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.
Other supplements that have been suggested for cholesterol have less evidence of being useful. In the case of red yeast rice, there is a potential danger because it contains a naturally-occurring form of lovastatin, a prescription drug. Garlic has now been shown to be ineffective for lowering cholesterol. Other supplements and food you may see touted include policosanol, coenzyme Q10, green tea, and soy.
Treatment of high cholesterol usually begins with lifestyle changes geared toward bringing levels down. These include losing weight if you’re overweight, and changing your diet to emphasize vegetables and fruits, fish, particularly cold water fish such as wild Alaskan salmon, mackerel, herring and black cod that provide heart healthy omega-3 fatty acids. If lifestyle changes don’t help or if you’re unable to make the changes your doctor recommends, cholesterol-lowering drugs may be prescribed. These include statins, which effectively lower LDL cholesterol; bile acid sequestrants that may be prescribed along with statins to lower LDL; nicotinic acid to lower LDL cholesterol and triglycerides and raise HDL; drugs called fibrates that may be prescribed to lower cholesterol and may raise HDL; and a drug called Ezetimibe to lower LDL by blocking the absorption of cholesterol in the intestine.
Eating seafood twice per week is a surefire way to reduce your risk of cardiovascular disease. Fatty fish like salmon yields some of the greatest anti-inflammatory and heart-healthy benefits, as a Journal of Nutrition study found salmon protein to significantly increase the proportion of HDL cholesterol. One tip: fish should be purchased wild and sustainably caught. For a consumer guide on how to make informed choices you can check out the consumer guides provided by the Monterey Bay Aquarium Seafood Watch.
More long-term studies are needed in order to determine whether or not it is the actual loss of weight or the diet and exercise that go along with it that causes the reduction in LDL levels. It is also possible that LDL cholesterol can eventually return to original levels, even when weight loss is maintained. Nonetheless, the prospect makes weight maintenance and good nutrition worthy goals to have.
Filled with plant-based antioxidants and minerals, this protein-packed dairy alternative can help improve your lipid levels. That’s because it’s lower in saturated fat than other vegan swaps (ahem, coconut oil). Unsweetened versions cut back on sneaky sources of added sugar often found in beverages, so use it in your morning latte for a cholesterol-lowering caffeine boost.
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.
If you don’t already know your HDL level, you can find out from blood work that includes a lipid profile. This profile tells you your overall total cholesterol as well as its individual parts, including HDL and LDL. There are no obvious signs or symptoms of high LDL cholesterol and low HDL cholesterol so it’s very important to maintain a healthy lifestyle and get your cholesterol checked regularly!
Hyperalphalipoproteinemia (HALP) may be familial, including primary (without CETP deficiency) and otherwise (with CETP deficiency), or secondary.  Familial HALP (aside from the primary form) is a well-documented genetic form of hypercholesterolemia characterized by a deficiency of CETP, a key protein in the reverse cholesterol transport (RCT) system that facilitates the transfer of cholesteryl esters from high-density lipoprotein (HDL) to beta lipoproteins. Primary HALP is a term used for familial elevated HDL cholesterol levels that are not due to CETP deficiency and for which the cause is unknown. Secondary HALP is due to environmental factors or medications.
As you already know, HDL is considered the good guy in the cholesterol game, and it can help your liver to get rid of the unhelpful cholesterol in your body. This is a very important task that HDL is able to accomplish since cholesterol can’t simply dissolve into the blood. The liver has the job of processing cholesterol among its other important jobs. HDL is the liver’s helper and a very good one at that. Having high levels of HDL reduces your risk for both heart disease and stroke, which is why you want to get your cholesterol under control. (10)
Barley, oatmeal and brown rice have lots of soluble fiber, which has been proven to lower LDL cholesterol by reducing the absorption of cholesterol into your bloodstream. Try switching out your regular pasta for the whole-grain version, or use brown rice instead of white. To give an added cholesterol-busting kick, top your morning oatmeal with high-fiber fruit like bananas or apples.
To maintain a healthy body, you should exercise on a daily basis. If you want another specific reason to start exercising or increase your frequency of exercise, it’s your HDL levels. Increased physical activity directly helps raise your HDL cholesterol — just another one of the many benefits of exercise. Vigorous exercise is the best choice for boosting HDL, but any additional exercise is better than none. (2)
However, although low levels of HDL predict increased cardiovascular risk, particularly in healthy individuals with no history of cardiovascular events, the relationship between HDL and CHD risk is complex, with HDL-C and cardiovascular disease having a nonlinear relationship. For example, research found that HDL levels above approximately 60 mg/dL showed no further improvement in prognosis, and the EPIC (European Prospective Investigation into Cancer and Nutrition)-Norfolk and IDEAL (Incremental Decrease in End Points through Aggressive Lipid Lowering) studies showed that very high levels of HDL may actually be associated with an increased risk of atherosclerotic disease. [5, 6, 2]
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]