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.
HDL cholesterol carries excess cholesterol to your liver so it doesn’t build up in your bloodstream. But when LDL cholesterol moves cholesterol throughout your body, it can build up in the walls of the arteries, making them hard and narrow. If you have too little HDL cholesterol and too much LDL, you may be diagnosed with high cholesterol, a condition that can lead to atherosclerosis, angina (often experienced as chest pain), heart attack, and stroke.
Do you dread opening up the white envelope of lab results after your annual physical only to discover a jumble of numbers, red ink, and arrows pointing every possible direction? Lipid or cholesterol panel results can be confusing to comprehend, and when numbers come back “out of range” it can only further fuel feelings of discouragement and helplessness.
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Not all oils are created equal when it comes to your heart health. Olive oil and soybean oil are mainly unsaturated fat, which can lower LDL cholesterol and at the same time increase HDL cholesterol. In a study published in July 2015 in The Journal of Nutrition, researchers found that including olive oil in the diet decreased LDL concentrations in healthy young men.
Fiber is your friend when cholesterol is the enemy, so reach for foods that are full of soluble fiber. Just be aware that fiber comes in different forms, with one called soluble fiber and the other known as insoluble fiber. While both are good for your heart, it’s soluble fiber that’s great for your cholesterol. In addition to making you feel full, soluble fiber can actually reduce the amount of cholesterol your body absorbs. According to the Mayo Clinic, eating at least five to 10 grams of soluble fiber each day can lower both your LDL and total cholesterol levels. So better fill up your kitchen, along your body, with fiber-filled foods.
Ask for tomato sauce with your pasta if you want to keep your cholesterol under control. Tomatoes are a significant source of a plant compound called lycopene, which reduces levels of LDL cholesterol. Research shows that the body absorbs more lycopene if the tomatoes are processed or cooked, so drink tomato juice and add tomatoes to your minestrone soup as well.

Barley contains a powerful type of soluble fiber that helps keep cholesterol levels in check by effectively lowering total and LDL cholesterol without affecting HDL. This beta-glucan fiber works by preventing the body's absorption of cholesterol from food. Look for minimally processed pearled barley, the variety most commonly found in supermarkets.
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.
Trans fats increase your LDL cholesterol, reduce your HDL levels and raise your risk of developing heart disease, stroke, diabetes and other chronic conditions. Trans fats lurk in fried foods, stick margarine, cookies, crackers, cakes, pie crusts and frozen pizza. Today, some food manufacturers are removing them from their products, but the only way to tell if a product is trans fat-free is to read labels while you’re shopping. Avoid products that list “partially hydrogenated oil” in the ingredients, since this is just a sneaky name for trans fats.

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.
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.
High levels of HDL cholesterol, often called "good" cholesterol, are associated with a reduced risk of coronary artery disease (CAD). It appears that HDL particles "scour" the walls of blood vessels, cleaning out excess cholesterol that otherwise might have been used to make the plaques that cause CAD. The HDL cholesterol is then carried to the liver, where it is processed into bile, and secreted into the intestines and out of the body.

Part of the “French paradox”-lower heart-disease rates in butter-and-cream-feasting France-may stem from the HDL benefits of wine consumption. For some people, however, alcohol causes more troubles than it cures. “Men should limit themselves to one or two drinks a day,” Willett says. “After that, you start worrying about adverse consequences.” While any alcoholic beverage will do, the antioxidants in red wine or dark beer may give you an added benefit.
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.

