What are the dietary sources of high-density lipoprotein (HDL) cholesterol?

Dietary Sources of HDL Cholesterol

There are no direct dietary sources of HDL cholesterol, as HDL is produced by the body rather than obtained from food. However, certain dietary patterns and specific foods can help increase HDL cholesterol levels and improve HDL functionality.

Foods That Can Help Increase HDL Levels

• Monounsaturated and polyunsaturated fats can raise HDL cholesterol levels when substituted for saturated fats or carbohydrates in the diet 1, 2
• Omega-3 fatty acids from fish and fish oil can improve HDL functionality and have beneficial effects on triglyceride levels 3, 4
• Olive oil, particularly extra virgin olive oil rich in phenolic compounds, can improve HDL functionality 5
• Moderate alcohol consumption, particularly red wine, has been associated with increased HDL-C levels (approximately 9.2%) 1
• Whole grains, fruits, vegetables, nuts, and legumes as part of an overall healthy dietary pattern can help improve HDL levels 6

Dietary Patterns That Support Healthy HDL Levels

• Mediterranean diet (fish, olive oil, fruits, vegetables, whole grains, legumes/nuts, and moderate alcohol consumption) has been shown to markedly improve HDL functionality 5
• Replacing carbohydrates with unsaturated fats can lead to progressively greater increases in HDL-C (7-12%) 1
• Limiting trans-fatty acids is crucial as they can reduce HDL cholesterol levels 3
• Maintaining a healthy body weight through appropriate caloric intake helps maintain healthy HDL levels 3

Factors That Negatively Impact HDL Levels

• Trans-fatty acids found in partially hydrogenated vegetable oils can increase LDL cholesterol and reduce HDL cholesterol 3
• Added sugars have been associated with decreased HDL-C levels 1
• Very low-fat diets (less than 15% energy as fat) can reduce HDL cholesterol levels 3
• Excess body weight adversely affects HDL cholesterol levels 3
• High carbohydrate diets (greater than 60% of energy), particularly those high in simple sugars, can lead to reduced HDL cholesterol 3

Practical Dietary Recommendations to Improve HDL

• Consume fish, especially oily fish, at least twice a week 3
• Choose monounsaturated fats (olive oil, avocados, nuts) as the predominant form of dietary fat 6, 2
• Limit intake of trans-fatty acids by avoiding foods containing partially hydrogenated vegetable oils 3
• Consume a diet rich in fruits, vegetables, nuts, and whole grains and low in refined grain products 3, 6
• If consuming alcohol, do so in moderation (may have beneficial effects on HDL levels) 3, 1
• Maintain a healthy body weight through appropriate caloric intake and regular physical activity 3

Important Caveats

• While these dietary strategies can help improve HDL levels, the primary focus should be on overall cardiovascular health rather than solely on increasing HDL 7
• The quality and functionality of HDL may be more important than absolute HDL-C levels for cardiovascular protection 5
• Dietary effects on HDL should be considered alongside effects on other lipoproteins (LDL, triglycerides) and overall cardiovascular risk 6
• Individual responses to dietary changes may vary significantly 3, 7