HDL cholesterol: the 'good' cholesterol and how to raise it

You raise HDL cholesterol mostly through lifestyle, but the gain is usually modest. Cardio, strength training and quitting smoking can lift your HDL by a few tenths of an mmol/l. More important than a high number: your cholesterol ratio and how well your HDL does its job.

HDL stands for high-density lipoprotein, the particle that carries excess cholesterol out of your artery wall back to your liver. That earned it the nickname 'good' cholesterol.

But that label is too simple. A nice HDL number is no free pass, and as you will read below, more HDL is not automatically better.

What is a healthy HDL value?

A healthy HDL value starts at roughly 1.0 mmol/l for men and around 1.2 mmol/l for women. Higher values are generally seen as more favourable, up to a point. Your HDL is only part of the story: you always read it alongside your LDL, triglycerides and your total ratio.

The values below are general reference points, not hard cut-offs. Your personal context, such as your other blood values and your lifestyle, decides what a number means.

The ratio between total cholesterol and HDL is often more informative than HDL alone. A ratio under 4 is usually seen as favourable, while a ratio above 5 often calls for a closer look together with your GP.

Want to know where HDL fits in the bigger picture? Our guide on cholesterol blood values lays out every fraction side by side.

How do you raise your HDL cholesterol?

You raise your HDL cholesterol mostly with regular cardio, strength training, quitting smoking and healthy fats. The effects are real but modest: a 2007 meta-analysis by Kodama found an average gain of about 0.065 mmol/l from aerobic training. Consistency matters more here than a single hard session.

Aerobic exercise is the best-supported tool. Think running, cycling or swimming, several times a week, long enough to break a sweat.

Strength training also seems to help, especially combined with cardio. For you as an athlete that is good news: you do not have to choose.

Quitting smoking can lift your HDL measurably. Smoking lowers your HDL and damages the artery wall, so you win on two fronts at once.

With food it is mostly about the quality of your fats. Unsaturated fats from fish, nuts and olive oil can shift your profile favourably, while an excess of sugar and alcohol tends to drive up your triglycerides.

My advice: do not chase the HDL number itself. Train consistently, eat clean and use your HDL as one of several data points, not your only goal.

Is a high HDL value always better?

No, a high HDL value is not automatically better. For a long time people thought more HDL always meant more protection, but that turns out to be too simple. Drugs that strongly raised HDL did not lower cardiovascular events in large trials, and very high HDL values sometimes seem to track with more risk instead.

The sharpest evidence comes from the REVEAL trial with anacetrapib, a CETP inhibitor. The drug raised HDL dramatically, yet the clinical benefit you would expect largely failed to appear.

The lesson: HDL is a marker, not a switch you can simply flip. It is not about how much HDL you have, but about how well it performs its transport task.

That is why we prefer to look at your whole profile rather than that one number. An isolated high HDL says little without the rest of your values beside it.

Why the ratio matters more than HDL alone

The cholesterol ratio carries more weight than HDL alone because it sets your 'good' and 'bad' cholesterol against each other. A moderate HDL with a low LDL can be more favourable than a high HDL with a high LDL. That is why doctors look at the ratio between total cholesterol and HDL, plus your triglycerides and non-HDL.

According to the Hartstichting, HDL helps move excess cholesterol out of your artery wall back to the liver, while LDL can leave it inside the wall. So it is the balance between those two streams that counts.

Non-HDL, simply your total cholesterol minus HDL, captures all your risky particles in one number. Many researchers find it a more practical measure than HDL on its own.

A low HDL combined with high triglycerides often points to an unfavourable metabolic pattern. That is why your HDL is best read alongside your triglycerides and your omega-3 index.

Want these values together in one view? The lipid panel measures your total cholesterol, LDL, HDL cholesterol and triglycerides in one go, with a doctor's assessment.

Your next step

Ready to act on this? Do not let your HDL stand alone, but view it alongside your ratio and your triglycerides. Schedule a test in a calm week, compare your values with your previous profile and discuss notable results with your GP before you change anything in your lifestyle or medication.

Bronnen

1. Hartstichting. Goed en slecht cholesterol. Geraadpleegd 2026.
2. HPS3/TIMI55-REVEAL Collaborative Group; Bowman L, Hopewell JC, Chen F, et al. Effects of Anacetrapib in Patients with Atherosclerotic Vascular Disease. N Engl J Med. 2017;377(13):1217-1227. PMID: 28847206.
3. Kodama S, Tanaka S, Saito K, et al. Effect of aerobic exercise training on serum levels of high-density lipoprotein cholesterol: a meta-analysis. Arch Intern Med. 2007;167(10):999-1008. PMID: 17533202.

Disclaimer

Every blood test result includes a professional assessment from a BIG-registered doctor. This article is general information and is not a substitute for medical advice. A blood test is a tool to help you have a better-informed conversation with your GP, not a diagnosis in itself. For treatment decisions, discuss your results with your GP.