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.
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.
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. [18] ) 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]
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.
You've probably heard that fried foods of all kinds, hydrogenated oils, and full-fat dairy products are cholesterol bombs that are best avoided (and not just by those watching their cholesterol levels). The American Heart Association recommends that everyone restrict these foods, as they contain trans and saturated fats, the "bad" kind that raises LDL cholesterol and leads to plaque buildup in the arteries.

As defined by the US National Cholesterol Education Program Adult Treatment Panel III guidelines, an HDL cholesterol (HDL-C) level of 60 mg/dL or greater is a negative (protective) risk factor. [3] On the other hand, a high-risk HDL-C level is described as being below 40 mg/dL. Randomized, controlled clinical trials have demonstrated that interventions to raise HDL-C levels are associated with reduced CHD events. A prospective analysis by Mora et al investigated the link between cholesterol and cardiovascular events in women and found that the baseline HDL-C level was consistently and inversely associated with incident coronary and coronary vascular disease events across a range of LDL-C values. [4]

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.
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.
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.
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
Besides putting your heart health at risk, sugar is also known to be one of the most significant contributors to metabolic syndrome. In fact, the recent 2015 Dietary Guidelines labeled sugar as a “nutrient of concern” and voiced recommendations for added sugars to not exceed greater than 10% of total daily calories. So, if your goal is to nip sugar in the bud and increase your HDL cholesterol levels, start by evaluating your libations.

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.
I just moved and had to go to a new doctor. At my first annual exam and lipid panel, she called me back for a consult because she wanted to put me on a statin due to “high” ldl cholestoral levels. I am female, 54, height 5’4” and weigh 130 lbs. My ldl was 123 – my triglycerides were 58. My hdl was 68. I had basically the same lipid panel 2 years ago at my last annual exam (before moving) and my doc there was not concerned other than suggesting I start a CoQ10 and Omega 3 regimen. I don’t smoke, I exercise at least 45 minutes a day (running, cycling, golf, walking, etc.) – my major weakness is sweets. Plus no heart disease in immediate family (both parents still alive at 79 & 80 – no history of stroke, etc.)
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.

Niacin (vitamin B3) is believed to block cholesterol production in the body. Although niacin in prescription supplement form appears to be most effective in increasing HDL, it may have side effects such as flushing, itching, and headache, so you may want to consider adding niacin-containing foods to your diet first. Niacin is found in high concentrations in crimini mushrooms, chicken breast, halibut, tomato, romaine lettuce, enriched bread, and cereals.
If you smoke, it’s time to pack it in. According to the American Heart Association, smoking reduces your HDL cholesterol levels, while increasing your risk of heart disease, high blood pressure and diabetes. If you’re a smoker, you need to quit. Once you stop smoking, you can significantly improve your HDL cholesterol level very quickly and start protecting your heart. And if you’re a non-smoker, you need to avoid exposure to second-hand smoke to prevent your health from going up in smoke.
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