How to Increase HDL Cholesterol Levels

Regular physical activity and exercise are the most effective lifestyle interventions for increasing HDL cholesterol levels. 1

Exercise Recommendations

Engage in at least 30 minutes of moderate-intensity aerobic exercise 5 times weekly 1
For healthy individuals: Perform prolonged moderate-intensity aerobic exercise at 70-80% heart rate reserve, combined with low-intensity resistance training at 50% of 1 repetition maximum (1RM) 1
For those with dyslipidemia: Progress to 85% maximum heart rate with moderate to high-intensity resistance training at 75-85% 1RM 1
Aim for a weekly exercise volume of 7-14 miles of jogging (or equivalent), which corresponds to approximately 1200-1600 kcal of energy expenditure per week 2
There appears to be a linear dose-response relationship between activity levels and HDL cholesterol levels - more activity generally yields greater HDL increases 1, 2

Reduce saturated fat intake to 7-10% of total calories 3
Include sufficient unsaturated fats (15-20% of calories) in your diet 3
Avoid trans-unsaturated fatty acids which can lower HDL cholesterol 1
Replace saturated fats with monounsaturated fats (olive oil, canola oil) and polyunsaturated fats (corn oil, peanuts) rather than high-carbohydrate foods 1
Limit refined carbohydrates and sugars, as high-carbohydrate diets can reduce HDL cholesterol levels 1

Achieve and maintain a healthy weight through caloric control 1, 3
Combining a healthy diet with weight loss and physical activity can increase HDL cholesterol by 10-13% 3
Weight reduction is particularly important for those with elevated triglycerides and low HDL cholesterol 1

Moderate alcohol consumption may increase HDL cholesterol, but should only be considered if not contraindicated for other health reasons 4
Smoking cessation can increase HDL cholesterol levels by up to 30% 1, 5
Combining multiple lifestyle interventions (diet, exercise, weight loss) produces more significant improvements in HDL cholesterol than any single intervention 6

If lifestyle modifications are insufficient, medications may be considered:
- Niacin (nicotinic acid) is the most effective drug for raising HDL cholesterol, but can affect blood glucose levels 1, 7
- Niacin therapy should start at 500mg at bedtime and can be gradually increased to 1000-2000mg daily 7
- Fibrates can also effectively increase HDL cholesterol levels 1

Women may respond differently than men to exercise interventions for HDL cholesterol, potentially requiring higher exercise volumes 2
For individuals with limited mobility, resistance training progressing from 50% to 75% 1RM in major muscle groups can be incorporated into circuit sessions 1
The combination of aerobic exercise and resistance training may provide enhanced benefits for the overall lipid profile compared to either modality alone 1
Improvements in HDL cholesterol should be viewed as part of an overall strategy to reduce cardiovascular disease risk 3, 4