HDL Cholesterol | Everything You Need to Know

September 26, 2019

When it comes to cholesterol, the “bad” kind, or low-density lipoprotein (“LDL”) cholesterol, tends to get most of the attention. And, it makes sense – after all, high LDL cholesterol can lead to a number of serious health issues, including an elevated risk for heart attack and stroke. Yet, the “good” cholesterol or high-density lipoprotein (“HDL”) is also an important measure of heart health.

Find out what you should know about the causes, optimal levels, and methods for achieving optimal HDL cholesterol below.

What Is HDL Cholesterol?

Computer keyboard with green HDL Cholesterol button

Cholesterol is a waxy protein found in all of the cells. It has many important functions, including the ability to build the body’s cells, and plays a crucial role in the development of hormones and vitamin D.

LDL or “bad” cholesterol can eventually accumulate within blood vessel walls, and narrow passageways, potentially leading to a clot that can cause a heart attack or stroke. HDL cholesterol, on the other hand, eliminates excess cholesterol in the blood by picking it up and transporting it back to the liver. There, the excess cholesterol is broken down and removed from the body.

People with higher levels of HDL cholesterol have a lower risk of heart attack and stroke. [1] Having high HDL can have anti-inflammatory and antioxidant effects. [2] Yet, because elevated LDL levels are known to pose a risk for serious health issues, doctors will often focus on LDL levels first. With that said, there is a significant overlap among lifestyle recommendations for lowering LDL cholesterol and raising HDL cholesterol.

Optimal HDL cholesterol levels vary by age and sex. In general, the recommendations for healthy HDL levels are as follows:

  • Ages 19 or younger: >45 mg/dl
  • Men age 20 or older: >40 mg/dl
  • Women age 20 or older: >50 mg/dl [3]

What Causes Low HDL Cholesterol?

Junk food on one side, chips, candy, burger and fries, and healthy food on the other, tomatoes, lettuce, grapes, apple. A poor diet causes lower HDL cholesterol levels.

There are a number of factors that can affect HDL levels. Some of these factors are within your control to address, while others are not. Here are some of the most common causes behind low HDL:

  • Uncontrolled diabetes: Too much glucose in the blood, a common characteristic of diabetes, can lower your HDL levels, while also increasing LDL and triglyceride levels. Lifestyle modifications and medications can help people with diabetes control their blood sugar levels.
  • Inactivity: A sedentary lifestyle could contribute to low HDL levels, along with many other health issues.
  • Poor diet: There are many foods that can affect cholesterol levels. Processed foods prepared with shortening, including cakes and cookies, as well as fried foods, often contain trans fats. These harmful substances can reduce your good cholesterol and raise bad cholesterol levels.
  • Being overweight: In addition to diet and physical activity, being overweight in itself can also impact HDL. Low HDL levels could be caused by carrying excess weight, especially if it’s concentrated on the waist area. [4]
  • Smoking: Smoking and secondhand smoke can cause HDL levels to drop. [5]
  • Certain medications: Blood pressure medications such as beta-blockers, certain anabolic steroids and progestins, and benzodiazepines (sedatives used to treat anxiety and insomnia) could lower HDL levels in certain individuals. [6]
  • Genetic factors: In some cases, extremely low HDL levels could be passed down by family members. In specific, significantly low HDL levels may be attributed to Tangier’s disease and hypoalphalipoproteinemia.

How Can You Raise Your HDL Cholesterol?

Muscular middle-aged man in blue tank in kitchen cutting up a chicken breast, who has high levels of HDL cholesterol

While there are medications available to help individuals control their cholesterol levels when clinically indicated, there are also many lifestyle habits you can adopt to raise your HDL levels. Here are some of the most impactful changes you can make to boost your HDL:

  • Following a Healthy Diet: While eliminating processed foods containing trans fats is a good place to start, people with low HDL cholesterol can also benefit from eating a rich blend of vegetables, fruits, and lean protein. In addition to controlling cholesterol, this eating style can also help to address high blood pressure and reduce the risk of heart disease. Eliminating foods with added sugars is another dietary habit to adopt for better overall health. [7]
  • Increasing Activity Levels: Regular exercise is an important way to increase HDL levels. In fact, you may witness benefits with just 60 minutes a week of moderate-intensity aerobic exercise. [8] Because each individual’s physical fitness needs can vary, however, it’s a good idea to consult with a professional to develop an exercise plan tailored to your needs and health goals.
  • Losing Weight: Exercising regularly and eating well will help you control your cholesterol, with the added benefit of allowing you to enjoy a healthy weight over the long term. And, because a higher waist circumference is associated with lower HDL levels, controlling your weight is important to keeping cholesterol levels in check.
  • Quitting Smoking: If you smoke, develop a plan to quit. In addition to reducing good cholesterol, especially in women, smoking can also cause triglycerides and LDL levels to spike. [9]
  • Controlling Alcohol Consumption: Up to one drink a day for women and two drinks a day for men 65 and younger has been linked to higher HDL levels, so if you normally drink more than this, be sure to limit your consumption. Excess alcohol could lead to weight gain, high blood pressure, and elevated triglyceride levels, so don’t start if you don’t drink already. [10]

