What to eat to increase good cholesterol

HDL cholesterol is the kind of cholesterol you want more of.

It's called the "good" cholesterol because it helps protect you from getting heart disease.

HDL cholesterol brings cholesterol to your liver, which sends it out of your body. So you want as much HDL as possible.

You can get a blood test to check your cholesterol level. If you're a man and your HDL level is below 40, or a woman with an HDL level lower than 50, you're more likely to get heart disease. Having an HDL level of at least 60 may help protect you from getting heart disease.

Of course, other things -- like not smoking, being active, eating a healthy diet, and staying at a healthy weight -- also matter for your heart's health. Many of those things also affect your HDL level.

5 Ways to Raise Your HDL Cholesterol

Some diet and lifestyle changes help boost HDL cholesterol levels:

  1. Get active. Physical activity can boost your HDL level. Get at least 30 minutes a day of moderate activity, most days of the week.
  2. Lose extra weight. If you're overweight, losing extra pounds can help raise your HDL levels, as well as cut your LDL ("bad") cholesterol levels.
  3. Choose better fats. The healthier choices are monounsaturated and polyunsaturated fats. You’ll find these in plants, nuts, and fish like salmon or tuna. And, like everything you eat, keep your portion sizes small. Fats pack a lot of calories in small amounts.
  4. Alcohol in moderation. Drinking moderate amounts of alcohol is linked to higher HDL levels. If you don't drink now, check with your doctor before you start, since alcohol has some risks not related to cholesterol.
  5. Stop smoking. Kicking the cigarette habit can raise your HDL level.

You’ve probably heard of high-density lipoprotein (HDL) cholesterol and low-density lipoprotein (LDL) cholesterol — the good and the bad, respectively. But did you know there are effective ways you can raise HDL cholesterol levels and protect your heart health?

HDL cholesterol carries excess cholesterol to your liver so it doesn’t build up in your bloodstream. But when LDL cholesterol moves cholesterol throughout your body, it can build up in the walls of the arteries, making them hard and narrow. If you have too little HDL cholesterol and too much LDL, you may be diagnosed with high cholesterol, a condition that can lead to atherosclerosis, angina (often experienced as chest pain), heart attack, and stroke.

Read on to find ways to boost HDL cholesterol — and the evidence behind them.

Start a Regular Exercise Routine and Stick With It

We’ve all heard it before. Regular exercise is important for maintaining heart health and can also increase HDL cholesterol levels. Physical activity such as running, walking, biking, and swimming, along with moderate weight training, are great choices to help boost those good cholesterol levels.

A June 2020 review in the American Journal of Physiology found that endurance training led to a significant rise in HDL. For both men and women, the review cited a number of studies that had subjects perform moderate to vigorous exercise a minimum of three days a week. This was also the case for body types ranging from overweight beginners to marathon runners.

“Exercise is excellent because it may independently raise your HDL but also leads to weight loss, which may account for additional gains in your HDL,” says Haitham Ahmed, MD, MPH, chair of cardiology at AdvantageCare Physicians in New York.

Lose and Keep Off the Extra Pounds

If you’re overweight or obese, shedding those excess pounds can help to raise HDL cholesterol. Leah Groppo, RD, CDE, a clinical dietitian at Stanford Health Care in Stanford, California, says that losing around 7 percent of your total body weight is enough to cause a metabolic shift. But, as Groppo notes, “maintaining weight loss is key.”

Abdominal obesity — fat that accumulates around your waist rather than in the hips and thighs — seems to be associated with heart disease risk and lower levels of the good cholesterol.

Effective weight loss methods include diet, exercise, and surgery. A comparative study published in December 2018 in Scielo.org found that obese participants who received sleeve gastrectomy, a type of weight loss surgery, showed a significant increase in their HDL cholesterol 12 months later.

Quit Smoking

We know that smoking cigarettes can lead to a number of health problems, including lung disease, cancer, and a greater risk of a heart attack. But did you know smoking can also suppress or lower those good cholesterol levels?

“Smoking can reduce HDL cholesterol in many ways, including by inhibiting HDL synthesis in the first place, blocking its maturation, and speeding up its clearance and metabolism,” Dr. Ahmed says. “Quitting smoking can help your HDL synthesis and metabolism to go back to their natural levels so that the HDL can do its job better again.”

