A: Before I answer that question, why bother to increase HDL cholesterol at all? Many studies have found that people with low levels of HDL are at increased risk for heart attacks, strokes, and other complications of arteries diseased by atherosclerosis: that's why we call HDL the "good" cholesterol. Given that, you'd think that raising HDL levels would reduce a person's risk for atherosclerosis. Unfortunately, despite a lot of research, we don't yet know if that's true, nor how best to raise HDL levels.
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.
“If your LDL levels are still too high after trying these 6 nutrition-based approaches, talk to your doctor about cholesterol-lowering medications like statins, but give these 6 tips your best shot,” encourages Dr. Danine Fruge, MD, ABFP, Medical Director at the Pritikin Longevity Center. “The right eating plan, like Pritikin, can be powerfully beneficial – and there are no adverse side effects.”

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.

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. 
Starting a simple exercise routine is another way to help lower your elevated LDL cholesterol level. And if you compound working out with the dietary tips listed above, you could potentially lower your LDL level by over 37 percent and increase your HDL cholesterol by over 5 percent in just two months. Not to mention the added benefits of losing weight, decreased stress, and higher energy, exercising is an all-around great activity to incorporate into your life. Aim for 30 minutes of physical activity, four to five times each week, and you’ll be well on your way.
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

A study of over 1 million US veterans showed a U-shaped relationship between HDL and total mortality, with 50mg/dL as the level associated with the lowest mortality. [7, 2] In addition, an analysis of the Framingham study demonstrated that LDL and triglyceride levels modify HDL’s predictive value; CHD risk was found to be higher when low HDL was combined with high LDL and/or triglycerides as compared with the presence of low HDL levels alone. [8, 2]  The relationship between HDL and CHD risk is also confounded by the presence of pro-atherogenic and inflammatory markers. [2]

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.


Because increasing HDL levels is thought to be such a beneficial thing, and because there is no easy or reliable way to do so, developing drugs that substantially raise HDL levels has become a major goal for several pharmaceutical companies. And indeed, several of these drugs have been developed, and have led to clinical trials to demonstrate their safety and efficacy.
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).
It’s about time you figure out how to eat this darn thing, because an artichoke is a heart-healthy powerhouse that may help raise levels of HDL, according to research published in the journal International Journal of Food Sciences and Nutrition! With about 10.3 grams of fiber per each boiled head, this makes artichoke one of the highest fiber vegetables in the entire produce aisle.

Eating walnuts regularly was linked with a reduced risk of heart disease, according to data from the Nurses' Health Study. Eating as little as one serving of these nuts each week can lower your chances of cardiovascular disease by up to 19%! Consider swapping walnuts for croutons in salads and soups; add ‘em to breakfast cereal or yogurt; or nosh on walnuts with fruit to reap the cholesterol-lowering benefits.
I very simply lowered my cholesterol 57 points in 6 month (257 to 200) and my ldl from 158 to 132 by not eating meat. It has now been a year since I stopped eating meat, I cannot exercise due to major surgery but lost 50lbs and will have my cholesterol retested in September for my annual checkup. I’m also planning on going back to the gym soon. High cholesterol runs in my family and I was determined not to go on medication like my mom. I gained 30lbs when I was injured, I did not intend to go back to my weight as a teenager when I stopped eating meat, just lower my cholesterol, that was just a perk. I never deprive myself of food, I eat fish and I don’t miss meat from my diet at all. It was a conscience choice I made to try and lower my cholesterol, no one told me to or advised me but it worked and I’m happy I took the path. Good luck to all and stay healthy!
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.

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.
HDL plays an important role in transporting cholesterol from the peripheral tissues to the liver, where it can be excreted; this process is known as reverse cholesterol transport (RCT). (The liver is the main organ for excretion of cholesterol, doing so either directly or by converting cholesterol into bile acids.) It is important to remember that most HDL measured in the blood is derived from the liver and intestine. Therefore, the concentration of HDL in plasma does not reflect cholesterol efflux from blood vessels or the efficiency of RCT. Moreover, HDL function in RCT is not mirrored by HDL measurements. [2]
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.
Eating seafood twice per week is a surefire way to reduce your risk of cardiovascular disease. Fatty fish like salmon yields some of the greatest anti-inflammatory and heart-healthy benefits, as a Journal of Nutrition study found salmon protein to significantly increase the proportion of HDL cholesterol. One tip: fish should be purchased wild and sustainably caught. For a consumer guide on how to make informed choices you can check out the consumer guides provided by the Monterey Bay Aquarium Seafood Watch.

Too much cholesterol in the blood builds up on artery walls causing hardening of the arteries (atherosclerosis). The buildup of cholesterol narrows arteries, slowing or blocking the flow of oxygen-carrying blood to the heart, which can manifest as chest pain. If blood flow to the heart is cut off because of clogged arteries, the result is damage to the heart muscle – a heart attack.