How To Improve Your Good Cholesterol – In Conclusion

Although low HDL levels are a health concern that should be addressed, there are many practical ways to raise them. From exercising regularly to enhancing your diet to minimize processed foods and prioritize heart-healthy choices, the lifestyle habits you use to achieve healthier cholesterol levels will also lead you to greater overall wellness.

And, with the help of the Cenegenics team who can offer tailored recommendations based on your comprehensive health evaluation, you can have peace of mind in knowing you’re making the best choices to optimize your cholesterol levels and your health.

To learn more about both the bad and good types of cholesterol and how they affect your health, read our full-length blog – Causes of High Cholesterol.

Next Steps in Maintaining Healthy Cholesterol Levels

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Key Resources

This guide was produced with contributions from the following key resources:

The Textbook of Age Management Medicine V1 for nutrition, mastering healthy aging, exercise and hormone replacement therapy

The Cenegenics Education and Research Foundation  

The Textbook of Age Management Medicine Volume 1: Mastering Healthy Aging Nutrition, Exercise and Hormone Replacement Therapy

Click to purchase

The Textbook of Age Management Medicine V2 for nutrition, mastering healthy aging, exercise and hormone replacement therapy

The Cenegenics Education and Research Foundation  

The Textbook of Age Management Medicine Volume 2: Mastering Healthy Aging Nutrition, Exercise and Hormone Replacement Therapy

Click to purchase

Textbook Authors:

Jeffrey Park Leake, M.D., CPT

Dr. Jeffrey Park Leake is a Partner and Director of Education at Cenegenics Elite Health specializing in age management and wellness. Having trained hundreds of physicians worldwide, Dr. Leake is also the Director of Education for the Clinical Strategies for Healthy Aging course at AMM Educational Foundation.


Todd David Greenberg, M.D., CSCS

Dr. Todd Greenberg is a practicing physician with a broad range of expertise, including wellness, exercise, sports injuries, and MRI of sports injuries. He is a Radiology Clinical Associate Professor at the University of Washington.

Additional Resources

What Are Processed Foods & Why Are They Dangerous?

4 Dos and Don’ts for Eating Healthy While Traveling

Healthy Snacks to Get You Through the Day

The Role of Vitamins and Minerals as Micronutrients

How Cenegenics Programs Differ from a Typical Weight Loss Program

Why Am I Gaining Weight: Psychology of Weight Loss

Tired of Being One In Every Three Adults Who Are Overweight in the U.S.?  Here’s How Cenegenics Can Help

Recognizing Your Risk Factors of Type 2 Diabetes


[1] Mayo Clinic, “HDL cholesterol: How to boost your ‘good’ cholesterol.” 24 Oct. 2018. Retrieved from URL: https://www.mayoclinic.org/diseases-conditions/high-blood-cholesterol/in-depth/hdl-cholesterol/art-20046388

[2] K Mahdy Ali, et al. “Cardiovascular disease risk reduction by raising HDL cholesterol – current therapies and future opportunities.” British Journal of Pharmacology. Nov. 2012. Retrieved from URL: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3504986/

[3] NIH, “HDL: The ‘Good’ Cholesterol.” 18 Apr. 2019. Retrieved from URL: https://medlineplus.gov/hdlthegoodcholesterol.html

[4] NIH; see above.

[5] NIH; see above.

[6] NIH; see above.

[7] NIH, “DASH Eating Plan.” 25 Apr. 2018. Retrieved from URL: https://medlineplus.gov/dasheatingplan.html

[8] Mayo Clinic; see above.

[9] Mayo Clinic; see above.

[10] Mayo Clinic; see above.

Contributor: Rudy Inaba Vice President of Health Performance

Rudy Inaba is Cenegenics’ Vice President of Health Performance. He is a recognized fitness and sports nutrition consultant with nearly 15 years of experience in clinical exercise physiology and lifestyle management. After pursuing his Master of Science in Clinical Exercise Physiology at the University of Nevada Las Vegas, Rudy joined Cenegenics where he leads 19 clinical locations nationwide in their advancements in kinesiology, nutritional biochemistry, and their analyses of industry research & market trending.

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