Before you begin dramatically changing your diet or taking any supplements, you should talk with your doctor and dietitian. Food is an outstanding and all-natural way to deliver more heart-healthy vitamins, minerals, and nutrients to your body. However, certain foods and supplements are off-limits because of their possible interactions with medications or prescriptions.
Avoid trans-fatty acids. These heart-damaging fats can reduce HDL (“good”) cholesterol levels and raise levels of LDL (“bad”) cholesterol. The tip-off that trans-fatty acids are present in foods is the listing of “partially hydrogenated oil” on a food’s ingredient list. Trans-fats are found in many brands of margarine and in most heavily processed foods, as well as in snack foods such as chips, crackers and cookies, and in the oils used to cook fast-food French fries, doughnuts and movie popcorn.
The small HDL particles consist of the lipoprotein ApoA-1, without much cholesterol. Thus, the small HDL particles can be thought of as “empty” lipoproteins, that are on their way to scavenge excess cholesterol from the tissues. In contrast, the large HDL particles contain a lot of cholesterol. These particles have already done their scavenging work, and are just waiting to be taken back up by the liver.
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]
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.
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 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.
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.
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.

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.

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
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