What is cholesterol ratio and why is it important? There are two types of cholesterol. One is harmful, and builds up in the arteries, but the other can actually benefit the body. In this MNT Knowledge Center article, learn about the difference between 'good' and 'bad' cholesterol. How do they affect the body? How can you manage high cholesterol? Read now
Tree nuts, such as walnuts, pistachios and pecans, have been shown to lower both total cholesterol and "bad" LDL cholesterol. Nuts are high in heart-healthy monounsaturated fat, fiber and several vitamins and minerals that are good for heart health. Nuts also contain plant sterols, which are natural compounds that block the cholesterol you eat from entering your bloodstream. While nuts are awesome to eat, don't go crazy. Portion control is still important—there are 163 calories in just 1 ounce of almonds. Add a small handful to oatmeal, top toast with nut butter or make a DIY trail mix with dried fruit and nuts.
While cholesterol is normally kept in balance, an unhealthy diet high in hydrogenated fats and refined carbohydrates can disrupt this delicate balance, leading to increased cholesterol levels. This imbalance is manifested in elevated LDL (bad cholesterol) and low HDL (good cholesterol), which increases the risk of heart attack or stroke. Other causes can include physical inactivity, diabetes, stress and hypothyroidism.

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 particles are thought to scour excess cholesterol from the walls of the blood vessels, thus removing it from where it can contribute to atherosclerosis. The HDL carries this excess cholesterol to the liver, where it can be processed. So, high levels of HDL cholesterol imply that a lot of excess cholesterol is being removed from blood vessels. That seems like a good thing.
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.

A largely vegetarian "dietary portfolio of cholesterol-lowering foods" substantially lowers LDL, triglycerides, and blood pressure. The key dietary components are plenty of fruits and vegetables, whole grains instead of highly refined ones, and protein mostly from plants. Add margarine enriched with plant sterols; oats, barley, psyllium, okra, and eggplant, all rich in soluble fiber; soy protein; and whole almonds.
LDL stands for Low-Density Lipoproteins. This type of cholesterol is produced by the liver and is instrumental in the creation of cell walls, hormones, and digestive juices. However, when your LDL level is high, it can start to form a plaque-like substance on the walls of your cardiovascular system, blocking the natural flow of blood and leaving you at severe risk for heart attack and stroke. Put simply, LDL is the bad kind of cholesterol. But fear not – there are several ways in which you can lower your LDL cholesterol and encourage the development of High-Density Lipoproteins (good cholesterol), which actually function to limit the level of LDL cholesterol in your system.
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.
Ground-breaking research published in the Journal of the American Medical Association (JAMA) studied nearly 9,000 European patients. All had previously suffered heart attacks. The trial found that those who reduced their LDL levels to an average 81 with high-dose statins significantly reduced their risk of major coronary events like heart attacks and strokes at the 4.8 year follow-up compared to patients who reduced their LDL to 104 on usual-dose statin therapy.
No, carbohydrates are not the enemy to fitness goals. Plus, when it comes to heart health, oatmeal is a humble workhorse. One of the highest fiber-per-dollar foods on the market, oatmeal is an inexpensive and hearty addition to any breakfast time routine. While not raising HDL levels directly, oatmeal lowers total cholesterol and LDL cholesterol levels even more, according to an American Journal of Lifestyle Medicine review, which in turn increases your HDL levels as a percentage of total cholesterol. Make weekend brunch fun for the whole family by serving up an oatmeal bar concept with a wide array of toppings and mix-ins such as chia seeds and raspberries.
There is considerable controversy over whether high cholesterol is in itself a cause of heart disease (the lipid hypothesis), or a symptom of an inflammatory condition that is the true cause of heart disease (the inflammation hypothesis). According to the latter theory, chronically high levels of inflammation creates small lesions on arterial walls; the body sends LDL to heal those lesions, but it ultimately accumulates and oxidizes, causing blockages. From this perspective, the best lifestyle approach to lower cardiovascular disease risk is to lower inflammation in the body rather than LDL levels.

