Thanks to powerful cholesterol-lowering statin drugs, driving down low-density lipoprotein (LDL), or “bad” cholesterol, has been the primary approach to improving cholesterol levels. But there’s more to the story of cholesterol and cardiovascular risk than LDL alone. Another key player is high-density lipoprotein (HDL), the “good” cholesterol. Higher levels of HDL are associated with lower cardiovascular risk. The good news about this good cholesterol is that simple lifestyle changes can help boost HDL, reports the June 2008 issue of Harvard Women’s Health Watch.

HDL removes LDL from artery walls and ferries it to the liver for processing or removal. HDL also fights potentially dangerous inflammation and clot formation. According to a recent review of research on HDL, there’s some evidence that increasing HDL can reduce the risk of heart attack and stroke – even without changes in LDL. Even a small increase in HDL cholesterol can benefit your heart and blood vessels.

Harvard Women’s Health Watch suggests several things people can do to boost HDL levels. Most of these strategies also improve health in other ways.

1. Get aerobic exercise. Moderate to vigorous aerobic exercise can boost HDL by 5% to 10%. Aim for five 30-minute sessions per week.

2. Lose weight if you need to. If you’re overweight or obese, you can boost your HDL level by about 1 mg/dL for every seven pounds lost, although any amount of weight loss will help.

3. If you smoke, quit. HDL levels rise by as much as 15% to 20% after you quit.

4. Eat a healthy diet. Specifically, avoid trans fats, which increase bad cholesterol, decrease good cholesterol, and counteract some of the health benefits of omega-3 fatty acids. Avoid highly refined carbohydrates, such as white-flour products. Include nuts in your diet. Some supplements such as fish oil or curcumin may modestly benefit your HDL, but more research is needed. (Any increase in HDL from moderate alcohol intake may not actually be increasing the HDL fraction that is beneficial to the heart, so alcohol is not recommended as an HDL boosting strategy).

5. Consider medications. Niacin, one of the B-vitamins available over the counter, is the most effective HDL-raising medication available. Niacin in higher doses can be strong medicine. There is a chance it can cause some problems with your liver when taken in mega doses, so work with your clinician if you want to try it (Newswise).