The Best Ways to Increase Your HDL Cholesterol

You may have read that you can improve your heart health by improving your cholesterol numbers. Specifically, a high level of HDL, known as “good cholesterol,” may help protect you from heart disease. So it’s useful to know what changes you can make to improve your HDL. 

Here we’ll review what you need to know about HDL, including what can affect your level and how to improve it. 

Two types of cholesterol

After your provider checks your cholesterol, you will see a few numbers on your lab report. One of them is your “total cholesterol.” This looks at all the different types of cholesterol levels in your body. Here we’ll look at two main types: HDL and LDL.

People often call high-density lipoprotein (HDL) the “good cholesterol.” This is because its job is to bring “bad cholesterol” to the liver so your body can remove it. High levels of HDL help decrease your heart disease risk. Here are the recommended levels of HDL to get heart health benefits: 

• For males: over 40 mg/dL

• For females: over 50 mg/dL

The other type of cholesterol — low-density lipoprotein (LDL) — is your “bad cholesterol.”  That’s because it can damage blood vessels, causing coronary artery disease, stroke, and peripheral artery disease. Lowering your LDL can decrease your risk of heart disease.

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So how low does your LDL need to be to get heart health benefits? For people at low risk of heart disease, the LDL goal is less than 100 mg/dl. For those at high risk, or those with diabetes and/or heart disease, the goal is less than 70 mg/dl. 

It can be difficult to remember the target levels of HDL versus LDL. Here’s a simple way to remember the goals for each: Aim high for HDL. Aim low for LDL. 

6 ways to increase your HDL cholesterol

There are some factors that lower your HDL that are outside of your control. But here’s the good news: There are steps you can take to increase your HDL. 

Experts recommend lifestyle changes — starting with your diet — as the best approach to improving your HDL. Examples include:

1. Swap fats. All fat isn’t “bad.” In fact, you need fat for many body functions. Choose healthier fats such as omega-6, omega-3, polyunsaturated, and monounsaturated fats. These types of fats are in a wide variety of foods such as flaxseed, chia seeds, olive oil, and oily fish. The Mediterranean diet is a great example.

2. Forget or reduce sugar. The American Heart Association (AHA) recommends males eat only 9 tsp of sugar per day and females eat 6 tsp per day. Most adults in the U.S. eat almost three times this amount daily. Sugar comes in many different forms, so be sure to read labels carefully when trying to eat less of it. If you have diabetes, controlling your blood sugar is especially important — raising your HDL level may even improve your diabetes.

3. Move more. The AHA recommends 150 minutes of physical activity a week. Cardiovascular exercise, or aerobic exercise, increases HDL levels. Exercise may also make HDL work better, so it can clear out more LDL. 

4. Stop smoking. Your HDL improves very quickly after you quit smoking (within 3 weeks). Quitting smoking isn’t easy, but it has many health benefits.

5. Keep a healthy weight. Carrying extra weight, especially around the belly, can reduce your HDL levels. Losing 5% to 10% of your body weight can increase your HDL levels. 

6. Limit alcohol. There’s a complicated relationship between alcohol and cholesterol. People who drink a small amount of red wine every day generally have higher HDL levels. But that’s likely not a cause and effect relationship. Also, drinking too much alcohol can increase your LDL and triglycerides. If you do drink alcohol, stick to the recommended amount of 1 drink per day. If you don’t drink, there’s no need to start now.

People commonly wonder if medications can help increase their HDL level. Providers don’t prescribe medications specifically to increase HDL. But medications that lower your LDL — such as statins, ezetimibe, and niacin — have the added bonus of increasing your HDL at the same time. 

According to guidelines, the most effective way to improve an HDL that’s below 40 mg/dL is to reach your LDL goal first. Then you can make lifestyle changes — such as changing your diet, exercising more, and quitting smoking. 

Benefits of increasing your HDL cholesterol

As mentioned, increasing your HDL cholesterol is good for your heart health. But what exactly does that mean? And are there other benefits? Research is ongoing, but studies suggest that target levels of HDL could: 

• Lower your risk of heart attack: A fatty buildup in the arteries (atherosclerosis) can lead to heart attacks. Experts believe HDL helps to clear cholesterol from the blood vessels, helping to prevent atherosclerosis. That said, there’s probably more to the story, because improving HDL doesn’t always reduce heart disease. 

• Lower your risk of stroke: There are a few different causes of strokes, but one of them is atherosclerosis in the arteries that supply the brain. 

• Improve your life expectancy: People who live longer have higher levels of HDL. Scientists believe the same genes that help you live longer are also responsible for higher levels of HDL. This may explain the genetic connection between a higher HDL and longer life expectancy. 

• Lower your risk of dementia: Studies have linked lower HDL levels to memory loss and dementia. But experts don’t yet understand exactly how this relationship works.

It’s important to note that recent research suggests it may be possible for your HDL to be too high. Research is ongoing to figure out the optimal range for HDL levels.

What can cause my HDL cholesterol levels to decrease?

If you have a low HDL level, you may be wondering about the cause. Your genetics are most likely to blame. While you can’t change your genetics, it can be helpful to know about other factors that might contribute to your HDL level. 

Research studies have also found links between lower levels of HDL and the following:

• Medical conditions, such as autoimmune diseases, Type 2 diabetes, and obesity

• Medications, such as beta blockers and anabolic steroids

• Minimal exercise

• Smoking

Other factors may also contribute to low levels of HDL, but more research is needed to understand these relationships better. They include:

• Menopause

• Not enough sleep

• Too much sugar in your diet

• Stress 

How do I know when I need to increase my HDL cholesterol?

There are no symptoms of low HDL — until you develop heart disease or metabolic conditions like obesity. The only way to know you need to increase your HDL is to have a blood test that checks your cholesterol. 

Experts recommend that adults over age 20 get cholesterol screening every 5 years. People who are at higher risk of heart disease should check their cholesterol more frequently.  

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Written by:

Sylvia Gonsahn-Bollie, MD

Dr. Sylvia Gonsahn-Bollie is a body-positive weight and wellness physician who is dual board-certified in internal medicine and obesity medicine. She is a women’s wellness expert, bestselling author, global speaker, philanthropist, and health educator.

Edited by:

Mandy Armitage, MD

Mandy Armitage, MD, has combined her interests in clinical medicine with her passion for education and content development for many years. She served as medical director for the health technology companies HealthLoop (now Get Well) and Doximity.

Reviewed by:

Alice Perlowski, MD, MA, FACC

Dr. Alice Perlowski is a board-certified cardiologist and fellow of the American College of Cardiology. She has seen patients and supervised trainees in the academic and private sector, with focuses in interventional cardiology, vascular medicine, preventative cardiology, and women’s heart health.

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