How to raise your HDL cholesterol

by | Aug 29, 2012
Olive Oil

Olive Oil

You’ve probably heard it is important to keep your cholesterol levels low, but if you want to protect yourself against heart disease you may be barking up the wrong tree.

Total cholesterol is actually a fairly poor predictor of heart disease, and LDL  “bad” cholesterol is only slightly better. Instead, the ratio of “good” HDL cholesterol to LDL is the most reliable indicator of cardiovascular health. That means higher HDL is as important (if not more so) than lower LDL for protecting against heart disease and atherosclerosis.

That’s right, you want higher HDL cholesterol.

HDL cholesterol scavenges the blood and removes dangerous cholesterol deposits from the arteries. An HDL level above 60 mg/dL is considered protective against heart disease whereas HDL below 40 mg/dL is a risk, even if your LDL is fairly low.

Last time I had my HDL tested it was above 80 mg/dL.

While drugs like statins are not very effective in raising HDL cholesterol, lifestyle modifications can raise HDL substantially.

10 Ways to raise your HDL cholesterol

  1. Exercise Exercise can substantially increase HDL cholesterol while lowering LDL cholesterol.
  2. Lose weight Weight loss is almost always accompanied by improved cholesterol numbers, including increased HDL.
  3. Don’t smoke Smoking has been shown to lower HDL while raising LDL cholesterol.
  4. Avoid trans fat Processed, trans fats simultaneously raise LDL cholesterol and lower HDL cholesterol, vastly increasing your risk of heart disease (similar to smoking). Margarin, shortening and other fake fats should always be avoided.
  5. Avoid low-fat diets Low-fat diets lower both LDL and HDL cholesterol and are not effective at reducing heart disease.
  6. Eat olive oil and avocados Monounsaturated fats such as those found in olive oil and avocados raise HDL and lower LDL.
  7. Eat fish Fish (especially fatty fish like salmon and sardines) contain omega-3 fats that raise HDL and lower LDL.
  8. Avoid refined carbohydrates Refined carbohydrates negatively impact HDL and raise LDL (bad news).
  9. Eat whole grains Whole, intact grains contain soluble fiber and niacin, both of which raise HDL and may lower LDL.
  10. Drink alcohol 1-2 drinks per day can be as effective as exercise in raising HDL levels. However too much alcohol raises risk for cancer and addiction.

For more information on cholesterol check out my video Cholesterol Explained.

Are you concerned about HDL? Is your doctor?

Originally published Sept 14, 2009.

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26 Responses to “How to raise your HDL cholesterol”

  1. Matt Shook says:

    I haven’t had my HDL tested since before I became an herbivore…and it was pretty good back then. I’m really curious what it would be now as I consider my diet to be far more diverse and nutritious. I got checks next to everything but #7.

    I’ve re-introduced eggs into my diet for a month or two now, and I’m really glad I did. I’ve heard eggs also help regulate HDL and LDL levels…any truth to this, and is it dependent up how they are prepared?

  2. Joan Nova says:

    Very informative, somewhat surprising (#5), and joyfully reassuring (#10). I just checked the results of my last test: HDL 72. Maybe I’ll have that second glass of wine tonight. 🙂

  3. Janet says:

    Your post is very timely for me. I just this morning received a call from my doctor. My cholesterol is VERY HIGH and she has prescribed a statin for me to start taking right away. I’m really upset about it as I thought I was doing a better job of eating right and boosting my exercise. Hopefully, with your information on how to raise my hdl cholesterol, I’ll get it under control again. Thank you.

  4. Good call on GCBC, Darya. I think the most devastating book on cholesterol is The Great Cholesterol Con by Anthony Colpo. Available from Amazon.

    Eating real food according to your preferences and not worrying about natural fats or your cholesterol level is really the way to go. Before I went Paleo (lowish carb, highish natural fats – animal, olive, coconut, avocado) I had your “average” lipid panel, with LDL in the 130s, HDL in the 60s, Trigs 150s, and so on.

