Why is one form of cholesterol considered good and another bad? There are actually as many as 18 kinds of cholesterol, but to save confusion, doctors divide them into two categories: LDL (bad) and HDL (good). Your liver manufactures most of your cholesterol, and small amounts of it go toward a variety of healthy purposes, including creating hormones that help turn food and exercise into muscle. Serving as cholesterol chauffeurs are fat/protein bunches called lipoproteins, and that’s where the fun begins: Low-density lipoproteins tend to deposit cholesterol on artery walls, where it builds up and eventually interferes with blood flow. But the high-density variety seems to take cholesterol back to the liver, where it can be eliminated from the body.
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.
Coronary heart disease: What you need to know The coronary arteries supply oxygen and blood to the heart. They can narrow, often because cholesterol accumulates on the arteries’ walls. This results in coronary heart disease, the most common type of heart disease in the U.S. Here, learn about risk factors, early warning signs, means of prevention, and treatments. Read now
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.
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.
All cherries are delicious, but there's something extra special about this sour variety. "I love snacking on dried Montmorency tart cherries not only because they have a sour-sweet flavor, but because they also have fiber," Gorin says. "Plus, you get other heart-helping benefits, too. Anthocyanins, a type of antioxidant found in purple and dark red fruits and vegetables, may help decrease the risk of heart attack in women."
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.
Swap extra-virgin olive oil for all your other oils and fats when cooking at low temperatures, since extra-virgin olive oil breaks down at high temperatures. Use the oil in salad dressings, sauces, and to flavor foods once they’re cooked. Sprinkle chopped olives on salads or add them to soups, like in this Sicilian fish soup. Just be sure to use extra-virgin olive oil in moderation, since it’s high in calories.

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.
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.
Lentils are pulses, a.k.a. the dry edible seeds of certain crops (like beans, chickpeas, and peas). Pulses are just everywhere these days because they’re packed with plant-based protein and fiber, not to mention antioxidants, minerals, and B vitamins. All of those compounds help protect you from plaque buildup while optimizing blood flow and assisting your body in efficiently using the nutrients you consume.
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.
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.
Grabbing a plum to snack on during the day is a sweet way to keep your cholesterol levels in check: The fruit contains anthocyanins — a.k.a. antioxidants — that help out your heart by lowering blood pressure and cholesterol. According to one study, eating three or more servings of anthocyanin-rich fruit each week can lower your heart attack risk by 34 percent.
In a Canadian study, drinking a few glasses of orange juice every day for four weeks increased participants’ HDL by 21 percent, possibly due to a flavonoid called hesperidin that appears extremely HDL-friendly. Subsequent research found that tangerine juice may be even more effective. Unfortunately, that much juice will add hundreds of excess sugar calories to your diet. So stick to a glass a day and be satisfied with lesser results. Or you can buy hesperidin as a supplement, though it won’t replace the many beneficial nutrients of orange juice (and certainly won’t taste as good).
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.

Fish can be fatty or lean, but it’s still low in saturated fat. Eat at least 8 ounces of non-fried fish each week, which may be divided over two 3.5- to 4-ounce servings. Choose oily fish such as salmon, trout and herring, which are high in omega-3 fatty acids. Prepare fish baked, broiled, grilled or boiled rather than breaded and fried, and without added salt, saturated fat or trans fat. Non-fried fish and shellfish, such as shrimp, crab and lobster, are low in saturated fat and are a healthy alternative to many cuts of meat and poultry.
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
Stick to a Low-Carb Diet – Also known as a ketogenic diet, a low-carb diet can lead to several health benefits, including weight loss, reduced blood sugar levels, and, of course, an increase in your HDL cholesterol. This is great for those who suffer from diabetes, metabolic syndrome, or obesity, but in truth, anyone can benefit from this type of diet!

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)
It’s a very common misconception that cholesterol is generally bad and high levels are always cause for serious concern. But what if I told you that there is a type of cholesterol that’s not only good at higher levels, but also decreases your risk of major health issues like heart disease? I have great news: This type of cholesterol really does exist. It’s called HDL cholesterol, and it’s our “good” cholesterol.

Get Moving – Want healthy HDL levels? It’s time to lace up those sneakers and start exercising! Being physically active is essential for a healthy heart. Many types of exercise will help raise your HDL cholesterol, including high-intensity exercise, aerobic exercise, and strength training. Shoot to exercise most days out of the week for at least 30 minutes each session to experience the benefits.
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]
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