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Read on to find ways to boost HDL cholesterol — and the evidence behind them.

1. Start a Regular Exercise Routine and Stick With It

Moderate-intensity aerobic activities include:

• Walking (at least 2.5 miles per hour)
• Water aerobics
• Biking slower than 10 miles per hour

Vigorous-intensity aerobic activities include:

• Running
• Swimming laps
• Vigorous aerobic dancing
• Cycling 10 miles per hour or faster
• Jumping rope
• Hiking uphill

“Exercise is excellent because it may independently raise your HDL but also leads to weight loss, which may account for additional gains in your HDL,” says Haitham Ahmed, MD, MPH, a cardiologist at AdvantageCare Physicians in New York City.

2. Lose and Keep Off Any Extra Pounds

If you’re overweight or obese, losing some weight can help to raise HDL cholesterol. Leah Groppo, RD, CDE, a clinical dietitian at Stanford Health Care in California, says that losing around 7 percent of your total body weight is enough to cause a metabolic shift. But, as Groppo notes, “maintaining weight loss is key.”

Effective weight loss methods include diet, exercise, weight-loss medications such as GLP-1 drugs, and surgery.

3. Quit Smoking

We know that smoking cigarettes can lead to a number of health problems, including lung disease, cancer, and a greater risk of a heart attack. But did you know smoking can also suppress or lower those good cholesterol levels?

“Smoking can reduce HDL cholesterol in many ways, including by inhibiting HDL synthesis in the first place, blocking its maturation, and speeding up its clearance and metabolism,” Dr. Ahmed says. “Quitting smoking can help your HDL synthesis and metabolism to go back to their natural levels so that the HDL can do its job better again.”

If you’re trying to quit smoking, talk to your doctor about the many methods to help you through the process.

4. Include Fatty Fish in Your Diet

“Omega-3 fatty acids, which are the type of fatty acids found in fish, can help increase your HDL cholesterol,” Ahmed says. “Two servings of fatty fish per week, including salmon, mackerel, or albacore tuna, can help you hit your omega-3 goals.” You’ll also get omega-3s from flaxseed, mixed greens, and walnuts.

5. Cut Back on Sugar and Refined Carbohydrates

When trying to reduce added sugar in your diet, Ahmed says, it’s best to slowly replace sugars with fruit and vegetables. He adds, “Also try to avoid trans fats, including fried foods or those prepared with shortening, since these may also reduce HDL.”

6. Cook With Healthy Oils

Groppo agrees. “Coconut oil is best used on the skin,” she says.

7. Eat More Antioxidant-Rich Foods

“Indulge in antioxidant-rich foods to increase HDL cholesterol,” Groppo says. “The more colors that you can get in your diet, the better.”

8. Talk to Your Doctor About Supplements

If all other methods of increasing your HDL cholesterol haven’t been effective, you might think of taking dietary supplements. Still, Ahmed cautions that supplements aimed at raising HDL only do so modestly. Also, supplements have not yet been proven to reduce heart attacks or strokes.

Speak to your doctor before taking any supplements to raise HDL cholesterol, because some supplements come with health risks or may interact with medication.

The Takeaway

• Lifestyle changes such as regular exercise, weight management, and stopping smoking are proven ways to boost HDL cholesterol — the “good” cholesterol — which can reduce your risk of heart disease.
• A diet that is low in refined grains and sugars and that includes fatty fish like salmon, healthy oils, and antioxidant-rich foods can help increase HDL levels.
• If you’re considering taking supplements to raise your HDL, it’s important to consult with your doctor to make sure it’s a safe and effective choice for you.

Additional reporting by Zachary Smith.

Robert F. Kennedy Jr., a leading voice of the Make American Healthy Again (MAHA) movement, was confirmed today by the Senate to serve as secretary of the Department of Health and Human Services (HHS) under the second Trump administration.

As HHS secretary, the nation’s top health job, Kennedy will have the ability to steer the direction of medical research for years to come and influence access to vaccines, drugs, and health insurance.

Here are some key things that might change with Kennedy in charge of HHS.

