HDL particles are heterogeneous. They can be classified as a larger, less dense HDL2 or a smaller, denser HDL3.  Normally, most of the plasma HDL is found in HDL3.  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.
Many people don't like to hear it, but regular aerobic exercise (any exercise, such as walking, jogging or bike riding, that raises your heart rate for 20 to 30 minutes at a time) may be the most effective way to increase HDL levels. Recent evidence suggests that the duration of exercise, rather than the intensity, is the more important factor in raising HDL cholesterol. But any aerobic exercise helps.
One drawback of going on a low-fat diet for some people is that it lowers HDL levels. If raising your HDL cholesterol is a primary concern, you should replace carbohydrates in your diet with fats, preferably mono- and polyunsaturated fats. But avoid trans fat, which can lower HDL levels. These steps can lower both total cholesterol and LDL and maintain HDL or boost it slightly, improving the ratio of total cholesterol to HDL.
Ask for tomato sauce with your pasta if you want to keep your cholesterol under control. Tomatoes are a significant source of a plant compound called lycopene, which reduces levels of LDL cholesterol. Research shows that the body absorbs more lycopene if the tomatoes are processed or cooked, so drink tomato juice and add tomatoes to your minestrone soup as well.
Altering your diet is the easiest way to lower your elevated LDL cholesterol, and should be your first course of action, as every cholesterol-lowering strategy starts with your dietary habits. A balanced diet consisting of fruits, vegetables, whole grains, fish, and various plants will significantly help you lower your LDL cholesterol level. It’s best to limit the amount of red meat, eggs, and dairy you consume. Plant-based diets not only help lower your LDL, but they can also help clear plaque buildup from your arteries.
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.
Salmon is rich in omega-3 fatty acids, which are healthy fats that can help reduce blood pressure. Eating salmon can improve your "good" HDL cholesterol, but it won't lower your "bad" LDL cholesterol. HDL cholesterol helps sweep cholesterol off your artery walls, preventing dangerous plaque from forming. The American Heart Association recommends eating fatty fish like salmon at least twice per week for heart-healthy benefits. Other fish that contain omega-3s, such as mackerel, tuna and sardines, can also help.
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.
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.
However, although low levels of HDL predict increased cardiovascular risk, particularly in healthy individuals with no history of cardiovascular events, the relationship between HDL and CHD risk is complex, with HDL-C and cardiovascular disease having a nonlinear relationship. For example, research found that HDL levels above approximately 60 mg/dL showed no further improvement in prognosis, and the EPIC (European Prospective Investigation into Cancer and Nutrition)-Norfolk and IDEAL (Incremental Decrease in End Points through Aggressive Lipid Lowering) studies showed that very high levels of HDL may actually be associated with an increased risk of atherosclerotic disease. [5, 6, 2]
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 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.
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.
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Substantial evidence now shows that a low-fat diet often reduces — rather than increases — HDL levels. This result is not specifically caused by “not enough fat,” but rather, is caused by consuming too many carbohydrates. The American Heart Association and the American College of Cardiology have quietly stopped recommending low-fat diets for heart disease prevention. Indeed, it is low-carb diets — and not low-fat diets — which are associated with higher HDL levels.
Try to eat it two to four times a week. “Not only are the omega-3 fats in fish heart-healthy, but replacing red meat with fish will lower your cholesterol by reducing your exposure to saturated fats, which are abundant in red meat,” Samaan says. The catch? Some types, like shark, swordfish, and king mackerel, are high in mercury. That can increase your risk for heart disease. Instead, choose wild salmon, sardines, and bluefin tuna.
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.
Treatment of high cholesterol usually begins with lifestyle changes geared toward bringing levels down. These include losing weight if you’re overweight, and changing your diet to emphasize vegetables and fruits, fish, particularly cold water fish such as wild Alaskan salmon, mackerel, herring and black cod that provide heart healthy omega-3 fatty acids. If lifestyle changes don’t help or if you’re unable to make the changes your doctor recommends, cholesterol-lowering drugs may be prescribed. These include statins, which effectively lower LDL cholesterol; bile acid sequestrants that may be prescribed along with statins to lower LDL; nicotinic acid to lower LDL cholesterol and triglycerides and raise HDL; drugs called fibrates that may be prescribed to lower cholesterol and may raise HDL; and a drug called Ezetimibe to lower LDL by blocking the absorption of cholesterol in the intestine.
A meta-analysis looked at randomized controlled trials for artichoke extract for high cholesterol. They found three studies worth analyzing and two showed some effect in lowering total cholesterol. Adverse events were mild, transient, and infrequent. The study said that larger clinical trials over longer periods are needed. The conclusion was that the evidence was not convincing, and the Cochrane Review discontinued updating its analysis of this research as of 2016.
So far, these studies have been disappointing, to say the least. The first major trial (concluded in 2006) with the first CETP inhibitor drug, torcetrapib (from Pfizer), not only failed to show a reduction in risk when HDL was increased but actually showed an increase in cardiovascular risk. Another study with another CETP inhibitor - dalcetrapib (from Roche) - was halted in May 2012 for lack of effectiveness. Both of these related drugs significantly increased HDL levels, but doing so did not result in any clinical benefit.
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.
Lose Some Weight – Those who are overweight or obese will increase their HDL cholesterol levels when they lose weight (along with experiencing a myriad of other amazing health benefits). There’s no magic diet pill you need to take to make this happen. In order to achieve weight loss, simply count your calories, restrict your carbohydrate and sugar intake, eat more vegetables and fruits, and begin exercising. Not only will you lower your LDL cholesterol, but you will also feel more energetic and happier!
The good news is that changing your cholesterol levels is well within your control as some of the smallest lifestyle tweaks can yield a profound impact. A fast track to boosting HDL includes quitting smoking and increasing physical activity. The American Heart Association recommends 30 minutes of moderate physical activity at least 5 times per week with two sessions of resistance training. Your choices at mealtimes, however, may prove to be an easier more attainable way to make lasting change. Here are the foods that raise HDL cholesterol.