As you already know, HDL is considered the good guy in the cholesterol game, and it can help your liver to get rid of the unhelpful cholesterol in your body. This is a very important task that HDL is able to accomplish since cholesterol can’t simply dissolve into the blood. The liver has the job of processing cholesterol among its other important jobs. HDL is the liver’s helper and a very good one at that. Having high levels of HDL reduces your risk for both heart disease and stroke, which is why you want to get your cholesterol under control. (10)
Soy isoflavones significantly decreased serum total cholesterol by 0.10 mmol/L (3.9 mg/dL or 1.77%; P = 0.02) and LDL cholesterol by 0.13 mmol/L (5.0 mg/dL or 3.58%; P < 0.0001); no significant changes in HDL cholesterol and triacylglycerol were found. Isoflavone-depleted soy protein significantly decreased LDL cholesterol by 0.10 mmol/L (3.9 mg/dL or 2.77%; P = 0.03). Soy protein that contained enriched isoflavones significantly decreased LDL cholesterol by 0.18 mmol/L (7.0 mg/dL or 4.98%; P < 0.0001) and significantly increased HDL cholesterol by 0.04 mmol/L (1.6 mg/dL or 3.00%; P = 0.05). The reductions in LDL cholesterol were larger in the hypercholesterolemic subcategory than in the normocholesterolemic subcategory, but no significant linear correlations were observed between reductions and the starting values. No significant linear correlations were found between reductions in LDL cholesterol and soy protein ingestion or isoflavone intakes.
Black beans, kidney beans, lentils, oh my! All are rich in soluble fiber, which binds to cholesterol in the blood and moves it out of the body. Recent studies show eating 4.5 ounces of beans a day can reduce LDL levels by 5 percent. Try black bean burritos, or dip some veggies in hummus, which is made with chickpeas, for an afternoon snack. Or try this Caramelized Onion and White Bean Flatbread -- beans are so versatile, the possibilities are endless.
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.

Altering your diet is the easiest way to lower your elevated LDL cholesterol, and should be your first course of action, as every cholesterol-lowering strategy starts with your dietary habits. A balanced diet consisting of fruits, vegetables, whole grains, fish, and various plants will significantly help you lower your LDL cholesterol level. It’s best to limit the amount of red meat, eggs, and dairy you consume. Plant-based diets not only help lower your LDL, but they can also help clear plaque buildup from your arteries.
According to the Mayo Clinic, ideal HDL levels for both men and women are 60 milligrams of cholesterol per deciliter of blood. If a man’s HDL level is below 40 milligrams of cholesterol per deciliter of blood or a woman’s HDL level is below 50 milligrams of cholesterol per deciliter of blood, then disease risk, specifically heart disease, is considered to be heightened. Even if your HDL level is above the at-risk number (but below the desirable number), you still want to work on increasing your HDL level so you can decrease your heart disease risk. (9)

While this belief is still thought to be almost always true, in recent years a fly has been found in the ointment. Drug companies have spent billions of dollars developing drugs that increase HDL cholesterol levels. However, to the dismay of all, these drugs have failed to reduce cardiac risk—despite the fact that they make HDL levels go up. Development of at least two of these drugs has now been halted. (More on this below.) So the HDL story is more complex than scientists originally had hoped.
Many fruits contain soluble fiber, which is important for lowering cholesterol, but apples have a leg up on other fruits. Apples (especially the skins) contain pectin, a type of soluble fiber that latches onto the "bad" cholesterol and guides it through your digestive system and out of your body, effectively lowering your LDL-cholesterol levels. Citrus fruits are also high in pectin, but since it's mostly in the pulp, you'll have to eat your fruits to get the benefits, rather than juice them. Luckily, apples are a little easier to pucker up to than lemons. Apples are also high in polyphenols, powerful antioxidants that help reduce inflammation.
Hayek T, Chajek-Shaul T, Walsh A, Agellon LB, Moulin P, Tall AR, Breslow JL. An interaction between the human cholesteryl ester transfer protein (CETP) and apolipoprotein A-I genes in transgenic mice results in a profound CETP-mediated depression of high density lipoprotein cholesterol levels. J Clin Invest. 1992 Aug;90(2):505–510. [PMC free article] [PubMed]
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.

Avoid trans-fatty acids. These heart-damaging fats can reduce HDL (“good”) cholesterol levels and raise levels of LDL (“bad”) cholesterol. The tip-off that trans-fatty acids are present in foods is the listing of “partially hydrogenated oil” on a food’s ingredient list. Trans-fats are found in many brands of margarine and in most heavily processed foods, as well as in snack foods such as chips, crackers and cookies, and in the oils used to cook fast-food French fries, doughnuts and movie popcorn.
Nordestgaard BG, Langsted A, Mora S, et al. Fasting is not routinely required for determination of a lipid profile: clinical and laboratory implications including flagging at desirable concentration cut-points-a joint consensus statement from the European Atherosclerosis Society and European Federation of Clinical Chemistry and Laboratory Medicine. Eur Heart J. 2016 Jul 1. 37 (25):1944-58. [Medline]. [Full Text].

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.

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