RFK Jr. Has Been Highly Skeptical of Vaccine Safety

But during the hearings, Kennedy repeatedly said that we need better science to prove vaccines are safe and effective, a position that some public health experts believe could undermine confidence in vaccines that actually have decades of evidence supporting their use.

“Vaccines save millions of lives,” says Stephen Morse, PhD, a professor of epidemiology at Columbia University Irving Medical Center in New York City.

Kennedy’s questions about this fact may lead more people to refuse vaccinations, making outbreaks more likely and increasing disability and deaths from measles, whooping cough, and other vaccine-preventable diseases, Dr. Morse says.

“His greatest damage will be in undermining public trust in vaccines,” says Lawrence Gostin, a professor and the director of the WHO Collaborating Center on Global Health Law at Georgetown University in Washington, DC.

As HHS secretary, Kennedy could influence what childhood vaccines are recommended by the CDC, how new vaccines get approved by the FDA, how much the government spends to research new vaccines, and what vaccines are covered for free by health insurance, Gostin says.

“He is unlikely to revoke vaccine approvals, although he could,” Gostin says. “He is more likely to cherry-pick the data and create distrust in vaccinations.”

Kennedy Wants to End the Chronic Disease Epidemic

Throughout his confirmation hearings, Kennedy expressed concern about how many Americans have unhealthy eating habits that have contributed to a surge in chronic health problems like obesity, heart disease, and diabetes.

“President Trump has asked me to end the chronic disease epidemic and make America healthy again,” Kennedy said during his confirmation hearings.

“No other nation in the world has what we have here,” Kennedy said. “We have the highest chronic disease burden of any country in the world.”

As HHS secretary, Kennedy could encourage changes in how the NIH allocates research funding to favor more spending on common chronic diseases. He could also push for changes to government-funded health plans that put more emphasis on chronic disease prevention and management.

Kennedy would have limited influence on food policy as HHS secretary, however, because dietary guidelines and food assistance programs fall under the Department of Agriculture. He could potentially change what ingredients the FDA allows in processed foods or what nutrition information goes on food labels.

“He could require companies to have more informative food labels and also put warnings on unhealthy foods,” Gostin says.

Kennedy Says He Will Follow Trump’s Directives on Reproductive Healthcare and Abortions

Kennedy didn’t provide a lot of clarity during his confirmation hearings about exactly how he might approach access to abortion.

“I agree with President Trump that every abortion is a tragedy,” Kennedy said. “I serve at the pleasure of the president. I’m going to implement his policies.”

As HHS secretary, Kennedy might be able to impact how the FDA regulates mifepristone.

“While he can revoke approval for mifepristone, I doubt he would do that,” Gostin says. “But he might influence the FDA to limit access to the medication, such as not allowing prescriptions through telemedicine.”

His Plans for Medicare, Medicaid, and the Affordable Care Act Are Unclear

As HHS secretary, Kennedy could play an outsize role in determining how easy it is for people to afford and access care through Medicare, Medicaid, and ACA health plans. He provided few specifics on his plans for these programs during his confirmation hearings.

Medicaid, which is jointly funded by state and federal governments, came up often during Kennedy’s confirmation hearings. Kennedy was critical of Medicaid during his hearings, and said that the program needs an overhaul.

He would also oversee implementation of ACA health plans and could push Congress to eliminate subsidies that make these plans more affordable. In his role as HHS secretary, Kennedy could also change how easy it is to enroll, how hard the government works to promote these plans, and what benefits are covered.

Kennedy could implement coverage changes that increase out-of-pocket costs, Gostin says. For example, “He could influence which vaccines are covered by the ACA cost-free.”

He Has Made Conflicting Statements About Ozempic and Other Weight Loss Drugs

Medicare currently covers the GLP-1 drug Wegovy for people who have both obesity and heart disease and the GLP-1 drugs Ozempic and Mounjaro for diabetes. Kennedy could influence whether these drugs are covered, and whether people with obesity can get them when they don’t have other chronic medical conditions.

In particular, “Eating a well-balanced, Mediterranean-based diet” can help minimize some of the complications from PV, says Stacy Morig, RD, an oncology dietitian with Dartmouth Cancer Center in Lebanon, New Hampshire. Plus, “Making small changes to their diet can also help people feel better overall.”

