HDL is more tightly controlled by genetic factors than are the other lipoproteins (ie, LDL, very–low-density lipoprotein (VLDL), intermediate-density lipoprotein [IDL], chylomicrons). For example, in certain families, especially some families with Japanese ancestry, a genetic deficiency of cholesteryl ester transfer protein (CETP) is associated with strikingly elevated HDL-C levels. [10]
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
Take fish oil. Fish oil contains an abundance of essential omega-3 fatty acids (omega-3s) that have been shown to lower triglyceride (blood fat) levels, minimize inflammation and clotting, and increase HDL (“good”) cholesterol. Research indicates that omega-3s may help reduce the risk and symptoms of a variety of disorders influenced by inflammation, including heart attack and stroke. You can add omega-3s to your diet by eating more cold water fish such as wild Alaskan salmon, sardines, herring, mackerel and black cod. If that’s not possible, Dr. Weil recommends taking two grams daily of a fish oil supplement that contains both essential omega-3 fatty acids, EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid). When choosing a supplement, look for one derived from molecularly distilled fish oils – these are naturally high in both EPA and DHA and low in contaminants. Also choose a supplement brand that has been independently tested and guaranteed to be free of heavy metals such as mercury and lead, and other environmental toxins including polychlorinated biphenyls, also known as PCBs.
Thanks everyone for all of your comments. If you have specific inquiries, please feel free to contact us at info@thefhfoundation.org. While we cannot give you medical advice, we may be able to help you find an FH specialist. Otherwise, continue to check back to our discussions, or consider joining our FH Support Group here: https://community.thefhfoundation.org/welcome
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.
8. Foods fortified with sterols and stanols. Sterols and stanols extracted from plants gum up the body's ability to absorb cholesterol from food. Companies are adding them to foods ranging from margarine and granola bars to orange juice and chocolate. They're also available as supplements. Getting 2 grams of plant sterols or stanols a day can lower LDL cholesterol by about 10%.
Avoid Artificial Trans Fats – We all know how delicious fast food, soda, and cookies are, but they present our bodies with so many negative health effects, including bloating, weight gain, lower HDL cholesterol levels, and higher instances of inflammation. Protect your heart health and your HDL cholesterol by avoiding artificial trans fats as much as possible. Indulging once in a while is okay; just make sure that it remains infrequent and in reasonable portions (enjoy ½ cup of your favorite ice cream – not ½ of the carton, for example).
Dr. Pacold notes that exercise has a greater effect on raising HDL cholesterol, which protects you from heart disease, than on lowering the LDL cholesterol that puts you at risk. It's good to know that even if you don’t see the numbers changing right away, regular exercise strengthens your heart and protects you from heart disease. If you’re not a big fan of exercise and not in great shape to begin with, remember that all you need to do to start reaping the heart-healthy benefits of exercise is 30 minutes of walking at a moderate pace every day. If you have a heart condition, talk with your doctor first about how much exertion is right for you when you begin, and then work your way up to your fitness goals for heart health.

Obesity results not only in increased LDL cholesterol but also in reduced HDL cholesterol. If you are overweight, reducing your weight should increase your HDL levels. This is especially important if your excess weight is stored in your abdominal area; your waist-to-hip ratio is particularly important in determining whether you ought to concentrate on weight loss.


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.
George T Griffing, MD is a member of the following medical societies: American Association for the Advancement of Science, International Society for Clinical Densitometry, Southern Society for Clinical Investigation, American College of Medical Practice Executives, American Association for Physician Leadership, American College of Physicians, American Diabetes Association, American Federation for Medical Research, American Heart Association, Central Society for Clinical and Translational Research, Endocrine Society 

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.
Rich in omega-3 fatty acids and all-around delicious, walnuts have also been shown to improve the HDL-to-total cholesterol ratio, according to a study published in the American Diabetes Association’s peer-reviewed journal, Diabetes Care. This ratio is used by physicians to assess overall cardiovascular risk and can provide more information than just one value alone. A desirable ratio is anything below 5:1, but a ratio of 3.5:1 indicates very minimal cardiovascular risk.
Nuts are high in polyunsaturated fatty acids, so almonds, walnuts, or pistachios can help reduce your LDL levels. Try sprinkling them on your salad, or eat them right out of hand as a snack. Just be sure to choose the low-salt option, and keep it to about 1.5 ounces a day -- nuts are also high in calories. For almonds, that’s about 30 almonds or 1/3 cup.
When it comes to cholesterol, not all types are created equal, and it is important to understand how lifestyle choices significantly impact cardiovascular health. High-density lipoprotein, or HDL, is known as the “healthy” or “good” type of cholesterol due to the fact that it scavenges and removes the “bad” type of cholesterol (low-density lipoprotein or LDL) known to clog arteries. A desirable HDL level is anything greater than 60 milligrams per deciliter (mg/dL).
A study published in February 2016 in the journal PLoS One concluded as much. For nearly 11,000 adults, researchers found that low to moderate alcohol consumption (20 or fewer drinks a week for a man, 10 or fewer for a woman) led to higher levels of HDL cholesterol. It also helped get them to healthier overall cholesterol levels, decreasing triglycerides (blood fats in blood) and lowering LDL cholesterol.
They're crisp, sweet and their hefty cargo of natural fiber, much of it in the form of pectin, helps to knock down LDL levels. Surprisingly, fresh pears contain even more pectin than apples do. Pectin binds with cholesterol and ferries it out of the body before it can be absorbed. A medium-size pear provides 16 percent of the recommended daily value for fiber. Other pectin-rich fruits include apples, bananas, oranges and peaches.
Thanks everyone for all of your comments. If you have specific inquiries, please feel free to contact us at info@thefhfoundation.org. While we cannot give you medical advice, we may be able to help you find an FH specialist. Otherwise, continue to check back to our discussions, or consider joining our FH Support Group here: https://community.thefhfoundation.org/welcome

In a Canadian study, drinking a few glasses of orange juice every day for four weeks increased participants’ HDL by 21 percent, possibly due to a flavonoid called hesperidin that appears extremely HDL-friendly. Subsequent research found that tangerine juice may be even more effective. Unfortunately, that much juice will add hundreds of excess sugar calories to your diet. So stick to a glass a day and be satisfied with lesser results. Or you can buy hesperidin as a supplement, though it won’t replace the many beneficial nutrients of orange juice (and certainly won’t taste as good).
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 one of the 73.5 million Americans who have unhealthy cholesterol levels, heart-healthy lifestyle changes are important ways to improve your cholesterol and prevent it from getting progressively worse. According to the Centers for Disease Control and Prevention (CDC), fewer than half of people with high LDL cholesterol (the type of cholesterol that puts you at risk for heart disease) are getting treated, and not even one in three have their high cholesterol under control.

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.
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]
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