There are two main types of cholesterol: high-density lipoprotein (HDL) and low-density lipoprotein (LDL). Some people refer to HDL as “good cholesterol,” as it can help remove excess LDL, or “bad cholesterol,” from the blood and tissues. Some people may need to increase their HDL levels, which they can do by making diet and other lifestyle changes. Cholesterol is a fatty substance that can build up in the blood. Excesses of LDL or other fats called triglycerides (TGs) can accumulate in the walls of the arteries and cause a buildup of plaque. This can eventually lead to heart attack or stroke.

However, HDL can absorb excess LDL from the blood and tissues and remove it from the body through the liver in a process called reverse cholesterol transport.

As a result, having low HDL can increase your risk of cardiovascular conditions, especially when LDL and TGs levels are also relatively high.

Adhering to a healthy diet and lifestyle plays a fundamental role in decreasing the risk of cardiovascular disease.

This article discusses some ways you can increase your HDL levels through your diet, supplementations, and other available options. It also answers some frequently asked questions about HDL.

Some foods are rich in types of fatty acids called long-chain omega-3 fatty acids, specifically eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA). Clinicians use these omega-3 fatty acids clinically to lower TGs.

Research has also shown that EPA and DHA can increase HDL levels, decrease LDL levels, and reduce inflammation, which plays a key role in maintaining cardiovascular health.

A 2018 study of people from Greenland who had a diet high in omega-3 polyunsaturated fatty acids also observed that astaxanthin increased HDL and decreased forms of LDL.

Oily fish can be rich in EPA and DHA. Seafood options include:

Fresh, canned, and frozen fish will all offer omega-3 fats. Try to limit portions of seafood to four portions per week, or two portions per week if you are pregnant, breastfeeding, or planning to become pregnant.

Additionally, meat-free sources of omega-3s include:

Although these foods may not contain as high levels of DHA and EPA directly, they do contain different omega-3s called alpha-linolenic acid (ALA). The body can then convert ALA into longer-chain fatty acids, including DHA and EPA.

The reddish-purple pigment in some fruits and vegetables indicates that the food contains phytochemicals called anthocyanins, which research has shown to increase HDL.

A 2021 controlled trial of 176 participants suggested that anthocyanins significantly increased HDL in individuals who had dyslipidemia. Similarly, a 2015 study observed that anthocyanin extracts increased HDL in people with diabetes.

Anthocyanin-rich foods tend to be red, purplish, or slightly blue, and they can include:

A 2017 trial compared the effects of nuts and olive oil from a Mediterranean diet on HDL after 1 year. The results of the study showed that both olive oil and nuts increased HDL but that olive oil had an even stronger effect.

Evidence indicates that the Mediterranean diet may relate to a reduced risk of cardiovascular disease.

Although the Mediterranean diet can vary, Mediterranean-style diets tend to prioritize whole foods such as vegetables, fruits, legumes, and seafood while limiting processed foods, sugar, and red meat.

A 2021 systemic review cited 13 studies that showed that the Mediterranean diet had favorable effects on the quality of HDL and the prevention of HDL dysfunction.

Learn more about 9 good foods for your cholesterol levels.

Trans fats, or trans-fatty acids, are a type of unsaturated fat that can raise LDL levels and lower HDL levels. While they can occur naturally in food in small quantities, the primary source of trans fats in the diet comes from processed foods.

Food manufacturers create trans fats to improve the texture and taste of food.

Reducing or avoiding trans fats can help balance your good and bad cholesterol levels to protect your cardiovascular health.

Trans fats are common in foods including:

You can also avoid trans fats by avoiding foods that include “partially hydrogenated oils” in the ingredients list.

Evidence suggests that there is a relationship between high blood sugar over time and a higher risk of cardiovascular disease.

One 2020 study observed that consuming 12 ounces of sugar sweetened beverages more than once per day links to having lower levels of HDL. These beverages included sodas, fruit flavored drinks, sports drinks, and coffee and tea with added sugar.

Furthermore, a previous 2016 study found that people who followed nutritional recommendations for limiting sugar in the diet had significantly higher HDL levels.