    And here’s the results of my Paleo diet:

    TC: 233
    LDL (direct, not Friedewald calc): 66
    HDL: drum roll…. 133
    Trigs: 47

    Here’s how the ratios work out:

    Total/HDL = 1.68 (average is 4-6 and ideal is 2-3; I’m on the extreme end of ideal)
    HDL/LDL = 2.02 (average is .3-.4 and ideal is above .4; again extreme end of ideal)
    Triglyceride/HDL = 0.35 (optimal is less than 2, so again, extreme end of ideal)

    One might question if HDL can be too high. While I’m sure there might be a point I don’t think I’ve reached it, and I eat quality food anyway.

    And there’s this:

    http://www.smh.com.au/lifestyle/wellbeing/scientists-find-wasted-blood-thats-worth-bottling-20091210-kmbp.html

    “A MASSIVE dose of HDL ”good” cholesterol injected into patients after a heart attack can quickly break down fatty deposits in the arteries and might prevent subsequent attacks, Australian scientists have said after early tests of a new therapy derived from donated blood….

    “In one study, a single infusion of HDL therapy had reduced the amount of fat in leg arteries by 60 per cent after a week, Dr Wright told a briefing in Sydney yesterday.”

    • Darya Pino says:

      Awesome, thanks for the info!!

    • Tuck says:

      Impressive HDL number. I just got mine tested, and my doctor commented that at 107 it was the highest HDL he’d ever seen. Given that he’s in his late 50s, I was pretty happy. 😉

      But I guess I have to bow to his HDL-ness, Mr. Nikoley. 🙂

      Darya’s leaving “Eat lots of animal fats” off that list. I know that’s what Richard and I do… Grass-fed Cream in coffee every morning is another winner.

    • Melissa says:

      I was also going ask if an elevated HDL could cause problems. My HDL was right around 100 when it was last tested. I noticed in the small print that the lab tested twice to verify this value was correct. I guess my high HDL is not typical. It sounds like my HDL would not be considered too high at this level. Who knows what the research will show in the future. : )

  5. kaye says:

    I hadnt had mine tested my HDl but thanks for sharing, i really need to stay away from the other food that is not good.

  6. Terrytown says:

    I am glad I ran across this article. I was recently told my HDL was low (mid 40s) and that I needed to exercise more and eat more fish. I used to eat brazil nuts alot and I wondered if this helped my HDL stay high. I hate exercising but have increased it to 2 to 3 days a week for 30 minutes.

  7. Fred Norton says:

    #3 is so true! I’ve seen a big improvement. About #5, this article on diets to reduce cholesterol refers to the TLC diet where it’s suggested that a diet low in saturated fats might lower total cholesterol.

  8. Dan H says:

    What’s fascinated me about the LDL/HDL issue is that it seems like LDL levels have direct health effects. Research shows that if you lower LDL with drugs – even with no clear lifestyle changes – it decreases heart attack risk.

    HDL seems to be more of a marker rather than a direct benefit. So far, the drugs that raise HDLs haven’t translated to improved health outcomes. It seems that the lifestyle changes that raise HDLs doing other things too that cause the real benefits.

    For me, exercise that the related weight loss is the main things that affect my HDL levels.

    • Darya Pino says:

      I agree, it’s an interesting dynamic and it’s amazing to me that it’s not all worked out at this point. I’m not convinced the effect of LDL is direct. Yes statins work (save lives), and do lower cholesterol, but that doesn’t mean the LDL is directly causative. There is some evidence that oxidized LDL, not LDL per se has a direct effect. But there is also an important role for triglycerides that provide the mechanism for oxidized LDL to build up. Ironically, for most people high triglycerides are treated with a low fructose, high fat diet (though some people require the opposite treatment).