Here are four things you can do today to shore up your diet.

1. Follow a Mediterranean Style of Eating

2. Try to Eat a Little Bit, As Often As You Can

If you’re struggling with weight loss, try to eat nutritious, high-calorie foods, such as a nutritional supplement or protein-rich snack (think: peanut butter and a banana, full-fat yogurt with fruit and nuts, or cheese and crackers), whenever you’re able. You can also work with a registered dietitian experienced in both nutrition and oncology. Together, you can create a balanced eating plan that gives you the nutrition you need.

3. Pay Attention to Iron Intake

But while many people with an iron deficiency can take an iron supplement or a multivitamin containing iron, people with PV can’t.

“We generally try to avoid supplementing with iron, because that will cause you to make more red blood cells and add fuel to the fire,” says Jacqueline S. Garcia, MD, a medical oncologist at Dana-Farber Cancer Institute in Boston.

4. Focus on Certain Types of Fiber if You Have Gastrointestinal Side Effects

If you are dealing with constipation, Morig recommends dried fruit, vegetables, and whole grains, which provide both insoluble and soluble fibers to encourage bowel movements.

If diet alone isn’t helping, talk to your clinician about stool softeners or laxatives to improve regularity, she adds.

The Takeaway

• A Mediterranean-style diet may help ward off heart complications from polycythemia vera and improve your overall well-being.
• Include more fruits and vegetables, nuts, olive oil, and whole grains in your diet.
• Iron-rich foods, such as spinach and meat, can boost your iron intake and help prevent iron deficiency.
• Work with an oncology dietitian to develop an eating plan for your nutritional needs.

Symptoms such as fatigue, itchy skin, and mental health issues can make it difficult to function, but they can be managed. “This is a chronic condition that people can live with,” says Jacqueline S. Garcia, MD, a medical oncologist at Dana-Farber Cancer Institute in Boston.

Here are some common challenges of living with PV and ways to cope, so you can stay healthy and live well as you manage this condition.

1. Fatigue Can Interfere With Daily Activities

The degree of fatigue can vary from one person to another and depend on age, menopausal status, other health conditions — such as cardiovascular disease or diabetes — and more factors, says Garcia.

Maintaining healthy lifestyle habits may help you feel more energized every day. For instance, Garcia recommends exercising in moderation, as long as you have your doctor’s okay and don’t push yourself if you feel faint.

In addition, Morig recommends eating a well-balanced diet, consuming regular meals throughout the day, managing stress (to the best of your ability), and getting adequate sleep to help reduce fatigue.

2. Itchiness Can Cause Discomfort

3. Regular Blood Draws Can Be a Burden

What to do about it: Regular visits for phlebotomy are not pleasant and can have an impact on every aspect of your life — work, home, social routines — but Garcia notes that the frequency will decrease over time. After initial treatment, your provider will introduce a medication that helps control blood cell counts. This will eventually reduce the need for phlebotomy treatment, potentially to as little as one or two times a year, if PV is managed well.

“The burden decreases. We tailor the frequency based on what the patient’s needs are,” says Garcia.

In the meantime, she says, there are ways you may be able to work with your medical providers to reduce the treatment burden, such as finding a local blood center for the phlebotomy procedure. “There are ways we can do this to avoid interrupting someone’s life too much,” she says. Bottom line: Be honest with your doctor about your barriers to treatment, so they can work with you to find a solution.

4. The Stress of PV Progression and Complications Can Affect Mental Health

PV is a blood cancer, and that word itself can lead to distress. “Anyone with a cancer diagnosis will have an appropriate amount of stress associated with it,” says Garcia. “Our job is to get patients into a controlled situation, so they’re at a much lower risk for disease progression and blood clots.”

Another strategy that may help is talking to your medical team. “Having a good relationship with your clinician can help you live with your disease, as opposed to waiting for something to happen,” says Garcia. “We can get people to have a good life expectancy with adequate support to reduce the anxiety surrounding it,” she says. If you’re experiencing stress, anxiety, or depression that’s affecting your daily life, ask your doctor to refer you to a mental health professional, support group, and other resources.

