The most important mechanism by which HDL exerts its antiatherogenic role is the removal of excess cholesterol from peripheral cells and its transport to the liver, a process commonly termed the reverse cholesterol transport system (RCT). Several proteins are involved in this process, including ATP-binding cassette transporter 1, LCAT, CETP, and hepatic triglyceride lipase (see Pathophysiology). [25]

All cherries are delicious, but there's something extra special about this sour variety. "I love snacking on dried Montmorency tart cherries not only because they have a sour-sweet flavor, but because they also have fiber," Gorin says. "Plus, you get other heart-helping benefits, too. Anthocyanins, a type of antioxidant found in purple and dark red fruits and vegetables, may help decrease the risk of heart attack in women."
Oatmeal is one of the best cholesterol-fighting foods because it is so high in beta-glucans, the soluble fibers that cause oats to bulk up in liquid when you make oatmeal. Soluble fiber lowers your LDL, or "bad," cholesterol by forming a sticky layer in the small intestine that blocks cholesterol from entering your bloodstream. Make oatmeal and skip the instant packs with lots of added sugar. (In a rush? See our picks for best instant oatmeals.) Add fruit to your oatmeal to naturally sweeten it and boost the soluble fiber content even more.
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.
Large doses of vitamin B3, or niacin, have been found to raise HDL as much as 20 percent and are often prescribed for people with cholesterol problems. But keep in mind that a daily multivitamin contains all the niacin most people need. Supplementing beyond that can have a variety of side effects, including facial flushing, heartburn and even liver damage, so don’t try it without consulting a doctor.
Too much cholesterol in the blood builds up on artery walls causing hardening of the arteries (atherosclerosis). The buildup of cholesterol narrows arteries, slowing or blocking the flow of oxygen-carrying blood to the heart, which can manifest as chest pain. If blood flow to the heart is cut off because of clogged arteries, the result is damage to the heart muscle – a heart attack.
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.
But keep in mind that not all cholesterol is created equally. LDL cholesterol, also known as “bad cholesterol,” is the form that can build up on the artery walls and increase your risk of heart disease. HDL cholesterol, on the other hand, is often dubbed “good cholesterol” because it travels through the bloodstream, removing harmful cholesterol from the arteries to help enhance heart health.

Plain and simple, exercise raises HDL levels. “We looked at doctors and others who ran the Boston Marathon,” notes Castelli. “While the average male HDL is 45, men who ran the marathon ranged around 55.” One Georgetown University study found increased HDL in those who ran seven miles a week or took part in four moderate 30-minute sessions of any aerobic activity.
Ivan V. Pacold, MD, a cardiology professor at Loyola University’s Stritch School of Medicine in Chicago, says that lifestyle choices matter, and “even if these changes don’t show up directly in your cholesterol numbers, they can be lowering your risk for heart disease.” So if you haven’t made the change to a heart-healthy lifestyle, here are nine ways to get started.
Are you pouring up a glass of OJ in the morning? Is your daily caffeine fix a fountain coke at the local gas station? What about that fruity cocktail tempting you at happy hour? Eliminating sweetened beverages from the daily routine is one of the easiest ways to cut thousands of calories or more per week, but will also put years on your life. Water is the best form of hydration and can be flavored with citrus, tropical fruits, and herbs to create a refreshing spa-like oasis that will increase HDL levels when it replaces your typical sugar-sweetened beverages.
Try to eat it two to four times a week. “Not only are the omega-3 fats in fish heart-healthy, but replacing red meat with fish will lower your cholesterol by reducing your exposure to saturated fats, which are abundant in red meat,” Samaan says. The catch? Some types, like shark, swordfish, and king mackerel, are high in mercury. That can increase your risk for heart disease. Instead, choose wild salmon, sardines, and bluefin tuna.

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.