      The HDL thing is just as weird. Yes the drugs haven’t worked (to save lives), but the lifestyle interventions that raise it do with a tight correlation to HDL levels, suggesting the situation is more complicated than HDL alone. HDL and triglycerides are actually a better predictors than LDL, from the data I’ve seen.

      My HDL is still super high (~80) and LDL pretty darn low (~60), so I can only assume I’m doing something right 😉

  9. Jorge G. says:

    I have been trying to get into a healthy lifestyle and recently was introduced to the great benefits of pomegranates. I know these help your HDL cholesterol. I’ve been buying POM juice that you find in any grocery store, and noticed it is 100% juice, but it comes from concentrate. Is this juice good? does it matter that it comes from concentrate?

  10. Robert Read says:

    “10 ways to raise HDL”
    Ways 1 to 9 have logic, would be pleased if you would explain why alcohol can raise HDL?
    Many thanks.

    R Read
    01/11/2011

  11. edvard says:

    Hi Darya, thanks, question: #10 alcohol examples please. Red wine?

    • Darya Pino says:

      It’s true of all ethanol. Sugar isn’t good for cholesterol/triglycerides though, so avoid those sweet cocktails.

    • Jon Pat says:

      My Internist when reviewing my low HDL recommended a glass of red wine per day. That sounded good to me but I was concerned about that raising my blood pressure that I’ve been working on lowering. When I asked if that wouldn’t raise my blood pressure he said: “I don’t think so”. To date, I haven’t gone that route only having an occasional glass of red wine.

  12. Charlotte says:

    Have you heard of the study from 1962 in the American Heart Journal where no correlation was found between cholesterol levels and atherosclerotic plaque? It’s mentioned in this article (http://thepeopleschemist.com/dude-high-cholesterol-heart-disease/) and I’d love your take.

  13. Brian says:

    Hi Darya, What are your sources for this? I understand that you have the best intentions, but perhaps some of your sources might be a bit…?

    Have you heard of “The Pritikin” program, the most effective recorded reversal program of heart disease? Please check in and let me know if you can change your list to be a bit more representative of the factual research on the issue. Thank you for your work.

    “The Pritikin program emphasizes high-fiber carbohydrates while restricting fat consumption to less than 10 percent of your total caloric intake.”

    “The Pritikin program has more than 100 peer-reviewed studies showing that it can effectively reverse heart disease and type 2 diabetes, lower blood pressure and cholesterol and reduce the symptoms of metabolic syndrome.”

    http://www.livestrong.com/article/433813-pritikin-diet-vs-atkins/

  14. Cassie T says:

    I recently had a health screening and everything looked fantastic… except my HDL was only 35 (LDL: 59) and I’m not quite sure what to do. I’m 25 years old, active, at a healthy weight, I don’t smoke, I eat mostly Real Food (thus minimal consumption of trans fat and refined carbohydrates), I cook with natural oils and am not on a low fat diet. The only thing I can really see to change is to eat more fish. Could eating fish more often (What’s recommended? 2-3 times a week?) really raise my HDL 25 points? And how much cardio is truly recommended? The last few months I’ve been a bit less active than usual (running 1-2 times a week for about 50 minutes – I lift weights 3-4 times per week), but I still get 10,000+ steps almost every day. I’m not sure what my cholesterol was prior to my decrease in cardio.

    Any tips? I never thought RAISING my cholesterol would be an issue!

    • Darya Rose says:

      Hi Cassie,

      You aren’t too far from the healthy zone, so I wouldn’t fret too much about it, especially with an LDL that is so low. More eggs and oily fish (2-3x/wk is great) should help a lot, and more fatty foods in general (e.g. nuts, avocados, red meat, etc.). Plus a glass of wine never hurts 🙂

      Darya

      • Cassie T says:

        Thanks for the encouragement, Darya! Eating fattier foods still feels counter intuitive for maintaining a good healthstyle despite everything I’ve learned from Summer Tomato. Thanks for the advice. I love an excuse to eat more fish and drink wine. 🙂

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