The Takeaway

• Polycythemia vera is a chronic, rare blood cancer that can be managed with proper treatment.
• Due to symptoms such as fatigue and the possibility of complications and progression, though, the disorder can negatively affect your quality of life.
• With proper treatment and management strategies, PV can be controlled so that symptoms such as anxiety, fatigue, and stress can be reduced and quality of life can be improved.

Diabetes-related excess sweating can also be managed or prevented with good diabetes management.

Monitor Your Glucose Levels

“The most important way to help reduce nerve damage that’s causing the excessive sweating is to understand your glucose levels, especially if they are staying above your personalized target range or goal,” says Shetal Desai Rautela, RDN, CDCES, a diabetes coach in private practice.

If your specific target range isn’t clear for you, book an appointment to see a diabetes healthcare professional. Good blood sugar control protects the nerves and can help prevent perspiration issues.

Adjust Your Diet

“Nutrition can help reduce the symptoms of excessive sweating, and is a cornerstone to lifestyle changes to keep glucose levels in check,” says Rautela.

Avoiding or limiting sugary foods is a must, but you don’t have to give them up entirely. “While occasional desserts to satisfy that sweet tooth is not a concern, frequent consumption can make it harder to manage glucose levels,” she says.

Exercise Regularly

Working out when your body’s sweat glands are already in overdrive may not seem appealing, but it is a great way to improve post-meal glucose levels, says Rautela.

“Try low-to-moderate intensity workouts, and it can be as simple as getting some steps in during the day to break up the work hours,” she says. “All and any steps taken aid in regulating the body temperature and improving glucose levels.”

Manage Stress Levels

To lighten your load, learn how to recognize your stressors and find ways to practice relaxation exercises, such as deep breathing and meditation, or talking to a friend. People with diabetes are significantly more likely to experience mental health conditions such as anxiety and depression. Sessions with a mental health provider should be considered a normal and important part of diabetes management.

The bulk of tea’s immunity-boosting and overall health benefits are tied to a group of antioxidants known as polyphenols. “A significant amount of epidemiological data has shown that a diet rich in polyphenols is protective against chronic health conditions such as cardiovascular disease and type 2 diabetes,” says Megan Meyer, PhD, the Durham, North Carolina–based senior director of science communications for the International Food Information Council. Her past research examined the effects of nutritional antioxidants on the immune system’s response to influenza.

Herbal teas may also support your immune system’s health. “Most herbal teas are known to have health-supporting qualities,” Lee says.

More Research on Tea and Immune System Health Is Needed

While the research on tea and immune system health sounds promising, the studies thus far either haven’t used humans or the population sizes involved were relatively small. Many studies also use tea in capsule or tablet forms, both of which usually pack a far greater dose of plant compounds than you’d find in a tea bag. Given these limitations, it’s tough to know whether a cup of tea will benefit a typical person’s immune system health. More large studies of humans using brewed tea are needed.

That said, health experts generally agree that brewed tea without a sweetener is a healthy beverage choice. “I personally believe that teas are a great way to add functional foods and herbs to your diet on a daily basis,” Lee says. So drink up! And if immune system health is your top concern, you might want to start with this list of the five top teas for a healthy immune system, in order of strongest evidence to weakest.

“While intentional weight loss can be beneficial for health, unintentional weight loss, especially in older adults, may reflect underlying neurodegeneration or other health conditions,” says lead study author Zimu Wu, PhD, a research fellow at Monash University in Australia.

Brain changes that start years before dementia symptoms appear may affect metabolism, appetite, mobility, and daily function, Dr. Wu says. All of these things can lead to unintended weight loss.

“Rather than causing dementia, it may be an early warning sign of dementia” Wu says.

Adults Who Developed Dementia More Likely to Experience Rapid Weight Loss

For the study, researchers followed 5,390 older adults for more than a decade, starting when they were 77 years old on average and free of dementia. All of the participants were cognitively healthy at the start of the study and had multiple tests over time for several dementia risk factors such as body weight, waist circumference, blood pressure, and cholesterol levels.

