What dietary sources can raise high‑density lipoprotein (HDL) cholesterol?

Dietary Sources to Raise HDL Cholesterol

To raise HDL cholesterol through diet, prioritize replacing saturated fats with unsaturated fats (particularly monounsaturated and polyunsaturated fats), maintain adequate total fat intake (avoiding very low-fat diets), engage in regular physical activity, achieve healthy weight, and consider moderate alcohol consumption if appropriate. 1, 2

Primary Dietary Strategy: Fat Quality Over Fat Restriction

The most effective dietary approach to raising HDL cholesterol involves replacing carbohydrates and saturated fats with unsaturated fats rather than simply reducing total fat intake. 3, 4

Specific Fat Recommendations:

• Monounsaturated fats (15-20% of calories) raise HDL cholesterol without lowering it, unlike some other interventions 1, 4

  • Sources: olive oil, canola oil, avocados, nuts (almonds, cashews, pecans)
  • These fats reduce LDL cholesterol while preserving or increasing HDL cholesterol 4

• Polyunsaturated fats also support HDL levels when replacing saturated fats 1, 2

  • Omega-3 fatty acids from fish show particular benefits to HDL function 5
  • Sources: fatty fish (salmon, mackerel, sardines), walnuts, flaxseed

• Avoid very low-fat, high-carbohydrate diets (>60% carbohydrate), as these can reduce HDL cholesterol and raise triglycerides 3

Critical Dietary Factors That Lower HDL (Avoid These):

• Trans fatty acids lower HDL cholesterol significantly—the only fat type that does this 3, 6

  • Avoid partially hydrogenated oils in commercially baked goods and fried foods 3
  • Limit to <1% of total energy intake 3

• High carbohydrate intake (especially refined carbohydrates and added sugars) can lower HDL cholesterol 3, 2

  • Replace refined grains with whole grains 7
  • Limit added sugars, particularly fructose 3, 2

Lifestyle Interventions Beyond Diet:

• Weight loss enhances HDL-raising effects of dietary changes 7, 1

  • Even modest weight loss improves HDL before reaching ideal body weight 7

• Regular physical activity is one of the most effective HDL-raising interventions 1

• Moderate alcohol consumption (if appropriate for the individual) increases HDL cholesterol by approximately 9% 2

  • This must be balanced against other health risks and is not recommended for everyone

• Smoking cessation improves HDL cholesterol levels 1

Expected Outcomes:

Combining a healthy diet with weight loss and physical activity can increase HDL cholesterol by 10-13% 1. When monounsaturated or polyunsaturated fats replace saturated fats, HDL increases by 7-12% depending on the specific fat substitution 2.

Important Caveats:

The relationship between dietary changes, HDL cholesterol levels, and cardiovascular outcomes is complex. While HDL cholesterol levels are inversely associated with coronary heart disease risk, the benefit of raising HDL through diet cannot be attributed solely to HDL changes, as dietary modifications have multiple pleiotropic effects on cardiovascular risk factors 2. Focus on overall dietary pattern quality rather than isolated HDL changes 5.

Antioxidant-rich dietary patterns (Mediterranean-style diets rich in vegetables, fruits, whole grains, fish, and olive oil) improve HDL function beyond just raising HDL levels 5. This functional improvement may be more important than absolute HDL cholesterol numbers.