And research agrees. A study published in September 2013 in Biomarker Research found that ex-smokers had higher HDL cholesterol than smokers, noting: “We conclude that quitting smoking increases HDL cholesterol, and that this increase occurs rapidly after quitting, with no clear pattern of change thereafter.”

If you’re trying to quit smoking, talk to your doctor about the many methods to help you through the process.

Become a Pescatarian

Following a pescatarian diet — eating mainly fish, fruit, veggies, and plant-based foods — may increase HDL cholesterol. In a study published in July 2016 in the British Journal of Nutrition, researchers concluded that a diet rich in foods including fatty fish showed an increase of HDL particles in the body, especially when compared to lean fish and meat.

“Omega-3 fatty acids, which are the type of fatty acids found in fish, can help increase your HDL cholesterol,” Ahmed says. “Two servings of fatty fish per week, including salmon, mackerel, or albacore tuna, can help you hit your omega-3 goals.” You’ll also get omega-3s from flaxseed, mixed greens, and walnuts.

Have a Glass of Wine — or Not

Drinking in moderation might increase good cholesterol levels. At least that’s what some of the research says. A review published in October 2019 in the journal Molecules concluded drinking red wine (in moderation), which contains the antioxidant compound resveratrol, may have a protective effect on the heart, but more research is required to understand the mechanisms involved. But you don’t have to have a glass of vino to boost your HDL cholesterol. Antioxidants found in red wine can also be found in fruits such as blueberries, grape juice, dark chocolate, and peanuts.

If you decide to drink, remember to do so in moderation. The Dietary Guidelines for Americans recommends one drink or less a day for women, and two drinks or less a day for men.

Cut Back on Sugar

Eating high-carb foods — such as foods with added sugar, white bread, cookies, and cakes — reduces HDL cholesterol levels, increasing the risk for metabolic disorders, according to a study published in November 2015 in Nature. 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.

A study of 2,500 people with diabetes, published in October 2016 in the journal Nutrition Metabolism Cardiovascular Disease, found that following nutritional recommendations to limit added sugar in the diet was linked to significantly higher HDL cholesterol levels.

A February 2020 Journal of the American Heart Association observational study that followed 6,000 subjects for an average of 12.5 years found that sugar-sweetened beverages like sodas and fruit juices had an adverse effect on lipoprotein concentrations.

When trying to reduce added sugar in your diet, Ahmed says, it’s best to slowly replace sugars with fruit and vegetables. He adds, “Also try to avoid trans fats, including fried foods or those prepared with shortening, since these may also reduce HDL.”

Cook With Healthy Oils

Not all oils are created equal when it comes to your heart health. Olive oil and sunflower oil are mainly unsaturated fat, which can lower LDL cholesterol and at the same time increase HDL cholesterol. In a study published in February 2019 in Frontiers in Nutrition, researchers found that high-polyphenol olive oil increased HDL cholesterol concentration by almost 50 percent.

Research also shows that coconut oil is beneficial in raising HDL, though it isn’t the best heart-healthy oil because of its high saturated fat content, which can raise LDL cholesterol.

In a Harvard Health Letter, Walter C. Willett, MD, chair of the department of nutrition at the Harvard School of Public Health in Boston, suggests using coconut oil sparingly because of the lack of research on how the oil may contribute to heart disease.

Groppo agrees. “Coconut oil is best used on the skin,” she says.

Eat More Antioxidant-Rich Foods

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.

“Indulge in antioxidant-rich foods to increase HDL cholesterol,” Groppo says. “The more colors that you can get in your diet, the better.”

Talk to Your Doctor About Supplements and Cholesterol

If all other methods of increasing your HDL cholesterol haven't been effective, you might think of taking dietary supplements. Still, Ahmed cautions that supplements aimed at raising HDL only do so modestly. Also, supplements have not yet been proven to reduce heart attacks or strokes.

Speak to your doctor before taking any supplements to raise HDL cholesterol, because some supplements come with health risks or may interact with medication.

Additional reporting by Zachary Smith