Most of the time, you want your cholesterol to be low—ideally less than 150 milligrams per deciliter (mg/dL). But as you likely know if you’ve had your levels tested, the results aren’t quite that simple.
Cholesterol tests will tell you not just your total cholesterol, but also your low-density lipoprotein, triglycerides, and high-density lipoprotein. And you actually want your high-density lipoprotein, or HDL, to be high.
HDL cholesterol is considered “good” cholesterol. While still a type of fat in your bloodstream, it doesn’t clog arteries, and higher levels are linked to lower chances of heart problems. Low-density lipoprotein, or LDL, is considered “bad” cholesterol because it’s the type that builds up in your arteries and can contribute to your risk for heart disease and stroke. Triglycerides, another type of fat in the blood, are tied to higher risks of heart attack and stroke if you also have low HDL or high LDL.
[time-brightcove not-tgx=”true”]It would make sense, then, that in order to protect your heart, you’d want to boost your good cholesterol, or HDL. But research examining increases in HDL so far hasn’t shown any subsequent reduction in heart problems, and medications that raise your good cholesterol don’t stave off those risks, either.
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“Starting from the 1970s, large population studies…showed that people who had very low levels of HDL cholesterol…had a higher risk of heart attacks,” says Dr. Anand Rohatgi, an academic cardiologist and professor of medicine in cardiology at UT Southwestern Medical Center. It’s a “powerful risk predictor,” he says, which is why low HDL made it into the heart disease risk calculators doctors still use today—but it doesn’t necessarily translate to a treatment tactic. Experts agree that the relationship between higher HDL levels and better heart health is correlational—not causative. “The challenge has been that when drugs have been studied that raise HDL cholesterol…that has never translated into a reduced risk for heart disease. So from a pharmaceutical standpoint, it’s not a treatment target—it’s a risk marker.” Instead of fixating on any one aspect of cholesterol, he says, you have to think of the numbers in concert, alongside other risk markers for heart problems like age, sex, blood pressure, and diabetes.
That said, certain lifestyle habits do increase HDL, Rohatgi says; we just don’t necessarily know what effect raising your HDL cholesterol actually has on your heart. The numbers alone “are not a crystal ball.”
The habits below are all associated with higher HDL levels—as well as other benefits for your heart and overall health.
A sedentary lifestyle is linked to a host of health problems, including a greater likelihood of heart disease. Moving more has routinely been shown to increase HDL levels, and it’s also linked to living longer and lower rates of heart disease.
Aim for about 30 minutes a day, five days a week, says Dr. Melissa Tracy, cardiologist and medical director of cardiac rehabilitation at Rush University Medical Center. It can be any form of cardio exercise—brisk walking, pickleball, dancing, swimming, cycling, or anything else you enjoy and will stick with—as long as it gets your heart rate up. You can even do a few 10- or 15-minute sessions each day if that fits into your schedule better, she says.
“Eating foods that are high in polyunsaturated and monounsaturated fats and antioxidants may improve the HDL to LDL ratio,” says Dr. Joy M. Gelbman, a cardiologist at Weill Cornell Medicine.
Choose options like olive oil and fatty fish over foods higher in saturated fats like red meat, full-fat dairy, fried foods, and baked goods.
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Making healthier diet choices overall means your body won’t store as much fat. You’ll be using your fat stores for some of your energy, which in turn helps your body metabolize cholesterol better, Tracy says. That may result in lower LDL and higher HDL, as HDL helps transport LDL to the liver where it’s processed and excreted, Rohatgi says.
Smoking not only lowers your HDL; it also makes the HDL you do have worse at its protective job. Quitting smoking can increase your HDL in a matter of weeks, according to a meta-analysis in Biomarker Research.
Experts don’t know exactly why this happens, but it might have to do with the way smoking stresses the body, Gelbman says.
“Exercise, weight loss in people [who are overweight], and smoking cessation are the key means for optimizing HDL,” Gelbman says. If you have obesity or are overweight, getting to a healthier weight may lower your triglycerides and LDL and lift your HDL.
And the weight loss doesn’t have to be dramatic: People who lost just 1 to 3 percent of their body weight displayed better improvements in HDL than people who lost just 1% of their body weight in an Obesity Research & Clinical Practice study.
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While finding a sustainable diet plan that helps you lose weight and keep it off is most important, research suggests eating more protein and fat and fewer carbs may have the biggest effect on HDL.
Experts still don’t completely understand the concrete heart benefits of higher HDL levels. “It’s complex and dynamic, and that’s what makes it hard to study and hard to pin down,” Rohatgi says. But heart-healthy habits have additional benefits regardless of their effect on your cholesterol, such as greater longevity, improved cardiovascular fitness, and lower risk of heart disease. The fact that they also increase your HDL in the process is an added perk.
