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.

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.
It’s harder to increase HDL or "good" cholesterol than it is to lower LDL or total cholesterol. It’s estimated that up to 80 percent of the variation in HDL from person to person is due to genetic factors. But the following steps have been shown to boost HDL—and they are worth taking because they also lower total cholesterol and help protect the heart in many ways beyond their effect on HDL.
Flavor foods with herbs and spices whenever you can. It’ll help you cut back on condiments high in saturated fat while maximizing flavor. Spices and herbs also pack antioxidants, which can help improve cholesterol levels when combined with veggies. Ones we love: Basil, cilantro, rosemary, sage, ginger, garlic, tarragon, black and red chili pepper, mint, and oregano.
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)
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.
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.
If you want to increase the benefits of the fats you eat, work out before you chow down. A study at the University of Missouri found that regular exercise prior to high-fat meals produces a large hike in HDL. I’m not suggesting that your excuse for indulging in high-fat meals ought to be a pre-meal workout, merely that exercise before a meal works to your heart’s advantage.
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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.
Catapano AL, et al. 2016 ESC/EAS guidelines for the management of dyslipidaemias: The task for the management of dyslipidaemias of the European Society of Cardiology (ESC) and European Atherosclerosis Society (EAS) developed with the special contribution of the European Association for Cardiovascular Prevention & Rehabilitaiton (EACPR). Atherosclerosis. 2016;253:281.

A study published in February 2016 in the journal PLoS One concluded as much. For nearly 11,000 adults, researchers found that low to moderate alcohol consumption (20 or fewer drinks a week for a man, 10 or fewer for a woman) led to higher levels of HDL cholesterol. It also helped get them to healthier overall cholesterol levels, decreasing triglycerides (blood fats in blood) and lowering LDL cholesterol.
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.
Other supplements that have been suggested for cholesterol have less evidence of being useful. In the case of red yeast rice, there is a potential danger because it contains a naturally-occurring form of lovastatin, a prescription drug. Garlic has now been shown to be ineffective for lowering cholesterol. Other supplements and food you may see touted include policosanol, coenzyme Q10, green tea, and soy.

If you want to increase the benefits of the fats you eat, work out before you chow down. A study at the University of Missouri found that regular exercise prior to high-fat meals produces a large hike in HDL. I’m not suggesting that your excuse for indulging in high-fat meals ought to be a pre-meal workout, merely that exercise before a meal works to your heart’s advantage.
If you have been looking high and low for ways to lower your cholesterol, you’re not alone. High cholesterol is one of the most common health problems today. So what is cholesterol? There is LDL (bad) cholesterol and HDL (good) cholesterol. LDL cholesterol encourages a waxy plaque to build up in your arteries, which can lead to heart disease and other conditions. HDL cholesterol clears this plaque from your arteries and removes it from your body, which reduces your risk of these problems. Together, these form your “total” cholesterol levels. The way to improve your overall cholesterol is make changes that lower your LDL levels and raise your HDL levels.
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.
Saturated fats. Typical sources of saturated fat include animal products, such as red meat, whole-fat dairy products, and eggs, and also a few vegetable oils, such as palm oil, coconut oil, and cocoa butter. Saturated fat can increase your levels of "bad" LDL cholesterol. But it has some benefits, too — it lowers triglycerides and nudges up levels of "good" HDL cholesterol.

The National Cholesterol Education Program recommends you take in 2 grams of plant sterols and stanols each day. The FDA allows an approved health claim on phytosterols stating, "Foods containing at least 0.65 gram per serving of vegetable oil plant sterol esters, eaten twice a day with meals for a daily total intake of at least 1.3 grams, as part of a diet low in saturated fat and cholesterol, may reduce the risk of heart disease."
Could one of your current prescriptions be a cause of your low HDL levels? Possibly! Medications such as anabolic steroids, beta blockers, benzodiazepines and progestins can depress HDL levels. If you take any of these medications, I suggest talking to your doctor and considering if there is anything you can do that could take the place of your current prescription.
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