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Cholesterol is present throughout your body in your cells and it includes a combination of low-density lipoprotein (LDL) and high-density lipoprotein (HDL). You may have heard that it's important to lower your LDL and increase your HDL levels, but not quite understood why.[1] Some cholesterol is required for your body to work properly, but having too much total cholesterol can lead to serious health problems, such as heart attack and stroke. LDL and HDL cholesterol function differently within your body, so having high LDL levels can put you at a higher risk of health problems, while having high HDL levels may be beneficial for your health. Look over your latest cholesterol numbers to see where you stand and determine if you may benefit from lifestyle changes or medication to balance out your LDL and HDL.

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    Get a lipoprotein panel to learn your LDL and HDL numbers. This is a simple blood test that most doctors order for their patients once every 5 years or more often if their last test was abnormal. By getting this test, you can learn important information about your health, including:[2]

    • Total cholesterol. Normal total cholesterol levels for men and women ages 20 and older is between 125 and 200 mg/dL (milligrams per deciliter).
    • HDL level. A normal HDL level for men ages 20 and older is greater than 40 mg/dL and for women ages 20 and older it is greater than 50 mg/dL.
    • LDL level. Normal LDL levels for men and women ages 20 and older are less than 100 mg/dL.
    • Non-HDL level, which is your total cholesterol minus your HDL number. Normal non-HDL levels for men and women ages 20 and older are less than 130 mg/dL.
    • Triglycerides. Normal triglyceride levels for men and women ages 20 and older are less than 150 mg/dL.

    Tip: Keep in mind that triglycerides are not the same as cholesterol, but high triglycerides can worsen the effects of high cholesterol, so checking your triglycerides is part of a routine lipoprotein panel. Very high triglycerides can be caused by high blood sugar and diabetes, so managing your blood sugar may bring down your triglyceride levels.

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    Note that LDL cholesterol is "bad" since it accumulates in the arteries. The reason why LDL is sometimes referred to as "bad" or "lousy" cholesterol is that it clings to your artery walls. This can lead to dangerous buildups of the waxy, fatty substance, which put you at risk of serious health problems, such as heart attack and stroke. If your LDL levels are above the normal level, work with your doctor to form a plan for lowering your LDL levels.[3]

    • You may be able to lower your LDL level by making simple lifestyle changes. However, if you have other factors that put you at risk of a heart attack or stroke, such as high blood pressure or high triglycerides, then your doctor may suggest a medication to help lower your LDL cholesterol.

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    Remember that HDL cholesterol is "good" because it removes cholesterol from your body. While having an elevated LDL number is bad, having a higher HDL number is good. This is because HDL cholesterol transports excess cholesterol through the arteries instead of allowing it to build up on the arterial walls. The cholesterol travels back to the liver where it can be processed and removed from your body.[4]

    • If your HDL level is low, making some simple lifestyle changes can help to raise it, and this may also help to lower your LDL and total cholesterol level. Talk to your doctor about specific things you can do to raise your HDL.
    • Some lifestyle changes you can make to improve your HDL levels include exercising, maintaining a healthy weight, quitting smoking if you're a smoker, and eating unsaturated rather than saturated fats.

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    Watch your triglyceride levels if your LDL is high and HDL is low. Be aware that high triglycerides combined with low HDL and high LDL puts you at an increased risk of heart attack and stroke.[5] If your triglycerides are between 151 and 199 mg/dL, they're considered to be borderline high while a triglyceride level above 200 mg/dL is considered high. Either way, it is important to lower your triglycerides, which you can do by making some simple lifestyle changes.[6]

    • Talk with your doctor if your triglycerides are high. High triglycerides may indicate a health condition, such as metabolic syndrome, hypothyroidism, type 2 diabetes, or a genetic condition that affects how your body processes fat.[7]

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    Adopt a diet that's low in fat and high in fiber. Reducing your overall intake of fat, especially saturated and trans fats, and incorporating more fiber-rich foods can help to improve your LDL and HDL numbers. Eat more whole foods, such as fruits, vegetables, lean proteins, low-fat dairy, and whole grains to get less fat and more fiber in your diet. Some other good diet strategies for balancing your HDL and LDL include:[8]

    • Cutting back on fast food and other fried and greasy foods.
    • Eliminating low-fiber items, such as prepackaged baked goods, chips, crackers, and white carbohydrates like white flour, pasta, and rice.
    • Reducing your intake of sugar and processed foods, such as soda, sugary cereals, and frozen entrees. This may also help to lower your triglycerides if they're elevated.[9]

