Dear Alice,

Despite medication, diet control, and exercise, I still have a ratio problem regarding HDL/LDL. What foods would you suggest to boost HDL, while reducing LDL?

Dear Reader,

It sounds as though you're utilizing all the methods that are typically recommended to help with healthy cholesterol methods, so keep it up! Although it’s unclear how long you’ve been on this regimen, it might be encouraging to know that it takes time for the body to adjust to lifestyle changes (and require different amounts of time for different people, too). Before moving on to nutrients that may improve your cholesterol ratio, it's good idea to have an understanding of how meaningful the cholesterol ratio is to your health.

When it comes to your heart health, there are two sets of cholesterol-related numbers that inform your risk for heart disease. Health care providers often suggest that looking at the numbers that are not associated with high-density lipoproteins (HDL or "good" cholesterol) to assess this risk. This is calculated by subtracting your HDL from your total cholesterol. Having what is referred to as a "non-HDL" cholesterol that is higher than 130 milligrams per deciliter (mg/dL) is indicative of increased risk. Your cholesterol ratio between HDL and LDL (low-density lipoproteins or "bad" cholesterol) is the other set of numbers used to understand disease risk. To calculate this number, your HDL is divided into your total cholesterol. Ideally, what results is a ratio that is lower than 3.5 to 1; higher ratios may denote a higher risk of heart disease.

With that information in mind, it's time to turn the focus to foods! There are a number of nutrients to consider when it comes to cholesterol. In addition to the other tools you mentioned, what you eat can certainly be a part of the cholesterol management puzzle. The good news is that there are many foods that can help you with optimize the ratio of HDL and LDL cholesterol levels. If you haven’t already, you might consider adding these nutrients to your dietary toolbox:

  • Soluble fiber: This type of fiber can reduce the amount of cholesterol your body absorbs into your bloodstream. More specifically, eating five to ten grams a day can help you make strides in lowering your LDL levels as well as your total cholesterol in general. And, great news: there are a lot of foods that are rich in soluble fiber, including oats, whole grains, beans, eggplant, okra, apples, strawberries, and citrus fruits.
  • Healthy fats: With that said, there are a few fats to incorporate in order to reap some cholesterol lowering benefits. First, look for foods that contain mono- and polyunsaturated fats, which can lower your LDL levels. These include vegetable and olive oils, and avocados. Foods containing omega-3 fatty acids are optimal options to add to your plate as well. Nuts, seeds, canola oil, ground flaxseed, and fatty fish (e.g., mackerel, sardines, tuna, and salmon) are good sources of omega-3s and can help improve your HDL/LDL ratio. While it’s recommended that these types of fats be a part of a healthy diet, some sources can be high in calories. As such, it’s good to keep your intake in moderation.
  • Plant sterols and stanols: Typically, you’ll find these added to other foods such as margarine, yogurt, orange juice, granola bars, and even chocolate! While sterols and stanols do not appear to affect HDL or triglyceride levels, they do hinder the body’s ability to absorb cholesterol. It’s been noted that in order to get the benefits from sterols and stanols, you’ll want to see that you’re getting at least two grams of these nutrients daily.
  • Soy products: A daily intake of about 25 grams of soy, such as soy milk or tofu, may help decrease your LDL levels.
  • Whey protein: This protein, found in dairy products, is typically sold as a supplement. When used as directed, it may help lower both LDL and total cholesterol levels.

In addition to some nutrients that you might want to add, there are a few other dietary and lifestyle factors that can do a number of on your cholesterol levels. As you bring balance to your HDL/LDL ratio, you may also want to consider:

  • Limiting saturated fats: The general recommendation regarding these fats in your diet is to limit them to under ten percent of your daily intake. Interestingly, while saturated fat can raise your LDL levels, there is some evidence to suggest that it may lower your triglycerides and provide an uptick in your HDL levels, too.  
  • Avoiding trans fats: These fats can lower your HDL and raise your LDL and triglyceride levels. They are typically found in processed foods and their presence is only required to be denoted in a nutrition label when the food product contains at least one gram per serving. As such, it’s a good idea to take a gander at the nutrition label. If the product lists “partially hydrogenated” oil as an ingredient (no matter the actual trans fat content listed), it may be wise to steer clear.  
  • Drinking in moderation (if you drink alcohol): There is a link between drinking moderately and higher HDL levels. However, it’s good to know that drinking in moderation means having no more than one standard drink per day for women of any age and men over the age of 65. For men under the age of 65, it’s recommended to keep alcohol intake to no more than two standard drinks per day. But there’s also a caveat here: though this link has been established, medical experts do not recommend that you start drinking alcohol to seek out this benefit if you don’t imbibe already!
  • Quitting smoking: If you’re a smoker, kicking the habit can increase HDL levels by up to ten percent. How’s that for a boost!

Again, it may take some time to both incorporate these changes and to see results. For more information on keeping on your cholesterol in mind, take a look at the related Q&As. You might also employ the assistance of your health care provider or a registered dietitian to further explore how to build a diet that's supportive of your health goals.

Alice!

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