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?

It sounds as though you're doing all the right things, so keep it up! Although you haven't seen results yet, it might encourage you to know that it takes time for the body to adjust to lifestyle changes (and different amounts of time for different people, too).

As for how food figures into the equation, recent research shows that by far the major dietary factor affecting blood cholesterol levels is the type of fats eaten. Mono- and poly-unsaturated fats lower LDL ("bad") cholesterol levels and raise those of HDL ("good"), while saturated and trans fats raise LDL levels. Some foods containing monounsaturated fats are olive oil, nuts, and avocados; foods containing polyunsaturated fats include corn, safflower, and cottonseed oils and fish. So, the short answer to your question is to eat more foods with mono- and poly-unsaturated fats.

Also, it's a good idea to watch the kinds of carbohydrates one eats. Highly processed carbohydrates — think corn-syrupy soda, glazed donuts, and black-and-white cookies — have been associated with elevated triglyceride blood levels and lowered HDL levels, increasing the risk of heart disease. As carbohydrates go, one's heart will be happier with carbohydrates such as fruit, oats, brown rice and other whole grains.

Here's an informational table to aid healthy decision-making at the dinner table.

	Pass On It						Pile It On
	Trans-Saturated			Saturated			Mono-Unsaturated			Poly-Unsaturated
Fats	vegetable shortening; partially hydrogenated vegetable oil, fried foods such as French fries, potato chips, and doughnuts			whole milk, butter, cheese, ice cream, red meat, chocolate, and coconuts			olive oil, peanut oil, canola oil, cashews, peanuts, almonds, and avocados			corn oil, soybean oil, safflower oil, cottonseed oil, and fish
	Highly Processed						Unprocessed
Carbs	foods containing corn syrup (such as soda) or refined sugar (such as sweet breakfast cereals, many bakery items, and hard candy), bread items made with bleached processed flour ("white bread")						fruits, whole wheat bread products, oats, legumes, bran, brown rice, bulgur wheat, barley, whole grain breakfast cereals, couscous

Remember to check out the Related Q&As below as well as the Harvard School of Public Health's Fats and Cholesterol info web page.

Alice

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