A total of 1,078 people developed dementia. Compared with people who didn’t develop dementia, those who did had more rapid declines in body weight and waist circumference during the study period, according to findings published in JAMA Network Open.

Along with faster weight loss, dementia patients also experienced a significantly bigger reduction in waist circumference in the decade before their diagnosis than their cognitively healthy peers did over that same time period, the study found.

While obesity in middle age is a risk factor for dementia, it’s not uncommon for people with this condition to have a lower body mass index (BMI) right before their diagnosis than cognitively healthy people the same age, says Mika Kivimaki, PhD, an epidemiology professor at University College London in England, who wasn’t involved in the new study.

“Lower weight does not indicate protection against neurodegeneration if it results from unintended weight loss due to preclinical neurodegeneration,” Dr. Kivimaki says. “However, healthy weight in midlife is protective, reducing the risk of diabetes and vascular diseases, which both are dementia risk factors.”

Cholesterol Levels Also Shifted in the Decade Before Dementia Diagnosis

One other risk factor also appeared to impact dementia risk. People with lower levels of high density lipoprotein (HDL) cholesterol, the good kind that helps keep blood vessels free of debris, were more likely to develop dementia, the study found.

People with lower blood pressure also appeared more likely to develop dementia, although this finding wasn’t statistically significant, meaning it’s possible that this connection was due to chance.

Findings Are ‘Surprising,’ Given Existing Knowledge on Dementia

The study wasn’t designed to prove whether or how any specific risk factors such as declines in body weight or waist circumference might directly cause dementia. It also didn’t examine the underlying causes for weight loss or lower HDL levels.

“The results of this study are surprising,” says Andrew Budson, MD, chief of cognitive behavioral neurology at the VA Boston Healthcare System and associate director of the Boston University Alzheimer’s Disease Research Center.

That’s because a lower body mass index, higher levels of HDL cholesterol, and lower blood pressure can all reduce dementia risk, says Dr. Budson, who wasn’t involved in the new study.

It’s possible that dementia patients in the study were losing weight and dropping their blood pressure because they were sick with some type of chronic illness, Budson says.

“Many illnesses, including but not limited to infectious diseases, increase the risk of dementia,” Budson says. “These are the only reasons that I can see as to why the results should have come out this way.”

How to Maintain Good Cognitive Health

Even so, there are many steps older adults can take to stay cognitively healthy as they age, such as eating a healthy diet, staying physically active, engaging in social and mental activities, managing stress, and maintaining a positive mood, Wu says.

The study findings also suggest that it makes sense to get a checkup if your weight drops and you’re not sure why, Wu adds. “Unexpected weight loss may be an early sign of dementia, so it is important to seek medical advice if it occurs,” Wu says.

Both dietary fiber and sugar alcohols are thought to have little or no impact on blood sugar, which is why those numbers aren’t included in a net carb count.

Fiber

Dietary fiber is a type of carbohydrate that the human body does not digest. It’s considered extremely healthy, and is mainly found in fruit, grains, legumes, and vegetables, especially when they are minimally processed. In theory, it has no impact on blood sugar.

“While fiber may not impact blood sugar directly, the idea for including fiber in meals is to allow for a more blunted response versus a straight spike or rise in blood sugar,” says Kimberlain. “In general, the more fiber a meal contains, the better.”

Sugar Alcohols

• Sorbitol
• Xylitol
• Lactitol
• Mannitol
• Erythritol
• Maltitol

A push by the National Institutes of Health (NIH) to slash funding for “indirect” research costs like lab equipment and computers could delay or end lifesaving medical studies all over the country, scientists say.

“These funds keep the lights on — literally and figuratively,” says Harlan Krumholz, MD, a professor and the director of the Center for Outcomes Research and Evaluation at the Yale University School of Medicine in New Haven, Connecticut.

These funds pay for things like lab space, compliance with regulations, IT infrastructure, administrative support, and expenses required for maintaining a safe and functional research environment, Dr. Krumholz says. Without these funds, research would grind to a halt.