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    Exercise for 2.5 hours every week. Getting a minimum of 2.5 hours of activity every week can help to reduce your LDL cholesterol while increasing your HDL cholesterol. Regular exercise also helps to lower your triglycerides.[10] You can accomplish this exercise goal by going for a 30-minute walk on most days of the week, participating in a few 1 hour long exercise classes at your gym each week, or doing 2.5 hours of exercise in 1 day, such as going for a long hike or bike ride.[11]

    • Small bouts of activity spread throughout the day also count towards your weekly total. For example, if you exercise for 10 minutes 3 times daily, this counts as 30 minutes per day.
    • Make sure to choose a form of exercise that you enjoy. This will help to increase the chances that you'll stick with it.

  3. 3

    Quit smoking if you're a smoker. Smoking is bad for your health in general, and quitting can increase your HDL, which means your body will be more efficient at removing cholesterol from your system. Set a quit date for yourself as a starting point. You may also want to talk to your doctor about medications and other supportive measures that may help you to quit smoking.[12]

    • For example, nicotine replacement products, such as patches, lozenges, or gum, may help to make it easier for you to go without cigarettes.
    • You may also look into support groups in your area or online to connect with other people who are trying to quit.

  4. 4

    Lose weight if you're overweight or obese. Being overweight or obese increases your risk of having high LDL cholesterol.[13] It also makes it harder for your body to use and remove excess cholesterol, which increases your risk of heart attack and stroke. Talk with your doctor to determine what might be a healthy weight goal for you and make a plan to reach your goal.[14]

    • Your doctor may base your weight loss goal on your current and ideal body mass index (BMI). You can check your BMI yourself using an online calculator.
    • Waist-to-hip ratio can also come into play when considering your weight loss goals. A higher waist-to-hip ratio puts you at a higher risk of heart attack and stroke, so you may need to set a higher weight loss goal to get this ratio down.

  5. 5

    Reduce your alcohol intake to a moderate level or avoid alcohol. Drinking in moderation is generally fine for your health. However, drinking in excess can raise your cholesterol and triglyceride levels, so cutting back may be helpful for improving your numbers. If you do drink alcohol, limit yourself to no more than 1 drink per day if you're a woman or 2 drinks per day if you're a man.[15]

    • One drink is defined as 12  fl oz (350 mL) of beer, 5  fl oz (150 mL) of wine, or 1.5  fl oz (44 mL) of spirits.

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    Talk to your doctor about medications that can lower your LDL. If your cholesterol levels do not improve with lifestyle changes alone, your doctor may recommend a medication to improve your levels. There are many different options available to treat high LDL, low HDL, and high triglycerides, so discuss the available medications and their side effects with your doctor. Your doctor may recommend a single medication or a combination of medications depending on your numbers.[16]

    • You may be a good candidate for statin therapy if your 10-year risk for heart disease is greater than 10%. Ask your doctor about your risk, or use a tool like the American College of Cardiology's ASCVD Risk Estimator Plus to generate your own risk estimate.[17]
    • Be aware that some statin medications can also increase your HDL levels along with your LDL. These medications include drugs like atorvastatin (Lipitor), fluvastatin (Lescol XL), and lovastatin (Altoprev).[18]

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    Ask your doctor about taking supplements. In addition to medications, you can also try supplements, such as niacin or omega-3 fatty acids, to improve your cholesterol levels. However, keep in mind that there is limited evidence for their effectiveness. Discuss these supplements with your doctor to find out which ones might be safe or helpful for you.[19]

    • Fish oil supplements have not been shown to be helpful for people who don't have any known cardiovascular problems. However, clinical trials show that an omega-3 fatty acid called icosapent ethyl may help lower triglycerides and reduce your risk of a heart attack if you have a history of cardiovascular disease.[20]
    • While niacin used to be recommended for managing poor cholesterol, there's not much evidence that it can improve your HDL levels or prevent cardiovascular disease. Healthy lifestyle changes are the best way to raise your HDL levels.

    Warning: Do not take an over-the-counter supplement without discussing it with your doctor first. Niacin and omega-3 fatty acids are available over-the-counter and may help to improve your cholesterol levels, but it's important to discuss taking these supplements with your doctor first.[21]

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