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.
As defined by the US National Cholesterol Education Program Adult Treatment Panel III guidelines, an HDL cholesterol (HDL-C) level of 60 mg/dL or greater is a negative (protective) risk factor.  On the other hand, a high-risk HDL-C level is described as being below 40 mg/dL. Randomized, controlled clinical trials have demonstrated that interventions to raise HDL-C levels are associated with reduced CHD events. A prospective analysis by Mora et al investigated the link between cholesterol and cardiovascular events in women and found that the baseline HDL-C level was consistently and inversely associated with incident coronary and coronary vascular disease events across a range of LDL-C values. 
Why is one form of cholesterol considered good and another bad? There are actually as many as 18 kinds of cholesterol, but to save confusion, doctors divide them into two categories: LDL (bad) and HDL (good). Your liver manufactures most of your cholesterol, and small amounts of it go toward a variety of healthy purposes, including creating hormones that help turn food and exercise into muscle. Serving as cholesterol chauffeurs are fat/protein bunches called lipoproteins, and that’s where the fun begins: Low-density lipoproteins tend to deposit cholesterol on artery walls, where it builds up and eventually interferes with blood flow. But the high-density variety seems to take cholesterol back to the liver, where it can be eliminated from the body.
advocacy AHA Call to Action CDC cholesterol Conference diet Dubai familial hypercholesterolemia FH FH Europe FH Family Cookbook FH Global Summit Genetic Testing Global Global Advocacy Global Call to Action on FH global policy Health Impact heart healthy Heart UK IAS ICD-10 Code Implementation Science International Atherosclerosis Society Living Well with FH living with FH low fat Meeting of the Americas NCD NCDs Noncommunicable Disease Oman Society of Lipid and Atherosclerosis OSLA Pioneer Award Policy Roger Williams Scientific Sessions WCC WHF WHO World Congress of Cardiology World Congress of Cardiology and Cardiovascular Health World Health Organization World Heart Federation
“If your LDL levels are still too high after trying these 6 nutrition-based approaches, talk to your doctor about cholesterol-lowering medications like statins, but give these 6 tips your best shot,” encourages Dr. Danine Fruge, MD, ABFP, Medical Director at the Pritikin Longevity Center. “The right eating plan, like Pritikin, can be powerfully beneficial – and there are no adverse side effects.”
Once you control your protein and starch portions, you can fill the rest of your plate with heart-healthy fruits and vegetables. Aim for four to five servings of vegetables and four to five servings of fruits every day. Fruits and vegetables are rich in vitamins and minerals and are great sources of fiber, which helps fill you up, control your weight, and improve cholesterol levels.
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.
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.
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.
A meta-analysis looked at randomized controlled trials for artichoke extract for high cholesterol. They found three studies worth analyzing and two showed some effect in lowering total cholesterol. Adverse events were mild, transient, and infrequent. The study said that larger clinical trials over longer periods are needed. The conclusion was that the evidence was not convincing, and the Cochrane Review discontinued updating its analysis of this research as of 2016.
You've probably heard that fried foods of all kinds, hydrogenated oils, and full-fat dairy products are cholesterol bombs that are best avoided (and not just by those watching their cholesterol levels). The American Heart Association recommends that everyone restrict these foods, as they contain trans and saturated fats, the "bad" kind that raises LDL cholesterol and leads to plaque buildup in the arteries.