Also, a healthier diet. Like the article said try to limit red meat to once a week, eggs to 2-3 a week (preferably boiled and not fried) at most, try to cut dairy or replace what you can like replacing cow milk with soy or almond milk, if you can’t handle that start with drinking only skim milk. Also, try eating fish 1-2 times a week! omega-3 found in fish like salmon raises HDL (protective against cardiovascular diseases) and lowers your LDL (the bad cholesterol, that causes cardiovascular disease). Green tea, red grapefruit, beans and even avocado and peanut butter (just don’t overdo it, too much good fat will eventually turn into bad fat), etc are also healthy choices.
Remember, some of the best ways to raise HDL cholesterol levels while simultaneously lowering LDL cholesterol include not smoking, exercising more, decreasing body weight, eating healthier fats, reducing refined carb intake, keeping alcohol consumption moderate, increasing niacin intake and watching your prescription drug use. Do these things and watch your HDL go up while your risk for heart disease and stroke goes down.
Plasma HDL is a small, spherical, dense lipid-protein complex that is half lipid and half protein. The lipid component consists of phospholipids, free cholesterol, cholesteryl esters, and triglycerides. The protein component includes apo A-I (molecular weight, 28,000) and apo A-II (molecular weight, 17,000). Other minor, but important, proteins are apo E and apo C, including apo C-I, apo C-II, and apo C-III.
Furthermore, in epidemiological studies involving over 100,000 individuals, people whose HDL cholesterol levels are below about 40 mg/dL had a substantially higher cardiac risk than those with higher HDL levels. This is the case even when LDL cholesterol ("bad" cholesterol) levels are low. Higher HDL levels have also been associated with a reduced risk of breast, colon and lung cancer.
No, carbohydrates are not the enemy to fitness goals. Plus, when it comes to heart health, oatmeal is a humble workhorse. One of the highest fiber-per-dollar foods on the market, oatmeal is an inexpensive and hearty addition to any breakfast time routine. While not raising HDL levels directly, oatmeal lowers total cholesterol and LDL cholesterol levels even more, according to an American Journal of Lifestyle Medicine review, which in turn increases your HDL levels as a percentage of total cholesterol. Make weekend brunch fun for the whole family by serving up an oatmeal bar concept with a wide array of toppings and mix-ins such as chia seeds and raspberries.

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.
According to a study published in November 2015 in the journal Nature, a diet high in carbohydrates — like added sugar, white bread, cookies, and cakes — reduces HDL cholesterol levels, increasing the risk for metabolic disorders. Refined carbohydrates found in foods labeled “low-fat” make these just as bad as full-fat foods because the fat is often replaced with carbohydrates from added sugar and other starches.

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.


Although this breakfast choice may not satisfy your kid (or your kid-at-heart), high fiber cereals are an easy way to improve your cholesterol profile. An American Journal of Clinical Nutrition study found that high fiber oat cereals lower LDL particle number without decreasing HDL concentrations, thus improving your ratio and giving HDL levels a percentage increase. Look for a product with a minimal amount of sugar and at least 5 grams of fiber per serving. A great oat-based choice is Barbara’s Morning Oat Crunch, which has 5 grams of fiber and 6 grams of protein per cup.

A study published in January 2016 in the journal Nutrients found that an antioxidant-rich diet raises HDL cholesterol levels in relation to triglycerides, and might be associated with a reduced risk of stroke, heart failure, and inflammatory biomarkers. Antioxidant-rich foods include dark chocolate, berries, avocado, nuts, kale, beets, and spinach.
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
It’s harder to increase HDL or "good" cholesterol than it is to lower LDL or total cholesterol. It’s estimated that up to 80 percent of the variation in HDL from person to person is due to genetic factors. But the following steps have been shown to boost HDL—and they are worth taking because they also lower total cholesterol and help protect the heart in many ways beyond their effect on HDL.
Typically, a fasting plasma lipid profile is ordered to measure LDL, HDL, total cholesterol, and triglyceride levels. Lipids in plasma and in isolated lipoprotein fractions are quantified by enzymatic methods. Prior consumption of food has little effect on the determination of HDL, with postprandial blood samples usually yielding results that can be well interpreted. [14, 2] Current clinically available techniques can determine the cholesterol content, but not the biologic function, of HDL particles. [2]
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.

A study published in January 2016 in the journal Nutrients found that an antioxidant-rich diet raises HDL cholesterol levels in relation to triglycerides, and might be associated with a reduced risk of stroke, heart failure, and inflammatory biomarkers. Antioxidant-rich foods include dark chocolate, berries, avocado, nuts, kale, beets, and spinach.

First, a quick explainer: Cholesterol is a waxy substance that travels through your bloodstream, but not all of it is bad. HDL cholesterol (a.k.a. "good" cholesterol) actually sweeps away LDL cholesterol, or the "bad" kind. A high LDL level puts you at risk for heart attacks and strokes because it can clog arteries with plaque, a condition called atherosclerosis. A blood test can determine whether you have high cholesterol, and your doctor may recommend exercise or medication in addition to a healthier diet.
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 
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