The small HDL particles consist of the lipoprotein ApoA-1, without much cholesterol. Thus, the small HDL particles can be thought of as “empty” lipoproteins, that are on their way to scavenge excess cholesterol from the tissues. In contrast, the large HDL particles contain a lot of cholesterol. These particles have already done their scavenging work, and are just waiting to be taken back up by the liver.
HDL particles are heterogeneous. They can be classified as a larger, less dense HDL2 or a smaller, denser HDL3. [16] Normally, most of the plasma HDL is found in HDL3. [17] To add to the complexity of HDL classification, HDL is composed of 4 apolipoproteins per particle. HDL may be composed of apo A-I and apo A-II or of apo A-I alone. HDL2 is usually made up only of apo A-I, while HDL3 contains a combination of apo A-I and apo A-II. HDL particles that are less dense than HDL2 are rich in apo E.

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.

If you’re getting worked up over high cholesterol, then start working out. Daily exercise can help raise your HDL cholesterol levels and reduce your LDL cholesterol, while protecting you from many health conditions. Begin by choosing an activity that sounds like fun to avoid “workout burn-out.” Consider jogging, brisk walking, cycling, tennis, swimming or hitting the gym. Find an exercise partner to make the activity more enjoyable and help you stay on track. And while exercise can lower your cholesterol, it can also reduce your stress and anxiety. So working up a sweat can also save you from sweating the small stuff.

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.


High levels of HDL cholesterol, often called "good" cholesterol, are associated with a reduced risk of coronary artery disease (CAD). It appears that HDL particles "scour" the walls of blood vessels, cleaning out excess cholesterol that otherwise might have been used to make the plaques that cause CAD. The HDL cholesterol is then carried to the liver, where it is processed into bile, and secreted into the intestines and out of the body.
While diet and exercise should be your two main options for fighting off LDL cholesterol, you can also look into the various dietary supplements that are on the market today. Consider omega-3 fish oils, artichoke extract, and green tea extract. Keep in mind that these natural products have not been fully proven to reduce your level of LDL cholesterol, but they may be able to help along the way.

There are two types of dietary fiber: soluble (viscous) and insoluble. To receive the greatest health benefit, eat a wide variety of all high-fiber foods. Refined foods, like white bread, white pasta and enriched cereals are low in fiber. The refining process strips the outer coat (bran) from the grain, which reduces the amount of fiber that's left.
If you’re getting worked up over high cholesterol, then start working out. Daily exercise can help raise your HDL cholesterol levels and reduce your LDL cholesterol, while protecting you from many health conditions. Begin by choosing an activity that sounds like fun to avoid “workout burn-out.” Consider jogging, brisk walking, cycling, tennis, swimming or hitting the gym. Find an exercise partner to make the activity more enjoyable and help you stay on track. And while exercise can lower your cholesterol, it can also reduce your stress and anxiety. So working up a sweat can also save you from sweating the small stuff.
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.

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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. 
While the world of wellness endlessly touts of benefits of anti-inflammatory foods, who knew eating these could kill two birds with one stone by also improving your cholesterol? Blueberries are rich in anthocyanins, the phytochemical that gives this berry its dark blue pigment and are essential to overall heart health through enhancing anti-inflammatory pathways as well as increasing HDL cholesterol levels, according to a study in The American Journal of Clinical Nutrition. One 2013 study found that consuming blueberries in tandem with exercise can increase HDL levels even more than exercise alone.
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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