We hear a lot about lowering total and LDL-C (bad) cholesterol, but less about raising the HDL-C (good) cholesterol. Having a higher than average HDL-C does not negate the adverse effects of an elevated LDL-C, but in terms of heart disease risk, the higher the HDL-C, the better. HDL cholesterol provides benefit by removing excess cholesterol, a process known as "reverse cholesterol transport". HDL-C transports "bad" cholesterol to the liver where it is removed from the blood stream and thus kept from being deposited into the walls of the coronary arteries. The National Cholesterol Education Program defines a low (unhealthy) HDL-C level as being below 40 mg/dL. In women, however, the HDL-C is considered to be low when it is below 50 mg/dL. Even in people with normal Total and LDL cholesterol levels, having a HDL-C below these levels above results in an increased risk of coronary artery disease. Raising HDL-C levels can be more difficult to achieve than lowering LDL-C, perhaps due to the major contribution offered by difficult-to-achieve lifestyle changes. Here are ways you can improve your HDL-C level: Get aerobic exercise: Getting regular aerobic exercise (jogging, swimming, biking, etc.) is one of the most important factors in raising HDL cholesterol levels. Information from the Cooper Aerobics Centers indicates that in healthy, sedentary people, 30 minutes of aerobic exercise 3 to 5 days a week can raise the HDL-C level by 3 to 9 percent. Lose weight: Not only does being overweight result in an increased LDL-C, but it can also be responsible for a reduced HDL-C. Up to a point, every 1 kilogram (2.2 pounds) of weight loss will result in an increase in HDL-C by an average of 0.35 mg/dl. Thus, a 22 pound weight loss in an overweight individual could raise the HDL-C level by 3.5 mg/dl. Stop smoking: Amazingly, if you quit smoking, your HDL-C can increase up to 15 percent to 20 percent. This exceeds the benefits discussed later from most of the medications used to raise HDL-C. Eat right: Removing saturated fats and trans fatty acids, from the diet will not only decrease LDL-C levels but it can also raise HDL-C levels. Saturated fats come primarily from animal sources, whereas trans fatty acids are produced when unsaturated vegetable fats are subjected to the process of hydrogenation. Instead of these, it is better to use unsaturated vegetable oils (canola, peanut, olive, flax, corn, safflower and sunflower) that are heart healthy. Drink alcohol in moderation: Moderate alcohol consumption (the equivalent of 1 1/2 oz. of alcohol per day) has been shown to significantly increase HDL-C levels. Because of the potential dangers of alcohol, however, an advisory panel of the American Medical Association has chosen to exclude alcohol consumption as a measure to reduce heart disease risk. This has created a dilemma in that despite well performed studies demonstrating that men who consume alcohol at least three to four days per week have a significantly reduced risk of myocardial infarction, it is not thought to be appropriate for physicians to recommend this measure to prevent heart disease. Take medications (when lifestyle measures fail): Primarily because of hereditary factors, some people may not be able to raise their HDL-C level adequately through lifestyle measures. In these people drug therapy may be required if additional elevation of HDL-C is deemed necessary. Several medications are capable of raising HDL-C levels, although in general they are less successful than the ones developed to reduce LDL cholesterol. Niacin, also known as Vitamin B3, is the most potent drug currently available for raising HDL-C levels, with studies demonstrating a 20 percent to 35 percent increase in those taking this medication. A class of cholesterol-lowering medications known as fibrates (gemfibrozil, fenofibrate) has been shown to raise HDL-C by 10 percent to 25 percent. Statins (Levacor, Zocor, Lipitor, Crestor, etc.), the most common class of medication used to lower total and LDL cholesterol, can increase HDL-C anywhere from 2 percent to 15 percent. Fish oil supplements enriched with omega-3 fatty acids have also been shown to raise HDL cholesterol levels. HDL-C is the "good" cholesterol because of the benefits that it exerts on the cardiovascular system. Raising HDL-C can be challenging, but through careful attention to lifestyle measures, and if necessary, appropriate medications, your risk of cardiovascular disease can be reduced.