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.
HDL levels below 40 mg/dL are associated with an increased risk of CAD, even in people whose total cholesterol and LDL cholesterol levels are normal. HDL levels between 40 and 60 mg/dL are considered "normal," and do not very much affect the risk of CAD one way or the other. However, HDL levels greater than 60 mg/dL are actually associated with a reduced risk of heart disease.
The tendency toward high cholesterol appears to be genetic although diet also influences cholesterol levels. Other factors that can influence cholesterol levels include being overweight and being physically inactive. The older you get, the more likely your cholesterol levels are to rise. Before menopause, women tend to have lower cholesterol levels than men of the same age, but after menopause, women’s LDL levels often increase.

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.


DAVID MONTGOMERY: The ways to reduce your bad cholesterol have a lot to do with your lifestyle. So your diet is really important. And although this kind of sounds trite, really one of the best and most effective ways to reduce cholesterol is by having a low fat diet, particularly saturated fat. We find saturated fat in eggs, dairy, and red meat. If you're able to reduce those, you reduce your bad fat, which reduces your bad cholesterol. Another really effective way that I use with my patients all the time to reduce your cholesterol is regular exercise. If you're doing aerobic type exercises, most days a week, four days a week, 30 minutes at a time, then you're doing your body the best amount of good, not just from lowering your cholesterol standpoint, but from so many different ways. There are other ways that we can reduce the fat. It may have to do with supplementations or medications. In some people, they are born with genetic conditions that predispose them to have very, very high cholesterol. And as a result of that, they have different problems like heart attacks or strokes. In those people, they really do benefit from cholesterol lowering drugs. But there are other things that you can get from over-the-counter, like omega fatty acids, omega-3 fatty acids in particular. They come in krill oil or fish oil. We've all heard of these before. And those help reduce parts of your cholesterol.


Cake with only 10 grams of carbs… have we died and gone to heaven?? When you substitute regular wheat flour for almond flour, true magic happens in the kitchen. Not only do you benefit from a serving of plant-based protein and get a delectably fluffy texture in your baked goods, but you’ll also experience the heart-healing power of nuts. Almonds have been found to increase low HDL cholesterol levels in coronary artery disease patients, according to a Journal of Nutrition study, as well as in healthy subjects. For a simple almond flour mug cake recipe click here, don’t miss Wholesome Yum’s recipe.
Eating seafood twice per week is a surefire way to reduce your risk of cardiovascular disease. Fatty fish like salmon yields some of the greatest anti-inflammatory and heart-healthy benefits, as a Journal of Nutrition study found salmon protein to significantly increase the proportion of HDL cholesterol. One tip: fish should be purchased wild and sustainably caught. For a consumer guide on how to make informed choices you can check out the consumer guides provided by the Monterey Bay Aquarium Seafood Watch.
As you already know, HDL is considered the good guy in the cholesterol game, and it can help your liver to get rid of the unhelpful cholesterol in your body. This is a very important task that HDL is able to accomplish since cholesterol can’t simply dissolve into the blood. The liver has the job of processing cholesterol among its other important jobs. HDL is the liver’s helper and a very good one at that. Having high levels of HDL reduces your risk for both heart disease and stroke, which is why you want to get your cholesterol under control. (10)

When it comes to cholesterol, not all types are created equal, and it is important to understand how lifestyle choices significantly impact cardiovascular health. High-density lipoprotein, or HDL, is known as the “healthy” or “good” type of cholesterol due to the fact that it scavenges and removes the “bad” type of cholesterol (low-density lipoprotein or LDL) known to clog arteries. A desirable HDL level is anything greater than 60 milligrams per deciliter (mg/dL).
No, carbohydrates are not the enemy to fitness goals. Plus, when it comes to heart health, oatmeal is a humble workhorse. One of the highest fiber-per-dollar foods on the market, oatmeal is an inexpensive and hearty addition to any breakfast time routine. While not raising HDL levels directly, oatmeal lowers total cholesterol and LDL cholesterol levels even more, according to an American Journal of Lifestyle Medicine review, which in turn increases your HDL levels as a percentage of total cholesterol. Make weekend brunch fun for the whole family by serving up an oatmeal bar concept with a wide array of toppings and mix-ins such as chia seeds and raspberries.
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.

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.


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.
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]
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