholesterol. How do they affect the body? How can you manage high cholesterol? Read now
Nordestgaard BG, Langsted A, Mora S, et al. Fasting is not routinely required for determination of a lipid profile: clinical and laboratory implications including flagging at desirable concentration cut-points-a joint consensus statement from the European Atherosclerosis Society and European Federation of Clinical Chemistry and Laboratory Medicine. Eur Heart J. 2016 Jul 1. 37 (25):1944-58. [Medline]. [Full Text].

How does that song go? "Beans, beans, they're good for your heart"? Well...those lyrics get it right! Beans are packed with cholesterol-busting soluble fiber, but that's not their only benefit. Beans are high in protein, which makes them a heart-healthy replacement for some animal protein sources, such as meat. For the biggest cholesterol-lowering benefits, add beans to chili, tacos and burritos (either in place of or in addition to meat). They're also great in soups and salads.
Different foods lower cholesterol in various ways. Some deliver soluble fiber, which binds cholesterol and its precursors in the digestive system and drags them out of the body before they get into circulation. Some give you polyunsaturated fats, which directly lower LDL. And some contain plant sterols and stanols, which block the body from absorbing cholesterol.
Research has shown the health benefits of eating seafood rich in omega-3 fatty acids, especially when it replaces less healthy proteins that are high in saturated fat and low in unsaturated fat. Including seafood high in omega-3 fatty acids as part of a heart-healthy diet can help reduce the risk of heart failure, coronary heart disease, cardiac arrest and the most common type of stroke (ischemic).
Paying close attention to what you eat can help you reduce your risk of developing atherosclerosis. Atherosclerosis is the narrowing of arteries caused by plaque build-up inside the arteries. As the arteries narrow, blood can't flow properly through the arteries. Theis can lead to a heart attack or stroke. If the artery-clogging process has already begun, you may be able to slow it down by making changes in your lifestyle, including your diet.

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.
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.
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.
If you smoke, it’s time to pack it in. According to the American Heart Association, smoking reduces your HDL cholesterol levels, while increasing your risk of heart disease, high blood pressure and diabetes. If you’re a smoker, you need to quit. Once you stop smoking, you can significantly improve your HDL cholesterol level very quickly and start protecting your heart. And if you’re a non-smoker, you need to avoid exposure to second-hand smoke to prevent your health from going up in smoke.

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]


Many people don't like to hear it, but regular aerobic exercise (any exercise, such as walking, jogging or bike riding, that raises your heart rate for 20 to 30 minutes at a time) may be the most effective way to increase HDL levels. Recent evidence suggests that the duration of exercise, rather than the intensity, is the more important factor in raising HDL cholesterol. But any aerobic exercise helps. 

Research has shown the health benefits of eating seafood rich in omega-3 fatty acids, especially when it replaces less healthy proteins that are high in saturated fat and low in unsaturated fat. Including seafood high in omega-3 fatty acids as part of a heart-healthy diet can help reduce the risk of heart failure, coronary heart disease, cardiac arrest and the most common type of stroke (ischemic).
Reduce the amount of sugar and flour in your diet. Recent evidence indicates that added sugar – in the form of table sugar (sucrose) or high-fructose corn syrup – is probably a greater contributor to heart disease than is consumption of saturated fat. This suggests that the inflammatory hypothesis may in fact have more validity than the conventional lipid hypothesis, although the debate is far from settled. As a general rule, Dr. Weil advises against consuming foods with added sugars, particularly soft drinks and highly processed snack foods, which can cause rapid spikes and dips in blood sugar levels. The result can be overeating, obesity and heart disease.
Besides putting your heart health at risk, sugar is also known to be one of the most significant contributors to metabolic syndrome. In fact, the recent 2015 Dietary Guidelines labeled sugar as a “nutrient of concern” and voiced recommendations for added sugars to not exceed greater than 10% of total daily calories. So, if your goal is to nip sugar in the bud and increase your HDL cholesterol levels, start by evaluating your libations.
How does that song go? "Beans, beans, they're good for your heart"? Well...those lyrics get it right! Beans are packed with cholesterol-busting soluble fiber, but that's not their only benefit. Beans are high in protein, which makes them a heart-healthy replacement for some animal protein sources, such as meat. For the biggest cholesterol-lowering benefits, add beans to chili, tacos and burritos (either in place of or in addition to meat). They're also great in soups and salads.

Population studies have shown that low levels of HDL cholesterol—less than 40 mg/dL for men and less than 50 mg/dL for women—increase the overall risk of coronary artery disease (CAD) and heart attacks. A person whose HDL level is lower than 35 mg/dL has eight times the risk of CAD as someone with an HDL level of 65 mg/dL. Experts have long thought that boosting HDL levels promotes heart health. But while low HDL is a strong and well-established risk factor for heart disease, the evidence for raising HDL remains uncertain. But experts agree that taking these heart healthy steps are still worthwhile.
Niacin is a B vitamin that your body uses to turn food into energy. It also helps keep your digestive system, nervous system, skin, hair and eyes healthy. Most people get enough niacin or B3 from their diets, but niacin is often taken in prescription-strength doses to treat low HDL levels. Niacin supplementation can can raise HDL cholesterol by more than 30 percent. (7)
Although this breakfast choice may not satisfy your kid (or your kid-at-heart), high fiber cereals are an easy way to improve your cholesterol profile. An American Journal of Clinical Nutrition study found that high fiber oat cereals lower LDL particle number without decreasing HDL concentrations, thus improving your ratio and giving HDL levels a percentage increase. Look for a product with a minimal amount of sugar and at least 5 grams of fiber per serving. A great oat-based choice is Barbara’s Morning Oat Crunch, which has 5 grams of fiber and 6 grams of protein per cup.

Of course, shifting to a cholesterol-lowering diet takes more attention than popping a daily statin. It means expanding the variety of foods you usually put in your shopping cart and getting used to new textures and flavors. But it's a "natural" way to lower cholesterol, and it avoids the risk of muscle problems and other side effects that plague some people who take statins.
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.
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.
Controlling your weight is an important part of getting to healthy cholesterol levels, so it’s crucial to know your portion sizes if you're trying to lower cholesterol. A portion of starchy carbohydrate, like potato or pasta, should be only about half the size of a baseball. A heart-healthy portion of meat should be about the size of a deck of playing cards, or about three ounces.
A study published in January 2016 in the journal Nutrients found that an antioxidant-rich diet raises HDL cholesterol levels in relation to triglycerides, and might be associated with a reduced risk of stroke, heart failure, and inflammatory biomarkers. Antioxidant-rich foods include dark chocolate, berries, avocado, nuts, kale, beets, and spinach.

There are tons of natural remedies out there for how to lower cholesterol levels, often promising quick results with next to no effort required on your part. But while it’s true that there are tons of options to keep cholesterol levels in check, it can actually be as simple as swapping out a few foods in your diet for healthier options, switching up your workout routine or adding a supplement or two into the mix.
HDL particles are heterogeneous. They can be classified as a larger, less dense HDL2 or a smaller, denser HDL3. [16] Normally, most of the plasma HDL is found in HDL3. [17] 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.
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