One drawback of going on a low-fat diet for some people is that it lowers HDL levels. If raising your HDL cholesterol is a primary concern, you should replace carbohydrates in your diet with fats, preferably mono- and polyunsaturated fats. But avoid trans fat, which can lower HDL levels. These steps can lower both total cholesterol and LDL and maintain HDL or boost it slightly, improving the ratio of total cholesterol to HDL.
Substantial evidence now shows that a low-fat diet often reduces — rather than increases — HDL levels. This result is not specifically caused by “not enough fat,” but rather, is caused by consuming too many carbohydrates. The American Heart Association and the American College of Cardiology have quietly stopped recommending low-fat diets for heart disease prevention. Indeed, it is low-carb diets — and not low-fat diets — which are associated with higher HDL levels.
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.
Coronary heart disease: What you need to know The coronary arteries supply oxygen and blood to the heart. They can narrow, often because cholesterol accumulates on the arteries’ walls. This results in coronary heart disease, the most common type of heart disease in the U.S. Here, learn about risk factors, early warning signs, means of prevention, and treatments. Read now
Salmon is rich in omega-3 fatty acids, which are healthy fats that can help reduce blood pressure. Eating salmon can improve your "good" HDL cholesterol, but it won't lower your "bad" LDL cholesterol. HDL cholesterol helps sweep cholesterol off your artery walls, preventing dangerous plaque from forming. The American Heart Association recommends eating fatty fish like salmon at least twice per week for heart-healthy benefits. Other fish that contain omega-3s, such as mackerel, tuna and sardines, can also help.
Niacin can be taken at lower doses rather than prescription levels, but supplementation can cause unwanted niacin side effects, especially when taking at high dosages. Some negative results of taking niacin include experience flushing, an uncomfortable feeling of heat, itching or tingling in the skin. Other side effects can include gastrointestinal, muscle and liver problems.
Some companies sell supplements that they say can lower cholesterol. Researchers have studied many of these supplements, including red yeast rice, flaxseed, and garlic. At this time, there isn't conclusive evidence that any of them are effective in lowering cholesterol levels. Also, supplements may cause side effects and interactions with medicines. Always check with your health care provider before you take any supplements.
Coronary heart disease: What you need to know The coronary arteries supply oxygen and blood to the heart. They can narrow, often because cholesterol accumulates on the arteries’ walls. This results in coronary heart disease, the most common type of heart disease in the U.S. Here, learn about risk factors, early warning signs, means of prevention, and treatments. Read now
Perhaps most disappointing of all, a new class of drugs (the so-called CETP-inhibitors), which several pharmaceutical companies have been enthusiastically developing for several years to raise HDL levels, has become a great disappointment. While these drugs do indeed increase HDL levels, they have not demonstrated an ability to improve cardiac risk — and on the contrary, studies appear to show a worsening in cardiac risk with some of these drugs. It is unclear today whether any CETP-inhibitors will ever reach the market.
Who doesn't love avocados? They not only taste amazing but also can help lower your cholesterol. Avocados are high in healthy monounsaturated fat, which helps lower "bad" LDL cholesterol. They also contain fiber, antioxidants and phytosterols, such as beta-sitosterol, which have also been shown to lower cholesterol. Don't hog the entire bowl of guacamole, though! One serving is just a quarter of a Hass avocado, which delivers 57 calories. Spread a few slices of avocado on your sandwich instead of mayo, or dip some veggies into a bowl of fresh guacamole.
Information on this website is provided for informational purposes only and is not intended as a substitute for the advice provided by your physician or other healthcare professional. You should not use the information on this website for diagnosing or treating a health problem or disease, or prescribing any medication or other treatment. Any third party offering or advertising on this website does not constitute an endorsement by Andrew Weil, M.D. or Healthy Lifestyle Brands.
Once you know your cholesterol levels, it’s time to discuss a plan with your doctor. Although changing your lifestyle to include a heart-healthy diet and plenty of exercise is usually the first step to lower cholesterol, some types of cholesterol problems like familial hypercholesterolemia may require medication right away. Work with your doctor to come up with the best cholesterol goals for you and the best ways to get there.
This healthy recipe pairs well with just about anything -- salmon, chicken, or game meat like bison and venison. It's also a superb go-to for quick-fix lunches or snacks. Ladle some into whole-wheat tortillas stuffed with crunchy veggies. Pour a cup or two into some chicken or vegetable stock for an easy soup. Or blend a big scoop of your beans and rice with a big bowl of lettuce greens and sliced tomatoes for a filling lunch salad.
Some companies sell supplements that they say can lower cholesterol. Researchers have studied many of these supplements, including red yeast rice, flaxseed, and garlic. At this time, there isn't conclusive evidence that any of them are effective in lowering cholesterol levels. Also, supplements may cause side effects and interactions with medicines. Always check with your health care provider before you take any supplements.
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.
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.
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].
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.
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