Fatty fish is not the only source of heart-healthy omega-3s! In fact, flaxseed is one of the richest sources of the anti-inflammatory fat. In animal models supplementation of flaxseed has shown to increase HDL levels which is why cardiologists and dietitians recommend it be incorporated into a balanced diet. Consumers beware though—in order for the gut to fully absorb the vitamins, minerals this seed provides, the ground version needs to be purchased.
Niacin is a B vitamin that your body uses to turn food into energy. It also helps keep your digestive system, nervous system, skin, hair and eyes healthy. Most people get enough niacin or B3 from their diets, but niacin is often taken in prescription-strength doses to treat low HDL levels. Niacin supplementation can can raise HDL cholesterol by more than 30 percent. (7)
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.
In humans, diets high in saturated fat and cholesterol raise HDL-cholesterol (HDL-C) levels. To explore the mechanism, we have devised a mouse model that mimics the human situation. In this model, HuAITg and control mice were studied on low fat (9% cal)-low cholesterol (57 mg/1,000 kcal) (chow) and high fat (41% cal)-high cholesterol (437 mg/1,000 kcal) (milk-fat based) diets. The mice responded to increased dietary fat by increasing both HDL-C and apo A-I levels, with a greater increase in HDL-C levels. This was compatible with an increase in HDL size observed by nondenaturing gradient gel electrophoresis. Turnover studies with doubly labeled HDL showed that dietary fat both increase the transport rate (TR) and decreased the fractional catabolic rate of HDL cholesterol ester (CE) and apo A-I, with the largest effect on HDL CE TR. The latter suggested that dietary fat increases reverse cholesterol transport through the HDL pathway, perhaps as an adaptation to the metabolic load of a high fat diet. The increase in apo A-I TR by dietary fat was confirmed by experiments showing increased apo A-I secretion from primary hepatocytes isolated from animals on the high fat diet. The increased apo A-I production was not associated with any increase in hepatic or intestinal apo A-I mRNA, suggesting that the mechanism of the dietary fat effect was posttranscriptional, involving either increased translatability of the apo A-I mRNA or less intracellular apo A-I degradation. The dietary fat-induced decrease in HDL CE and apo A-I fractional catabolic rate may have been caused by the increase in HDL particle size, as was suggested by our previous studies in humans. In summary, a mouse model has been developed and experiments performed to better understand the paradoxical HDL-raising effect of a high fat diet.
A cup of tea does more than soothe on a stressful day. Both green and black tea can help lower cholesterol levels. Green tea is prepared from unfermented leaves and black tea from fully fermented leaves of the same plant. Researchers believe that catechins, a type of antioxidant found in tea, are responsible for its cholesterol-lowering effect. The more fermented the tea leaves, the lower the catechin content and the higher the caffeine content. 

A 2014 study published in the journal PLoS One found that a diet rich in foods including fish, especially fatty fish, increased the size of HDL particles, which may help improve cholesterol transport throughout the body. The American Heart Association recommends eating fish at least twice a week, especially varieties that contain omega-3 fats, such as salmon, trout, and herring. A serving is considered 3.5 ounces cooked.
Hyperalphalipoproteinemia (HALP) may be familial, including primary (without CETP deficiency) and otherwise (with CETP deficiency), or secondary. [15] Familial HALP (aside from the primary form) is a well-documented genetic form of hypercholesterolemia characterized by a deficiency of CETP, a key protein in the reverse cholesterol transport (RCT) system that facilitates the transfer of cholesteryl esters from high-density lipoprotein (HDL) to beta lipoproteins. Primary HALP is a term used for familial elevated HDL cholesterol levels that are not due to CETP deficiency and for which the cause is unknown. Secondary HALP is due to environmental factors or medications.
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.
In randomly screened children aged 6-19 years who had age-, race-, and sex-specific total plasma cholesterol levels greater than or equal to 95th percentile levels, 7.8% of white males, 12.8% of white females, 25% of black males, and 17.2% of black females had hypercholesterolemia due to elevated high-density lipoprotein [HDL] cholesterol levels (but not due to elevated low-density lipoprotein [LDL] cholesterol levels) greater than age-, sex-, and race-specific 95th percentile levels. That is, they had HALP.

If you don’t already dust your cappuccino with cinnamon or shake pepper on your pasta, listen up: Spices like garlic, curcumin, ginger, black pepper, coriander, and cinnamon do more than flavor your food, they can also improve cholesterol. Research shows that eating a half to one clove of garlic each day could lower cholesterol up to 9%. Bonus: Adding extra seasoning to your food also reduces your appetite, so it’s easier to drop excess pounds, Steinbaum says.

There is considerable controversy over whether high cholesterol is in itself a cause of heart disease (the lipid hypothesis), or a symptom of an inflammatory condition that is the true cause of heart disease (the inflammation hypothesis). According to the latter theory, chronically high levels of inflammation creates small lesions on arterial walls; the body sends LDL to heal those lesions, but it ultimately accumulates and oxidizes, causing blockages. From this perspective, the best lifestyle approach to lower cardiovascular disease risk is to lower inflammation in the body rather than LDL levels.
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.
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