Dr. Pacold notes that exercise has a greater effect on raising HDL cholesterol, which protects you from heart disease, than on lowering the LDL cholesterol that puts you at risk. It's good to know that even if you don’t see the numbers changing right away, regular exercise strengthens your heart and protects you from heart disease. If you’re not a big fan of exercise and not in great shape to begin with, remember that all you need to do to start reaping the heart-healthy benefits of exercise is 30 minutes of walking at a moderate pace every day. If you have a heart condition, talk with your doctor first about how much exertion is right for you when you begin, and then work your way up to your fitness goals for heart health.
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.
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.
HDL particles are thought to scour excess cholesterol from the walls of the blood vessels, thus removing it from where it can contribute to atherosclerosis. The HDL carries this excess cholesterol to the liver, where it can be processed. So, high levels of HDL cholesterol imply that a lot of excess cholesterol is being removed from blood vessels. That seems like a good thing.
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.

While cholesterol is normally kept in balance, an unhealthy diet high in hydrogenated fats and refined carbohydrates can disrupt this delicate balance, leading to increased cholesterol levels. This imbalance is manifested in elevated LDL (bad cholesterol) and low HDL (good cholesterol), which increases the risk of heart attack or stroke. Other causes can include physical inactivity, diabetes, stress and hypothyroidism.
Olive oil is a plant-based fat, so it's a better choice when you're trying to lower your "bad" cholesterol than fats that come from animals. It’s great mixed with red wine vinegar, a minced garlic clove, and a little ground pepper for a salad dressing. For something different, try braising vegetables like carrots or leeks. Just drizzle 3 tablespoons of oil over vegetables in a snug baking dish, scatter some herbs, cover with foil, and put in a 375-degree oven for about 45 minutes.
Black beans, kidney beans, lentils, oh my! All are rich in soluble fiber, which binds to cholesterol in the blood and moves it out of the body. Recent studies show eating 4.5 ounces of beans a day can reduce LDL levels by 5 percent. Try black bean burritos, or dip some veggies in hummus, which is made with chickpeas, for an afternoon snack. Or try this Caramelized Onion and White Bean Flatbread -- beans are so versatile, the possibilities are endless.
A study published in January 2016 in the journal Nutrients found that an antioxidant-rich diet raises HDL cholesterol levels in relation to triglycerides, and might be associated with a reduced risk of stroke, heart failure, and inflammatory biomarkers. Antioxidant-rich foods include dark chocolate, berries, avocado, nuts, kale, beets, and spinach.
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.
Olive oil is a plant-based fat, so it's a better choice when you're trying to lower your "bad" cholesterol than fats that come from animals. It’s great mixed with red wine vinegar, a minced garlic clove, and a little ground pepper for a salad dressing. For something different, try braising vegetables like carrots or leeks. Just drizzle 3 tablespoons of oil over vegetables in a snug baking dish, scatter some herbs, cover with foil, and put in a 375-degree oven for about 45 minutes.
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
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]
Aside from the inconvenience of taking niacin, two recent, highly-anticipated clinical trials have suggested that raising HDL levels with niacin failed to demonstrate any improvement in cardiovascular outcomes. Furthermore, treatment with niacin was associated with an increased risk of stroke and increased diabetic complications. At this point, most doctors are very reluctant to prescribe niacin therapy for the purpose of raising HDL levels.
There is some research suggesting that artichoke leaf extract (Cynara scolymnus) may help to lower cholesterol. Artichoke leaf extract may work by limiting the synthesis of cholesterol in the body. Artichokes also contain a compound called cynarine, believed to increase bile production in the liver and speed the flow of bile from the gallbladder, both of which may increase cholesterol excretion.
Besides putting your heart health at risk, sugar is also known to be one of the most significant contributors to metabolic syndrome. In fact, the recent 2015 Dietary Guidelines labeled sugar as a “nutrient of concern” and voiced recommendations for added sugars to not exceed greater than 10% of total daily calories. So, if your goal is to nip sugar in the bud and increase your HDL cholesterol levels, start by evaluating your libations.
"These fish are best for cholesterol, but any fish is better than red meat," says Pacold. “Every time you have fish as a protein source instead of red meat, you are doing your heart a favor.” If you don't eat fish, you can get your needed dose of omega-3s in the form of a diet supplement pill, he suggests. Flaxseeds, walnuts, and even mixed greens are plant-based options to get more omega-3s in your diet.
Eating walnuts regularly was linked with a reduced risk of heart disease, according to data from the Nurses' Health Study. Eating as little as one serving of these nuts each week can lower your chances of cardiovascular disease by up to 19%! Consider swapping walnuts for croutons in salads and soups; add ‘em to breakfast cereal or yogurt; or nosh on walnuts with fruit to reap the cholesterol-lowering benefits.

You've probably heard that fried foods of all kinds, hydrogenated oils, and full-fat dairy products are cholesterol bombs that are best avoided (and not just by those watching their cholesterol levels). The American Heart Association recommends that everyone restrict these foods, as they contain trans and saturated fats, the "bad" kind that raises LDL cholesterol and leads to plaque buildup in the arteries.
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