One of the most effective ways to prevent heart disease is to maintain healthy blood cholesterol levels. Elevated blood cholesterol can lead to coronary artery disease, heart attack, and stroke.

You can make lifestyle changes to take charge of your heart health. Managing your cholesterol level is a crucial lifestyle change. Other factors include controlling high blood pressure, maintaining a healthy weight (maintaining or achieving your ideal body weight), not smoking, exercising, and controlling diabetes and stress.

If you have several risk factors, such as having diabetes, being overweight, having high blood pressure, smoking, and having a high cholesterol level, they can accumulate and significantly increase your risk of heart disease. Some risk factors are beyond your control, like being a man aged 45 years or older or being a woman aged 55 years or older. Some individuals have a family history of heart disease.

To mitigate these risks, it's essential to know your lipids (LDL, HDL, triglycerides, and coronary risk ratio). Cholesterol-lowering medications are available, but they are not a substitute for exercise and dietary modifications. Lifestyle changes should be the first approach.

Dietary intake high in saturated fat is associated with elevated total blood cholesterol levels and an increased risk of heart disease and other vascular conditions. To simplify, reduce your overall fat intake, with particular attention to saturated fats.

The American Heart Association recommends that fats should constitute no more than 30% of your daily calorie intake, but 25% or even 20% is even better. Of that 20%, very little should come from saturated fat.

• Calculate your daily calorie requirement based on your desired weight. As a rule, multiply your desired weight in pounds by 11 if you have a sedentary lifestyle, 13 if moderately active, and 15 if active. This total gives you your recommended daily calorie count.
• Determine the grams of fat you should consume in a day (see chart). Don't get bogged down by trying to measure saturated and unsaturated fat grams; this information is available on food labels. Focus on the total grams of fat.

Certain foods offer health benefits for controlling cholesterol and overall heart health beyond providing basic nutrition. The International Food Information Council identifies these food choices:

• Broccoli (heart health, blood pressure, cholesterol, cancer)
• Fish or fish oil (heart health, blood pressure, cholesterol)
• Green leafy vegetables (heart health, blood pressure, cholesterol, cancer)
• Oranges or orange juice (heart health, blood pressure, cholesterol, cancer)
• Carrots (heart health, blood pressure, cholesterol, cancer)
• Garlic (heart health)
• Fiber (heart health)
• Oats/oat bran/oatmeal (heart health)

Lowering cholesterol levels should start at the grocery store. Read food labels and purchase foods low in saturated fat and cholesterol (note that dietary cholesterol differs from blood cholesterol).

To assist with grocery shopping, use this shopping list from the National Heart, Lung, and Blood Institute:

• Breads such as whole wheat, rye, pumpernickel, or white
• Soft tortillas, corn or whole wheat
• Hot and cold cereals except granola or muesli
• Rice (white, brown, wild, basmati, or jasmine)
• Grains (bulgur, couscous, quinoa, barley, hominy, millet)
• Fruits: Any fresh, canned, dried, or frozen without added sugar
• Vegetables: Any fresh, frozen, or (low salt) canned without cream or cheese sauce
• Fresh or frozen juices, without added sugar
• Fat-free or 1% milk
• Cheese (with 3 grams of fat or less per serving)
• Low-fat or nonfat yogurt
• Lean cuts of meat (eye of round beef, top round, sirloin, pork tenderloin)
• Lean or extra lean ground beef
• Chicken or turkey, white or light meat (remove skin)
• Fish (most white meat fish is very low in fat, saturated fat, and cholesterol)
• Tuna, light meat canned in water
• Peanut butter, reduced fat
• Eggs, egg whites, egg substitutes
• Low-fat cookies or angel food cake
• Low-fat frozen yogurt, sorbet, sherbet
• Popcorn without butter or oil, pretzels, baked tortilla chips
• Nuts such as walnuts, pecans, and macadamia nuts
• Margarine (soft, diet, tub, or liquid)
• Vegetable oil (canola, olive, corn, peanut, sunflower)
• Non-stick cooking spray
• Sparkling water, tea, lemonade

Regular aerobic exercise helps prevent high blood pressure and raises your HDL (the good) cholesterol level. The minimum recommended is at least 30 minutes a day, as suggested by the Surgeon General and most heart health organizations. More exercise is likely better, but any amount is better than none.

How much exercise?

Walking 2 miles in 30 minutes, three times a week, constitutes a moderate level of aerobic exercise. This can raise your HDL cholesterol by 1 to 3 points (higher is better). More vigorous exercise may not increase your HDL further but will likely lower your LDL cholesterol (lower is better).

If you can't fit in a 30-minute block of exercise at once, do a few minutes of exercise here and there throughout the day (climb the stairs at work, walk around the block on your lunch break, park and walk). The more physical activity you engage in, the better it is for your blood pressure as well.