The “good” cholesterol is called HDL, which stands for high-density lipoprotein. HDL earns its reputation by absorbing cholesterol from your blood and carrying it back to the liver, which then flushes it from the body. This cleanup process is what makes it protective, and it’s the number your doctor wants to see go up on a cholesterol test.
What HDL Actually Does
Cholesterol doesn’t dissolve in blood, so it travels on protein carriers called lipoproteins. HDL is the densest of these carriers, and its job is essentially waste removal. It picks up excess cholesterol from your artery walls, including from the fatty deposits that can build up and narrow blood vessels over time. Once HDL collects that cholesterol, it delivers the load to your liver, where it’s broken down and excreted. This entire loop is called reverse cholesterol transport.
This process is why HDL is linked to lower heart disease risk. Epidemiological data suggests that each 1 mg/dL increase in HDL is associated with roughly a 2% to 3% reduction in the risk of cardiovascular death. HDL doesn’t just passively float around; it actively pulls cholesterol out of the arterial plaques that cause heart attacks and strokes.
HDL vs. LDL: The Key Difference
LDL, or low-density lipoprotein, is the “bad” cholesterol. It makes up the majority of your body’s cholesterol and deposits it into artery walls, where it can accumulate into plaques. HDL does the opposite: it removes cholesterol from those same walls and sends it to the liver for disposal. Think of LDL as a delivery truck dropping off packages you don’t want, and HDL as the truck hauling them away.
Both show up on a standard lipid panel, the blood test your doctor orders to check your cholesterol. That panel reports four numbers: total cholesterol, LDL, HDL, and triglycerides. It may also calculate your non-HDL cholesterol (total cholesterol minus HDL), which captures all the potentially harmful cholesterol types in a single figure.
Healthy HDL Levels
For both men and women, an HDL level of 60 mg/dL or higher is considered optimal. The thresholds for “low” differ by sex: below 40 mg/dL is considered low for men, while below 50 mg/dL is considered low for women. Low HDL is an independent risk factor for heart disease, meaning it raises your risk even if your LDL is in a healthy range.
Interestingly, more isn’t always better. Recent research has complicated the old assumption that higher HDL is universally protective. Extremely high levels don’t appear to offer additional cardiovascular benefit and, in some populations like people with high blood pressure, may even be associated with increased risk. The sweet spot for most people is that 60 mg/dL and above range, not necessarily the highest number possible.
How to Raise Your HDL
Exercise is the most reliable lifestyle tool for increasing HDL, though the benefit depends on your starting point. People with high triglycerides and low HDL tend to see the most improvement from regular aerobic activity, with studies showing around a 5% increase in HDL levels. Those who already have normal triglycerides may see little change from exercise alone, but the cardiovascular benefits of physical activity extend well beyond cholesterol numbers.
Diet plays a significant role too. The core strategy is swapping the types of fat you eat. Saturated fats (found in full-fat dairy, butter, and fatty meats like sausage and bacon) and trans fats (found in some fried and processed foods) tend to worsen your cholesterol profile. Replacing them with unsaturated fats makes a measurable difference. Olive oil, avocados, and nuts are all sources of monounsaturated fats that support healthier HDL levels. Avocados in particular have been shown to improve both HDL levels and the quality of LDL particles.
Omega-3 fatty acids, found in salmon, mackerel, and other fatty fish, can help raise HDL while also lowering triglycerides. Fiber-rich foods like oatmeal and beans contribute as well. On the flip side, limiting refined carbohydrates and added sugar helps, since excess sugar intake is closely linked to lower HDL and higher triglycerides.
How HDL Is Measured
HDL is measured through a simple blood draw as part of a lipid panel. Most guidelines recommend adults aged 20 and older get a lipid panel at least every four to six years, with more frequent testing if you have risk factors for heart disease. Fasting for 9 to 12 hours before the test is sometimes required, though many labs can now measure HDL accurately without fasting.
When you get your results, look at HDL alongside your other numbers rather than in isolation. A high HDL can partially offset a borderline LDL reading, while a low HDL alongside high LDL or high triglycerides paints a more concerning picture. Your doctor may also calculate the ratio of total cholesterol to HDL, which gives a quick snapshot of overall cardiovascular risk.