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.
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.
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.
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.
HDL is plasma’s smallest and densest lipoprotein. The major apolipoproteins of HDL are apo A-I and apo A-II, the alpha lipoproteins. An elevated concentration of apo A-I and apo A-II, known as hyperalphalipoproteinemia (HALP), is associated with a lower risk of CHD. Conversely, hypoalphalipoproteinemia increases the chances of CHD development.  HALP generally does not produce any unusual clinical features (although corneal opacity has been associated with the condition), and it should not be considered a disease entity but rather a fortuitous condition that can increase longevity because of the related decrease in CHD incidence. 
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.
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.
Resistance training is a form of physical activity that forces your muscles to contract, building up strength and endurance. Some research also shows that resistance training could have beneficial effects on heart health as well and may decrease total and LDL cholesterol. (31) Weight lifting and bodyweight exercises like squats or lunges are some examples of resistance training that you can add to your routine.
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]
However, environmental factors also have a significant impact on HDL levels. Factors that elevate HDL concentrations include chronic alcoholism, treatment with oral estrogen replacement therapy, extensive aerobic exercise, and treatment with niacin, statins, or fibrates. [11, 12, 13] On the other hand, smoking reduces levels of HDL-C, while quitting smoking leads to a rise in the plasma HDL level.
Foods like oatmeal, apples, prunes, and beans are high in soluble fiber, which keeps your body from absorbing cholesterol. Research shows that people who ate 5 to 10 more grams of it each day saw a drop in their LDL. Eating more fiber also makes you feel full, so you won’t crave snacks as much. But beware: Too much fiber at one time can cause abdominal cramps or bloating. Increase your intake slowly.
Pasta and heart health together in one sentence seems to be an oxymoron, however with one small tweak spaghetti can become a cholesterol-busting meal. Instead of opting for white, refined noodles, choose the less-processed, vitamin-enriched counterpart: whole grain pasta. Barilla makes one that has 7 grams of fiber per serving, and — what’s more — none of the stress-fighting B-vitamins have been removed. A B vitamin known as niacin has been found to decrease LDL levels and increase HDL when taken in doses above your vitamin requirement, according to a guide to lowering your cholesterol by the U.S. Department of Health and Human Services.
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
HDL’s unpredictable actions are one of the reasons why lowering LDL cholesterol often gets more focus as primary defense against heart disease and stroke. However, the medical world, both conventional and holistic, still agrees that raising low HDL is a very smart health move because low HDL cholesterol can be more dangerous than high LDL cholesterol. (8)
Olive oil is a plant-based fat, so it's a better choice when you're trying to lower your "bad" cholesterol than fats that come from animals. It’s great mixed with red wine vinegar, a minced garlic clove, and a little ground pepper for a salad dressing. For something different, try braising vegetables like carrots or leeks. Just drizzle 3 tablespoons of oil over vegetables in a snug baking dish, scatter some herbs, cover with foil, and put in a 375-degree oven for about 45 minutes.
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.
Raise your glass for heart health! In moderation, alcohol is known to raise HDL, or "good," cholesterol. Drinking a daily glass of red wine increased "good" HDL cholesterol and also decreased "bad" LDL cholesterol after a few months, found one study. Red wine also contains antioxidants called polyphenols that help keep your blood vessels healthy and strong. Remember that moderation means one drink for women or two for men daily and, in this case, more is not better.
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.
An easy way to make the switch from trans fats is by replacing them with unsaturated fats, which don’t increase your LDL cholesterol, according to WebMD. Unsaturated fats are found in olive oil, canola oil, vegetable and sunflower oils, as well as fish, nuts, seeds and avocados. Just as unsaturated fats are healthy choices, unsaturated fats are not. Be sure to limit your intake of unsaturated fats, which are found in fatty meats, cold cuts, whole milk, whole-milk cheeses and many store-bought baked goods and snacks. Instead, enjoy lean cuts of meat, skim milk, low-fat cheeses and yogurt, and wholesome snacks to trim down your cholesterol levels.
Research has shown the health benefits of eating seafood rich in omega-3 fatty acids, especially when it replaces less healthy proteins that are high in saturated fat and low in unsaturated fat. Including seafood high in omega-3 fatty acids as part of a heart-healthy diet can help reduce the risk of heart failure, coronary heart disease, cardiac arrest and the most common type of stroke (ischemic).
Can my HDL be too high? It is well known that not all cholesterol is bad for you. Of HDL and LDL cholesterol, HDL packs some great benefits. This MNT Knowledge Center article examines when high HDL cholesterol is good, and whether higher is always better? Learn how to find the right balance along with some healthful ways to achieve high HDL. Read now
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.