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.
When your body has too much LDL cholesterol, the LDL cholesterol can build up on the walls of your blood vessels. This buildup is called “plaque.” As your blood vessels build up plaque over time, the insides of the vessels narrow. This narrowing blocks blood flow to and from your heart and other organs. When blood flow to the heart is blocked, it can cause angina (chest pain) or a heart attack.
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.
If you skip breakfast, you might want to give the most important meal of the day another shot. Women who eat a bowl of fiber-rich cereal every morning have lower levels of cholesterol than those who don't eat breakfast at all. It's all thanks to the fiber: "Fiber binds with cholesterol and speeds its excretion before it reaches your arteries," says Tanya Zuckerbrot, RD.
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.
Large doses of vitamin B3, or niacin, have been found to raise HDL as much as 20 percent and are often prescribed for people with cholesterol problems. But keep in mind that a daily multivitamin contains all the niacin most people need. Supplementing beyond that can have a variety of side effects, including facial flushing, heartburn and even liver damage, so don’t try it without consulting a doctor.
Barley contains a powerful type of soluble fiber that helps keep cholesterol levels in check by effectively lowering total and LDL cholesterol without affecting HDL. This beta-glucan fiber works by preventing the body's absorption of cholesterol from food. Look for minimally processed pearled barley, the variety most commonly found in supermarkets.
There is some research suggesting that artichoke leaf extract (Cynara scolymnus) may help to lower cholesterol. Artichoke leaf extract may work by limiting the synthesis of cholesterol in the body. Artichokes also contain a compound called cynarine, believed to increase bile production in the liver and speed the flow of bile from the gallbladder, both of which may increase cholesterol excretion.
That’s a ridiculous idea. It would go against every piece of dietary advice about cholesterol that the government and most doctors have pushed for the last 60 years. Fat is supposed to raise your cholesterol and give you a heart attack, not lower it. To lower your cholesterol, the American Heart Association says you’re supposed to cut out saturated fat and eat lots of whole grains, fruits, cereal, vegetable oils, and the leanest cuts of meat possible.
Foods high in monounsaturated fats (such as olive oil, nuts, and the oils in many salad dressings) seem to boost HDL best; it’s likely that foods high in omega-3 fatty acids (such as cold-water fish) do so as well. Saturated fats, the kind in meat and dairy foods, are likely to drive up harmful LDL, so take this opportunity to cut way back. Worst of all are trans-fatty acids, the hardened oils often found in margarine, crackers and other snack foods-a substance Harvard Medical School nutrition expert Walter C. Willett, M.D., author of Eat, Drink, and Be Healthy, calls “uniquely bad.” These foods can do exactly the opposite of what you want, lowering HDL while raising LDL.
Trans fatty acids are likely present in many of your favorite prepared foods— anything in which the nutrition label reads "partially hydrogenated vegetable oils" — so eliminating them from the diet is not a trivial task. But trans fatty acids not only increase LDL cholesterol levels, but they also reduce HDL cholesterol levels. Removing them from your diet will almost certainly result in a measurable increase in HDL levels. 
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.

Unsaturated fats are considered the healthiest fats because they improve cholesterol, help reduce inflammation (a risk factor for heart disease), and help decrease the overall risk of developing heart disease. The main source of unsaturated fats is plant-based foods. These fats are usually liquid at room temperature. There are two types of unsaturated fat: monounsaturated and polyunsaturated.

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.
Reduce the amount of sugar and flour in your diet. Recent evidence indicates that added sugar – in the form of table sugar (sucrose) or high-fructose corn syrup – is probably a greater contributor to heart disease than is consumption of saturated fat. This suggests that the inflammatory hypothesis may in fact have more validity than the conventional lipid hypothesis, although the debate is far from settled. As a general rule, Dr. Weil advises against consuming foods with added sugars, particularly soft drinks and highly processed snack foods, which can cause rapid spikes and dips in blood sugar levels. The result can be overeating, obesity and heart disease.

If you smoke, it’s time to pack it in. According to the American Heart Association, smoking reduces your HDL cholesterol levels, while increasing your risk of heart disease, high blood pressure and diabetes. If you’re a smoker, you need to quit. Once you stop smoking, you can significantly improve your HDL cholesterol level very quickly and start protecting your heart. And if you’re a non-smoker, you need to avoid exposure to second-hand smoke to prevent your health from going up in smoke.
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

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.
Where HDL is concerned, “you can’t be too thin,” Castelli says. One report found about a 1 percent rise in HDL for every pound of fat lost. This doesn’t mean you have to turn yourself into a toothpick, but that you should work on getting rid of excess flab as you add muscle. (Use a body-fat monitor rather than a scale to chart your progress.) Fortunately, fat loss is likely to go hand in hand with the exercise and dietary modifications that also raise HDL levels.
3. Beans. Beans are especially rich in soluble fiber. They also take awhile for the body to digest, meaning you feel full for longer after a meal. That's one reason beans are a useful food for folks trying to lose weight. With so many choices — from navy and kidney beans to lentils, garbanzos, black-eyed peas, and beyond — and so many ways to prepare them, beans are a very versatile food.

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.

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