There are many health benefits associated with exercising regularly. One of these benefits is the effect of exercise on cholesterol.

Many studies have shown that various types of exercise increase HDL. A 2021 systematic review investigated data from 23 different studies and observed that all studies demonstrated improvements in HDL in people who exercised compared with those who did not exercise.

Another 2020 review that cited a number of studies found that endurance training also led to a significant increase in HDL in different groups. These groups ranged from sedentary or overweight beginners to experienced athletes.

Cigarette smoking is a risk factor for cardiovascular disease.

This is partly the result of the effects that smoking can have on cholesterol. Smoking can cause LDL cholesterol to build up, causing further plaques of cholesterol and clogging up arteries. As smoking can also cause damage to the arterial walls themselves, this can cause more cholesterol to collect in these damaged areas.

Smoking can also lower the body’s levels of HDL.

Quitting smoking can help you see rapid health improvements and lower the risk of cardiovascular disease.

In addition to some lifestyle factors, stress is also a risk factor for cardiovascular disease.

Finding ways to effectively manage stress can improve your quality of life and have a protective effect on heart health and cholesterol levels.

For instance, a 2019 study showed that monks who practiced meditation for 6 months or longer had higher levels of HDL compared with monks who were newer to meditation and those who did not meditate.

The American Heart Association (AHA)’s 2017 statement endorses meditation as a way to help reduce the risk of cardiovascular disease.

Niacin is a popular supplement for balancing cholesterol levels.

A 2020 meta-analysis observed that niacin significantly increased HDL. Additionally, niacin appeared to reduce blood TGs and LDL.

Results from a 2019 meta-analysis of 119 clinical trials also associated niacin with a reduction of some cardiovascular events. However, the researchers noted that because much of the research into niacin for lipid management is older, the results may not accurately reflect current populations and lifestyles.

Additionally, as with all supplements and medications, niacin may cause side effects.

Always consult with your doctor before taking any supplements, and let them know about any medications and supplements you are already taking.

You may first be aware of having low HDL levels or high LDL and TG levels after having a routine blood test. This is because having high cholesterol does not cause symptoms unless it has progressed and is causing more severe complications.

A doctor may order testing for cholesterol if you are at risk of having high cholesterol. This risk may be based on your age, body mass index (BMI), or other conditions you may have, such as diabetes or high blood pressure.

If your cholesterol levels are above the expected range, your doctor may recommend medication or lifestyle adjustments.

In addition to lifestyle management, some people may require clinical treatment.

Statins are a very popular option for treating high cholesterol levels and for the prevention of cardiovascular disease. They work to lower LDL levels and increase HDL levels to slow the buildup of arterial plaque.

Statins can be safe and effective, but they may interact with other medications and may not be appropriate for those who are pregnant or who have chronic liver disease.

Although doctors can prescribe medications such as statins, they may also recommend lifestyle changes to increase HDL and lower LDL to optimize your outcome.

Learn more about clinical treatments for high cholesterol levels.

Below are some frequently asked questions about how to increase HDL.

Making lifestyle modifications such as getting regular exercise, eating a plant-based diet, and managing stress may help increase your HDL naturally without the use of medication.

However, some medications — such as statins — can be safe and effective and may be necessary in more severe cases.

The researchers behind a 2019 study suggest that exercise may help contribute to HDL quality and function by improving its antioxidative and anti-inflammatory properties. Other researchers have added that exercise may improve the process of excretion of LDL and the body’s metabolism of cholesterol.

However, experts call for more research to fully understand exactly how HDL responds to exercise and what level of exercise may be most effective for HDL improvements.

Having a lower level of HDL, or “good,” cholesterol is a risk factor for developing cardiovascular disease. However, there are several lifestyle modifications you can make that can help increase your HDL cholesterol levels and reduce your risk of cardiovascular conditions.

These modifications include eating a Mediterranean diet or a plant-based diet with servings of fatty fish, getting regular exercise, and using stress management techniques. Avoiding smoking and not eating processed foods containing trans fats can also help increase HDL levels and reduce other risk factors for cardiovascular conditions.

Contact your doctor for advice if you want to make changes to your diet or lifestyle to address cholesterol levels.

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