Cholesterol

One of the best ways to prevent heart disease is to keep your blood cholesterol at healthy levels. High blood cholesterol can lead to coronary artery disease, heart attack, and stroke.

You can make lifestyle changes to take control of your heart health. Managing your cholesterol level is one such important lifestyle change. Others include controlling high blood pressure, keeping your weight within normal limits (maintaining or re-establishing your ideal body weight), not smoking, exercising, and controlling diabetes and stress.

If you have a number of risk factors, such as having diabetes, being overweight, having high blood pressure, smoking, and having a high cholesterol level, they add up and greatly increase your risk for heart disease. Some risk factors you cannot control, such as being a man aged 45 years or older or being a woman aged 55 years or older. Some people have a family history of heart disease.

Reduce the risks as much as you can, and that includes knowing your lipids (LDL, HDL, triglycerides, and coronary risk ratio). Cholesterol-lowering medications are available, but they are not a substitute for exercise and dietary changes. Lifestyle changes should be employed first.

Dietary intakes high in saturated fat are linked to high total blood cholesterol counts and pose an increased risk for heart disease and other vascular diseases. To simplify the whole issue, reduce all fats in your diet, paying particular attention to saturated fats.

The American Heart Association suggests that fats should represent no more than 30% of all calories you consume in a day, but 25% or 20% is even better. Of that 20%, very little should come from saturated fat.

• Decide how many total calories you need a day to maintain your desired weight. As a rule of thumb, you multiply your desired weight in pounds by 11, if your life is sedentary; 13 if moderately active; and 15 if active. The total gives you your recommended daily calorie count.
• Determine how many grams of fat you should eat in a day (see chart). Don't get distracted by trying to measure the grams of saturated and unsaturated fat (this information is on food labels). Simply focus on total grams of fat.

Certain foods really do have 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)

Lower cholesterol levels should start at the grocery store. Read food labels and buy foods low in saturated fat and low in cholesterol (cholesterol itself is found in some foods, and this type of cholesterol is different from blood cholesterol).

To help you know what to look for when 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. At least 30 minutes a day is the minimum suggested by the Surgeon General and most heart health organizations. The bottom line on exercise is that more is probably better, but some is still better than no

How much exercise ?

Walking 2 miles in 30 minutes 3 times a week constitutes a moderate level of aerobic exercise. That may be enough to raise your HDL cholesterol from 1 to 3 points (higher is better). Exercising more vigorously may not raise your HDL any more, but will likely lower your LDL cholesterol (lower is better).

If you can't get in a 30-minute block of exercise all 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 will be for your blood pressure too.