If you’re getting worked up over high cholesterol, then start working out. Daily exercise can help raise your HDL cholesterol levels and reduce your LDL cholesterol, while protecting you from many health conditions. Begin by choosing an activity that sounds like fun to avoid “workout burn-out.” Consider jogging, brisk walking, cycling, tennis, swimming or hitting the gym. Find an exercise partner to make the activity more enjoyable and help you stay on track. And while exercise can lower your cholesterol, it can also reduce your stress and anxiety. So working up a sweat can also save you from sweating the small stuff.
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.
While the world of wellness endlessly touts of benefits of anti-inflammatory foods, who knew eating these could kill two birds with one stone by also improving your cholesterol? Blueberries are rich in anthocyanins, the phytochemical that gives this berry its dark blue pigment and are essential to overall heart health through enhancing anti-inflammatory pathways as well as increasing HDL cholesterol levels, according to a study in The American Journal of Clinical Nutrition. One 2013 study found that consuming blueberries in tandem with exercise can increase HDL levels even more than exercise alone.
Most of us do not get enough fiber in our diet. The recommended amount is 25-35 grams of dietary fiber per day. Dietary fiber is a type of carbohydrate that the body cannot digest. As fiber passes through the body, it affects the way the body digests foods and absorbs nutrients. Fiber can help reduce your LDL cholesterol level. A fiber-rich diet can also help control blood sugar, promote regularity, prevent gastrointestinal disease and help you manage your weight.
So far, these studies have been disappointing, to say the least. The first major trial (concluded in 2006) with the first CETP inhibitor drug, torcetrapib (from Pfizer), not only failed to show a reduction in risk when HDL was increased but actually showed an increase in cardiovascular risk. Another study with another CETP inhibitor - dalcetrapib (from Roche) - was halted in May 2012 for lack of effectiveness. Both of these related drugs significantly increased HDL levels, but doing so did not result in any clinical benefit.
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Muscle pain, also called myopathy, occurs in 2% to 11% of people treated with statins, reported investigators at the University of Wisconsin Hospital and Clinics in Madison, and although the pain usually subsides once the statin is discontinued, it can take several months to do so. Like previous studies, the Wisconsin scientists also found that the negative side effects of statins increased as dosages increased.
As a result of all this, doctors don’t just want you to lower your total cholesterol count; they want you to change the ratio as well, so you have more HDL and less LDL. “When we looked at the data, we found that the higher your HDL went, the lower your risk of heart attack,” says cardiologist William Castelli, M.D., former director of the Framingham Heart Study in Massachusetts. An HDL level of 75 or more seems to convey extra longevity for many people, while a count of 100 or more is so beneficial that it was dubbed the “Methuselah syndrome” by one researcher. HDL less than 35 or so, meanwhile, can carry significant risk of heart disease. Genetics plays a large role in HDL. A few guys have naturally low levels and need to keep their LDL low as well to make up for it. (As Castelli puts it, you don’t need a substance that removes cholesterol from your blood if you don’t have much to begin with.) But there’s plenty that everyone else can do to pump up their HDL. Never one to shirk from a task that doesn’t involve housecleaning, I managed to find two handfuls of ways to turn my “good” numbers into great numbers.
A cup of tea does more than soothe on a stressful day. Both green and black tea can help lower cholesterol levels. Green tea is prepared from unfermented leaves and black tea from fully fermented leaves of the same plant. Researchers believe that catechins, a type of antioxidant found in tea, are responsible for its cholesterol-lowering effect. The more fermented the tea leaves, the lower the catechin content and the higher the caffeine content.
DAVID MONTGOMERY: The ways to reduce your bad cholesterol have a lot to do with your lifestyle. So your diet is really important. And although this kind of sounds trite, really one of the best and most effective ways to reduce cholesterol is by having a low fat diet, particularly saturated fat. We find saturated fat in eggs, dairy, and red meat. If you're able to reduce those, you reduce your bad fat, which reduces your bad cholesterol. Another really effective way that I use with my patients all the time to reduce your cholesterol is regular exercise. If you're doing aerobic type exercises, most days a week, four days a week, 30 minutes at a time, then you're doing your body the best amount of good, not just from lowering your cholesterol standpoint, but from so many different ways. There are other ways that we can reduce the fat. It may have to do with supplementations or medications. In some people, they are born with genetic conditions that predispose them to have very, very high cholesterol. And as a result of that, they have different problems like heart attacks or strokes. In those people, they really do benefit from cholesterol lowering drugs. But there are other things that you can get from over-the-counter, like omega fatty acids, omega-3 fatty acids in particular. They come in krill oil or fish oil. We've all heard of these before. And those help reduce parts of your cholesterol.

The good news is that changing your cholesterol levels is well within your control as some of the smallest lifestyle tweaks can yield a profound impact. A fast track to boosting HDL includes quitting smoking and increasing physical activity. The American Heart Association recommends 30 minutes of moderate physical activity at least 5 times per week with two sessions of resistance training. Your choices at mealtimes, however, may prove to be an easier more attainable way to make lasting change. Here are the foods that raise HDL cholesterol.


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.
Flavor foods with herbs and spices whenever you can. It’ll help you cut back on condiments high in saturated fat while maximizing flavor. Spices and herbs also pack antioxidants, which can help improve cholesterol levels when combined with veggies. Ones we love: Basil, cilantro, rosemary, sage, ginger, garlic, tarragon, black and red chili pepper, mint, and oregano.
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