Foods and Dietary Patterns That Increase HDL Cholesterol
No specific foods are "rich in HDL" because HDL is a lipoprotein made by your body, not a nutrient found in food—however, certain dietary patterns and foods can increase your body's production of HDL cholesterol, with the most effective approach being weight loss combined with increased physical activity and specific dietary modifications. 1, 2
Critical Clarification About HDL and Diet
The question contains a fundamental misconception: HDL (high-density lipoprotein) is not a food component but rather a particle your body produces. 1 The American Heart Association guidelines explicitly state that it has not been conclusively demonstrated that increases in HDL cholesterol levels induced by diet and lifestyle modifications lead to reduced coronary disease risk, making HDL a less certain target for dietary therapy compared to LDL reduction. 1
Most Effective Dietary Strategies to Raise HDL
Weight Loss and Physical Activity (Primary Interventions)
- Reducing adiposity and increasing physical activity are of particular importance for individuals with low HDL cholesterol, as these are the most evidence-based approaches. 1
- Combining a healthy diet with weight loss and physical activity can increase HDL-C by 10% to 13%. 2
Specific Foods That Improve HDL Function and Levels
Mediterranean Diet Components (Strongest Evidence):
- Extra virgin olive oil: Increases in virgin olive oil consumption (10 g/day) are associated with increments in cholesterol efflux capacity (+0.7%). 3
- Nuts: Increases in nut intake (30 g/day) are linked to increments in paraoxonase-1 activity (+12.2%), which improves HDL functionality. 3
- Fish: Fish consumption increments (25 g/day) are associated with increases in paraoxonase-1 activity (+3.9%). 3
- Legumes: Increases in legume intake (25 g/day) are linked to increments in paraoxonase-1 activity (+11.7%) and decreases in cholesteryl ester transfer protein activity (-4.8%). 3
- Whole grains: Increases in whole grain consumption (25 g/day) are associated with increments in cholesterol efflux capacity (+0.6%). 3
Dietary Fat Quality:
- A diet low in saturated fat (7-10% of calories) but sufficient in unsaturated fat (15-20% of calories) increases HDL-C. 2
- Moderate alcohol consumption (if not contraindicated) can increase HDL levels. 2
Alternative Dietary Patterns:
- Low-carbohydrate diets raise HDL cholesterol levels by approximately 10%. 4
- The DASH diet raises HDL by 21% to 33%. 4
- Soy protein with isoflavones raises HDL by 3%. 4
Important Caveats About Dietary Approaches
Avoid These Dietary Patterns:
- Low-fat, high-carbohydrate diets can reduce HDL cholesterol levels, particularly when carbohydrates are derived from sugars rather than unprocessed grains. 1
- The reduction in HDL may be more evident with diets high in sugars than in diets where carbohydrate is derived from unprocessed grains. 1
Trans Fats Lower HDL:
- Trans-unsaturated fatty acids can reduce HDL cholesterol and should be limited. 1
- Trans fats are found in prepared foods containing partially hydrogenated vegetable oils (cookies, crackers, baked goods, commercially prepared fried foods, some margarines). 1
Practical Clinical Algorithm
For patients with low HDL cholesterol:
First-line approach: Initiate weight reduction program and increase physical activity (most evidence-based). 1, 2
Dietary modifications:
Eliminate trans fats from partially hydrogenated oils. 1
Consider low-carbohydrate approach if Mediterranean diet is not feasible or effective, as this raises HDL by approximately 10%. 4
Smoking cessation if applicable (not food-related but critical for HDL). 2
Common Pitfall to Avoid
Do not recommend very low-fat diets (<15% of energy) for patients with low HDL, as these can paradoxically lower HDL cholesterol levels, particularly when carbohydrates replace fat. 1 When coupling weight management efforts with dietary changes in patients with low HDL, it may be prudent to limit carbohydrate intake rather than fat intake. 1