“It would be like giving funding for cars and drivers, but not for the roads. Or for planes and pilots, but not for the FAA [Federal Aviation Administration] or airports,” Krumholz says. “It’s not excess — it’s essential.”

How the NIH Funds Critical Research

Typically, these grants earmark 27 to 28 percent of funds for indirect costs, the NIH said. Some grants, however, set aside more than 60 percent of funds for indirect costs. Going forward, the NIH said it will cap indirect costs at 15 percent of grant funds.

The Courts Have Halted the Cuts — for Now

“Right now, it is causing distraction and despair, in the context of so many attacks on NIH,” says Theodore Iwashyna, MD, PhD, an intensive care doctor and a professor at Johns Hopkins Medicine in Baltimore. “Some of my staff and some younger trainees have asked, ‘Should I be looking for another job?’”

The costs the NIH is trying to cut over cover supplies that can be used on multiple research projects — spending that actually saves money in the long run, Dr. Iwashyna says.

“Computers are indirect costs. They are essential for research, but don’t get used up,” Iwashyna says. “Research office space, lab space, staplers, libraries — all of these are not specific to only a single project, so they are covered under indirect costs.”

If the research cuts are implemented, “it will be devastating,” Iwashyna says. “Cutting indirect costs like this means making lots of research impossible. So my children and grandchildren will be sicker and die sooner, because discoveries will not be made, and the biomed-fueled economy so important in so many places will fall apart.”

Indirect Costs Allow for Efficient Use of Resources

Nora Becker, MD, PhD, an assistant professor of medicine at the University of Michigan in Ann Arbor, studies women’s health, reproductive health, and chronic disease management. She works with massive data sets that can’t be analyzed on a regular computer.

“One option would be for me and everyone who wants to work with similar data to each buy an incredibly expensive high-performance computer,” Dr. Becker says. “But each of those expensive computers would only be usable by one researcher. So instead, my university takes indirect funds from grants and funds a university-wide high-performance server — a shared resource that all faculty and staff can use.”

Sharing resources enables more efficient use of grant funds and enables more research overall to get completed, Becker says.

NIH Funding Has Saved Countless Lives

Many advances in medicine like the ones that have already transformed countless lives will not be possible if the NIH drastically reduces research funding. NIH funds have helped fight everything from cancer and HIV to diabetes and obesity.

“Thirty years ago, HIV was the leading cause of death among men [ages 25 to 44] in the United States,” Becker says. “Now it’s a treatable chronic disease with almost normal life expectancy.”

Cancers that were previously deadly now have effective treatments with excellent survival odds, Becker adds.

As for diabetes and obesity, “When I was a medical student, drugs like Wegovy and Ozempic didn’t exist,” Becker says. “Now they’re first-line treatments.”

NIH funding is the reason the United States is the world leader in scientific and medical innovation and discovery, Becker says. If the NIH goes ahead with slashing grant funds for indirect costs, “research will stop, new discoveries will not be made, and more people will die,” Becker says.

Ankylosing spondylitis is characterized by inflammation in certain joints, mainly the sacroiliac joints (where the spine attaches to the pelvis), the spine, and the hips. This inflammation causes symptoms such as low back pain and stiffness.

Ankylosing spondylitis isn’t the only form of arthritis linked to heart disease, says David Pisetsky, MD, a rheumatologist and professor of medicine at the Duke University School of Medicine in Durham, North Carolina.

“Most rheumatic diseases are associated with increased risk for cardiovascular disease,” Dr. Pisetsky says. “AS, rheumatoid arthritis, psoriasis, and lupus all have inflammatory components, and when the immune system gets inflamed, it may play out in the cardiovascular system as much as the joints.”

• Heart failure
• High blood pressure
• Ischemic stroke

• Coronary heart disease
• Cardiomyopathy
• Heart valve disease

People with ankylosing spondylitis are also more likely to have high cholesterol and high blood sugar (hyperglycemia) and to be overweight or obese — all factors that further increase heart disease risk, says Susan Goodman, MD, a rheumatologist at the Hospital for Special Surgery in New York City.

Costochondritis Pain vs. Heart Attack