What is a healthy HDL (good cholesterol) level, and can I raise it?
Raising HDL through lifestyle is possible, but your genes set the ceiling. Lowering triglycerides through less sugar and alcohol, more exercise, and weight reduction has the greatest effect.
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.
The claims are based on multiple human studies and population research. No randomised controlled trials or meta-analyses testing specific interventions for raising HDL are included in the sources. The associations are predominantly observational; firm conclusions about cause and effect for lifestyle interventions are therefore limited.
What is a healthy cholesterol level and when should I be concerned?
A normal LDL value does not give a complete picture of your cardiovascular risk. Ask your doctor about your remnant cholesterol as well, especially if cardiovascular disease or Alzheimer's disease runs in your family.
How early should you start lowering your LDL cholesterol?
Starting as early as possible pays off: LDL damage accumulates from childhood, and every year that your LDL remains lower counts. If familial high cholesterol runs in your family, discuss with your doctor whether screening from a young age makes sense.
Should you worry about mildly elevated cholesterol?
A mildly elevated cholesterol is not automatically harmless: the overall picture, including triglycerides and lipoprotein(a), determines your risk. Have those values measured and discuss them with your doctor if cardiovascular disease runs in your family.
Can losing weight noticeably improve my blood pressure and cholesterol?
Losing weight noticeably lowers your blood pressure and improves your cholesterol profile, but which value improves the most depends on your diet. And if the weight comes back, most of the gains disappear too.
How healthy is olive oil and what is it good for?
Olive oil, and extra-virgin olive oil in particular, is well supported as protective for the heart and blood vessels, especially when used in place of butter and as part of a varied, plant-based diet.
Which foods or supplements keep your blood vessels healthy?
The Mediterranean diet most demonstrably lowers your risk of heart and blood vessel disease. Individual supplements do not help.