How to increase the good cholesterol
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How to Increase Good Cholesterol (HDL)
Increasing high-density lipoprotein (HDL) cholesterol, often referred to as "good cholesterol," is crucial for reducing cardiovascular risk. Here are several evidence-based strategies to boost HDL levels:
Cholesteryl Ester Transfer Protein (CETP) Inhibition
CETP Inhibitors and HDL Levels
Inhibition of cholesteryl ester transfer protein (CETP) has been explored as a method to significantly increase HDL cholesterol levels. Studies have shown that CETP inhibitors can raise HDL levels by as much as 72.1%. However, the ILLUMINATE trial, which investigated the CETP inhibitor torcetrapib, was halted due to increased mortality and morbidity, attributed to off-target toxicity. This highlights the complexity and potential risks associated with CETP inhibition as a strategy for increasing HDL.
Exercise and Physical Activity
Aerobic and Resistance Training
Regular physical activity, particularly aerobic exercise, is well-documented to increase HDL cholesterol levels. A study comparing different exercise intensities found that high-intensity exercise significantly increased HDL-C and apolipoprotein A-I levels by 17% and 12%, respectively. Additionally, combining aerobic and resistance training has been shown to be more effective in raising HDL levels compared to either type of exercise alone.
Exercise in Overweight Individuals
For overweight individuals, combining a hypocaloric diet with regular exercise can enhance HDL levels. Men who combined diet and exercise saw a 13% increase in HDL levels, compared to a 2% increase in those who only dieted. This suggests that exercise plays a critical role in improving HDL levels, especially when combined with dietary changes.
Dietary Interventions
Carbohydrate-Restricted Diets and Eggs
Dietary modifications, such as carbohydrate-restricted diets (CRD), can also positively impact HDL levels. A study involving overweight men found that consuming three eggs per day within a CRD increased HDL-C levels significantly. This suggests that dietary cholesterol from eggs can be beneficial in the context of a low-carbohydrate diet.
Olive Oil and Polyphenols
Extra virgin olive oil, particularly high in polyphenols, has been shown to improve HDL lipid fractions. Although it did not significantly enhance HDL-mediated cholesterol efflux capacity, it did increase serum HDL levels. This indicates that incorporating high-polyphenol olive oil into the diet can be a useful strategy for boosting HDL.
Garlic Supplementation
Garlic has been studied for its lipid-lowering effects, including its impact on HDL cholesterol. Meta-analyses have shown that garlic supplementation can lead to a modest but significant increase in HDL levels. This makes garlic a potential non-pharmacologic option for improving HDL cholesterol.
Conclusion
Increasing HDL cholesterol can be achieved through a combination of lifestyle modifications, including regular exercise, dietary changes, and specific dietary supplements. While pharmacologic interventions like CETP inhibitors show promise, they come with significant risks. Therefore, focusing on sustainable lifestyle changes such as aerobic and resistance training, carbohydrate-restricted diets with eggs, and the inclusion of high-polyphenol olive oil and garlic in the diet are effective and safer strategies for boosting HDL levels.
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