These include:. Bottom line: Consuming fruits and vegetables rich in anthocyanins may help increase HDL cholesterol levels. The omega-3 fats in fatty fish provide benefits to heart health, including a reduction in inflammation and better functioning of the cells that line the arteries 40 , Some research suggests that eating fatty fish or taking fish oil supplements may also help raise low levels of HDL cholesterol 42 , In a study of 33 people with heart disease, participants who consumed fatty fish four times per week for 8 weeks had an increase in HDL cholesterol levels.
The particle size of their HDL also increased However, other studies found no increase in HDL cholesterol in response to increased fish or omega-3 supplement intake Bottom line: Eating fatty fish several times per week may help increase HDL cholesterol levels and provide other benefits to heart health. Artificial trans fats have many negative health effects due to their inflammatory properties 45 , There are two types of trans fats.
One kind occurs naturally in animal products, including full fat dairy. In contrast, manufacturers create artificial trans fats, which are present in margarines and processed foods, by adding hydrogen to unsaturated vegetable and seed oils. These fats are also known as industrial trans fats or partially hydrogenated fats. In addition to increasing inflammation and contributing to several health concerns, these artificial trans fats may lower HDL cholesterol levels.
To protect heart health and keep HDL cholesterol within the healthful range, it is best to avoid artificial trans fats altogether. Bottom line: Research suggests that artificial trans fats can lower HDL levels and increase inflammation, compared with other fats. Although HDL cholesterol levels are partly determined by genetics, there are many things a person can do to naturally increase their levels. This includes eating healthful fats, such as olive oil, coconut oil, and fatty fish, and avoiding harmful trans fats.
Getting regular exercise, quitting smoking, and eating antioxidant-rich foods are also effective for increasing HDL cholesterol. The habits and practices that raise HDL cholesterol often provide other health benefits, and they are key components of a healthful lifestyle. Doctors advise people to limit their overall cholesterol but maximize levels of high-density lipoprotein HDL cholesterol. Why is this, and it is…. There are many ways to improve cardiac health, and watching what we eat is one of the most important.
Here, we provide details of 16 heart-healthy…. The body needs cholesterol, but too much bad cholesterol can be harmful and is a major risk factor for heart disease and stroke. In this article…. High cholesterol is a risk factor for heart attacks and coronary heart disease, because it builds up in the arteries, narrowing them. It does not…. There are two types of cholesterol. There is early difficulty recognizing acceptable no-fat foods and dealing with the constant challenge of redesigning most traditional choices at every meal.
In Dr. Ornish's experiment, a list of fat-free recipes taken from low-fat cookbooks and other resources on weight loss, cardiac health, and healthy lifestyle changes was given to each participant. For the initial several months, the constant challenge of shopping for appropriate foods and finding appropriate menus was a major focus [ 27 ]. There were also two other major factors that helped the participants adhere to the extreme change in their diet. Esselstyn credits Dr.
He actively involved himself in their care through frequent personal contact over a period of years and through periodic semisocial meetings that centered around the treatment plan. His personal investment in the success of his participants was clear to them. The patients were also motivated by their initial weight loss, improved feeling of well-being, and decreasing angina. In another study done at Tufts University, researchers concluded that healthier eating habits and a bit of discipline can help recondition the human brain to prefer healthy foods to junk foods [ 28 ].
The researchers found that people did not start out their lives with a love for French fries and other junk foods. People gain those cravings through eating it repeatedly. Susan B. Roberts, a professor of both nutritional science and psychology at the Tuft's Friedman School of Nutrition Science and Policy and Tufts University School of Medicine, studied MRI images of the brains of obese and overweight participants before and after completion of a six-month weight loss program.
The results showed the areas of the brain associated with learning and addiction were transformed, with pleasure response centers becoming more sensitive to healthier food and less drawn to unhealthy, higher-calorie foods [ 28 ].
This supports the hypothesis that unhealthy habits are not necessarily fixed and that improved eating habits can be adopted and maintained. The findings suggest that we may begin to crave strict diets, such as the one used by Dr. Ornish to stop the progression of atherosclerotic plaque in his patients, if we condition our brain by repeatedly eating healthy foods.
Additional research supports the hypothesis that the Western diet of eating a high concentration of meat, oil, and dairy plays a large role in America's high rate of cardiovascular death.
In other cultures and society where plant-based nutrition is prevalent there are extremely low rates of cardiovascular disease. In a paper authored by Strom and Jensen, they observed that in Norway between and there was a strong relationship between cardiovascular mortality and changes in intake of fat in the form of butter, milk, cheese, and eggs, with the changes in mortality lagging behind dietary changes by approximately one year [ 29 ].
During this time, German occupying forces confiscated their livestock, limiting Norwegians to plant-based nutrition. The death rate from strokes and heart attacks plummeted during this time. After World War II and the German occupation period, the Norwegians started eating animal based products again and the cardiovascular death rates increased as well. The results from this study may correlate animal based products with cardiovascular disease, but there are a number of other explanations which could have contributed to these results.
