What is a healthy HDL (good cholesterol) level, and can I raise it?

HDL, the 'good cholesterol', has been linked to cardiovascular health for decades: the lower your HDL, the greater your risk of atherosclerosis. But 'the higher the better' is not entirely accurate. Even people with very high HDL can develop coronary artery disease. It is not just the quantity that matters, but also how well your HDL functions, particularly its ability to remove cholesterol from artery walls.

Your HDL level is largely determined by your genes. Not everyone can therefore raise it equally effectively through lifestyle changes. A rare inherited variant raises HDL and lowers the risk of coronary artery disease, but it occurs in only a small group of Icelanders. Chronic kidney disease can also impair HDL function, regardless of how healthily you live.

The most powerful lever you have yourself lies with triglycerides, the fats in your blood. High triglycerides are almost always accompanied by lower HDL. Even values just within the normal range are already associated with a higher risk of type 2 diabetes and a less favourable HDL profile. Lowering triglycerides is therefore probably the most direct way to improve your HDL as well.

In people with type 2 diabetes, being overweight and insulin resistance are associated with lower HDL. Notably, even in women, who naturally tend to have higher HDL, being overweight pushes HDL down.

In practical terms, eating less sugar and fast carbohydrates, drinking less alcohol, exercising more, and losing weight if you are overweight are the best-supported measures. The sources do not mention any specific supplements or medications with a proven HDL-raising effect. If you have a condition such as kidney disease or diabetes, discuss this with your doctor, because your HDL function may be impaired in a way that lifestyle alone cannot resolve.