For women after menopause, a study published in August 2016 in the journal Diabetes & Metabolism found that high intensity interval training (on a bicycle) led to better HDL cholesterol levels as well as significant weight loss. And a study published in May 2016 in the journal Applied Physiology, Nutrition, and Metabolism found that obese men who engaged in aerobic interval training (running on a treadmill) or resistance training (with weights) just three days a week for 12 weeks had significantly increased HDL cholesterol when compared with obese men who did no training.
HDL is more tightly controlled by genetic factors than are the other lipoproteins (ie, LDL, very–low-density lipoprotein (VLDL), intermediate-density lipoprotein [IDL], chylomicrons). For example, in certain families, especially some families with Japanese ancestry, a genetic deficiency of cholesteryl ester transfer protein (CETP) is associated with strikingly elevated HDL-C levels. 
Starting a simple exercise routine is another way to help lower your elevated LDL cholesterol level. And if you compound working out with the dietary tips listed above, you could potentially lower your LDL level by over 37 percent and increase your HDL cholesterol by over 5 percent in just two months. Not to mention the added benefits of losing weight, decreased stress, and higher energy, exercising is an all-around great activity to incorporate into your life. Aim for 30 minutes of physical activity, four to five times each week, and you’ll be well on your way.
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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.
Because increasing HDL levels is thought to be such a beneficial thing, and because there is no easy or reliable way to do so, developing drugs that substantially raise HDL levels has become a major goal for several pharmaceutical companies. And indeed, several of these drugs have been developed, and have led to clinical trials to demonstrate their safety and efficacy.
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.
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.
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.
Different foods lower cholesterol in various ways. Some deliver soluble fiber, which binds cholesterol and its precursors in the digestive system and drags them out of the body before they get into circulation. Some give you polyunsaturated fats, which directly lower LDL. And some contain plant sterols and stanols, which block the body from absorbing cholesterol.
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.
Along with exercising, eating a healthy diet is one of the most important things you can do to reach and maintain healthy cholesterol levels. Learn how to read nutrition labels and know the difference between healthy and unhealthy fats. Calories, calories from fat, total fat, saturated fat, and trans fat numbers are all right there on the nutrition facts label to help you make heart-healthy choices.
According to a study published in November 2015 in the journal Nature, a diet high in carbohydrates — like added sugar, white bread, cookies, and cakes — reduces HDL cholesterol levels, increasing the risk for metabolic disorders. Refined carbohydrates found in foods labeled “low-fat” make these just as bad as full-fat foods because the fat is often replaced with carbohydrates from added sugar and other starches.
Including fish in your diet can increase HDL cholesterol in a short period of time. In a study published in February 2014 in the journal PLoS One, researchers concluded that a diet rich in foods including fish showed an increase in the size of HDL particles in the body, which could help improve cholesterol transport through the body. The researchers saw the positive effects of a diet that included fish in as little as 12 weeks.
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