Another study observing the nutritional conditions during this time period in Norway points out other nutritional factors that have been shown to play a significant role in cardiovascular disease [ 30 ]. Sugar intake was also cut in half during this time. In Finnish men had the highest ischemic heart disease mortality rate in the world. The main focus of the strategy was to reduce the high saturated fat intake.
Finnish villages were invited to participate in a cholesterol-lowering competition to demonstrate the feasibility of changing their diet and obtaining measurable, positive outcomes.
Another positive effect that plant-based diets have on our health is its impact on our gut microbiome. Researchers have been continuing to unfold our understanding of the microbiome and its effect on human biology. As humans we have more bacteria than we do cell and gene count. The microflora has been found to have health promoting effects such as improved digestion, absorption, vitamin synthesis, and lowering of gas distension [ 31 ].
The good news is that we can alter our own microflora depending on the foods we eat. A study between two monozygotic Finnish twins found that diet played an important role in the modulation of their stool microbiota.
The cotwins who ingested the same amounts of saturated fatty acids had very similar denaturing gradient gel electrophoresis profiles of Bacteroides spp. There are certain bacteria within the gut microflora that further breakdown the carnitine and choline found in animal products to trimethylamine TMA. There are multiple studies published in that indicate that high levels of TMAO in the blood are associated with an increased risk of major adverse cardiovascular events [ 32 ].
A plant-based diet appears to select against gut flora that produce TMA by essentially starving the bacteria of carnitine and choline. One study had a group of vegans consent to participating in a study where they ate red meat and had their blood TMAO levels monitored. The study found that the formation of TMAO from the carnitine challenge was negligible in the vegans, compared to the control group, who had their TMAO levels drastically increase from eating the same amount of carnitine [ 33 ].
This concept explains the well-established link between high levels of meat consumption and cardiovascular disease risk. A recent article in the New England Journal of Medicine shows that choline in eggs, poultry, dairy, and fish produces the same toxic TMAO as carnitine in red meat [ 34 ].
This further explains plant-based protection from heart disease. While nutrition may be the most important lifestyle factor in stimulating reverse cholesterol transport, studies have shown that the intervention treatment is best when it is paired with exercise. One of the reasons for this is the positive effect exercise has on our HDL cholesterol levels. Epidemiological and clinical intervention data have consistently shown that low levels of HDL cholesterol are associated with an increased risk of cardiovascular disease.
The first step in the management of low HDL cholesterol levels is to increase physical activity [ 35 ]. A study done in Czech Republic on obese women indicated that physical activity is required to trigger reverse cholesterol transport [ 36 ]. Efflux of cholesterol from prelabeled macrophages to plasma acceptors of tested individuals was used as a reverse cholesterol transport measure.
Changes in reverse cholesterol transport were analyzed in 15 obese women after 9-week intervention, which consisted of 5 sessions of increased physical activity per week.
Each session lasted 60 minutes long and 3 of the 5 were under controlled conditions in a fitness center. The other two sessions were usually bicycling or brisk walking.
At the beginning of the 9-week intervention and at the end blood specimens were obtained. At the end of the 9-week intervention the 15 obese women produced a substantial drop of body weight of more than 7 kg on average. The maximal body weight decrease was The significant finding of this experiment was the correlation between the amount of weight lost and the individual change of cholesterol efflux.
Volunteers with the smallest weight reduction also displayed the smallest change of cholesterol efflux after intervention. In another study including sedentary men, the results showed that exercise can significantly change lipoprotein profiles [ 37 ]. In this study, sedentary men were randomly assigned to one of the following three experimental conditions: weight loss by exercise, weight loss by diet, and control.
These were measured at baseline, 7 months, and 1 year. There was increased mean HDL mass concentrations for both the diet induced and exercise induced weight loss groups.
These results suggest that physical activity increases HDL levels as much, or possibly more, than dieting. HDL is one of the primary factors in inducing reverse cholesterol transport, making exercise another key component of preventing and treating cardiovascular disease. Similar results were found in another study evaluating the main steps of reverse cholesterol transport in a group of well-trained soccer players in comparison to sedentary controls [ 38 ]. The capacity to promote cholesterol efflux from cells was significantly higher in the soccer players than in the control individuals However, lecithin: cholesterol acyltransferase and cholesteryl ester transfer protein activities did not reach a statistically significant difference between both groups.
Several studies have indicated that the most consistent effect of exercise on lipoprotein metabolism is an increase in high-density lipoprotein HDL. A study published in the American Heart Association Journal investigated the effect of physical fitness on HDL and reverse cholesterol transport. The researchers studied several key steps in reverse cholesterol transport in endurance-trained athletes and compared them with a reference group of physically active individuals [ 39 ].
The 25 endurance-trained athletes were recruited from triathlon, biathlon, swimming, and running teams, while the reference group consisted of 33 normally active males.
Cholesterol efflux was tested as the capacity of plasma to promote cholesterol efflux from a macrophage cell line.
In this same study, researchers also found that the trained athletes reached a threshold, where additional physical exercise did not correlate with higher HDL cholesterol levels. This may be linked to the threshold in the increase in muscle mass associated with increasing fitness.
The cholesterol contained within HDL is known to be inversely related to cardiovascular disease; however, several failed clinical trials have created doubt HDL's ability to reverse atherosclerosis in patients. Several of these trials aimed at raising HDL cholesterol.
Large outcome trials using niacin, fibrates, or cholesterol-ester-transfer-protein CETP inhibitors were performed but overall showed negative results or were only positive in subgroups [ 43 ]. These studies showed that simply raising HDL cholesterol will not reverse atherosclerosis. These negative studies were followed up with genetic studies, which indicated that low HDL cholesterol is not causally linked to atherosclerotic events [ 44 ].
A potential explanation for these inconsistent studies is due to the fact that HDL can be dysfunctional and lose their protective properties, such as in diabetes or inflammation. In periods of inflammation, apolipoprotein AI exhibits extensive posttranslational modifications through oxidative processes, particularly by myeloperoxidase, a peroxidase enzyme expressed in neutrophil granulocytes. The myeloperoxidase pathway inhibits cholesterol efflux causes HDL to lose its endothelial cell protective effects [ 45 ].
As mentioned earlier in the text, studies involving exercise have not only increased HDL concentration, but also increased reverse cholesterol transport.
Future studies could explore the different effects of exercise that could increase reverse cholesterol transport. For example, other studies have shown that increasing certain apolipoproteins, such as apolipoprotein AI, can induce plaque regression without a change in HDL concentration [ 46 ].
Discovering the exact mechanism of which weight loss and exercise improve HDL functionality will help explain why some HDL-increasing agents have not been shown to be clinically effective. Other medications that focus on the functionality of HDL may be more beneficial. For example, niacin has been shown to restore HDL functionality in diabetic patients and improve reverse cholesterol transport, without having a major impact on the concentration of HDL cholesterol [ 47 ].
However, the AIM-HIGH trial investigated simvastatin alone versus simvastatin with niacin on patients with established coronary artery disease and found that, among patients with atherosclerotic cardiovascular disease and LDL cholesterol levels of less than 70 mg per deciliter, there was no incremental clinical benefit from the addition of niacin to statin therapy during a month follow-up period, despite significant improvements in HDL cholesterol and triglyceride levels [ 48 ].
The most likely explanation for these results is that, for such a population, already being aggressively treated with statins to lower LDL-C, it is hard to show an additional benefit. It could be possible that the additional niacin treatment would be more beneficial for a higher risk group with higher LDL concentration.
Going forward, we have yet to establish a clinical translation for altering HDL concentration and function with medication.
Several studies have shown the power of HDL to favorably modify plaque biology, but future studies need to further investigate the mechanistic base of HDL and focus on improving its function, rather than increasing its concentration.
Keep reading to learn more about HDL and what foods you should be eating to raise your HDL ratio in relation to total cholesterol. HDL is the good kind of cholesterol and the kind you typically want, whereas low-density lipoprotein LDL is the kind you want to keep in check.
HDL is like a vacuum cleaner for cholesterol in the body. Your liver expels it from your body. Ultimately, this helps reduce your risk of heart disease, heart attack, and stroke. The American Heart Association recommends getting a cholesterol blood test by age Below is a breakdown of what your HDL cholesterol results mean. Learn more about your overall cholesterol levels here. A bagel with cream cheese for breakfast, a piece of fried chicken for lunch, and a bowl of ice cream at night are not ideal for keeping your cholesterol in check.
These are sources of saturated and trans fat. They can increase your LDL and total cholesterol levels. The things that increase HDL are actually not food but several medical and environmental factors.
Preventing or avoiding the following increases your HDL:. Some hormones, such as estrogen or thyroid hormone , increase HDL concentrations. Exercise and moderate alcohol consumption are associated with higher HDL, too, according to research. Learn more about your cholesterol ratio here. The Mediterranean diet can be a good place to start. A study showed that, in people with risk factors for metabolic disease, following the Mediterranean diet effectively lowered overall blood cholesterol.
The type of heart-healthy fat found in olives and olive oil can lower the inflammatory impact of LDL cholesterol on your body, according to research published in Use extra-virgin olive oil instead of other oils and fats when cooking at low to moderate temperatures, since extra-virgin olive oil breaks down at high temperatures. The U. Department of Agriculture defines one tablespoon of extra virgin olive oil as a single serving. Whole grains, including bran, cereals, and brown or wild rice, may lower your LDL and total cholesterol.
Weight loss is especially helpful for people who have an apple-shaped body. Effective weight-loss methods include diet, exercise, and surgery. A study published in January in the journal Surgery for Obesity and Related Diseases found that participants who received laparoscopic adjustable gastric banding showed a significant increase in their HDL cholesterol long-term, 12 years later.
Smoking cigarettes can lead to a number of health problems, including lung disease and cancer, and also increases your risk of heart attack. But did you know smoking can also suppress or lower those good cholesterol levels? Ahmed says. And research agrees.
Including fish in your diet can increase HDL cholesterol in a short period of time. In a study published in February in the journal PLoS One , researchers concluded that a diet rich in foods including fish showed an increase in the size of HDL particles in the body, which could help improve cholesterol transport through the body. The researchers saw the positive effects of a diet that included fish in as little as 12 weeks.
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