We’ve all heard of someone having “high cholesterol,” and your doctor may have even told you that yours is high. Most of us would agree that it’s a bad thing, but few really know what cholesterol is or how to combat unhealthy levels.

Cholesterol is a fat-like substance that your body actually needs a small amount of in order to function normally. However, if you have too much of it in your bloodstream, the extra amounts may be deposited in your coronary arteries where it can lead to the narrowing and blockages that cause the signs and symptoms of heart disease.

In some cases, certain prescription medication can cause elevated cholesterol levels, but for the most part, inherited risk factors, a sedentary lifestyle and an unhealthy diet are the main causes:

• Weight: Excess weight may modestly increase your LDL (bad) cholesterol level. If you are overweight and have a high LDL cholesterol level, losing weight may help you lower it. Weight loss especially helps to lower triglycerides and raise HDL (good) cholesterol levels.
• Physical activity/exercise: Regular physical activity may lower triglycerides and raise HDL cholesterol levels.
• Mental Stress: Several studies have shown that stress raises blood cholesterol levels over the long term. One way that stress may do this is by affecting your habits. For example, when some people are under stress, they console themselves by eating fatty foods. The saturated fat and cholesterol in these foods contribute to higher levels of blood cholesterol.
Not sure whether you are at risk? If your doctor doesn’t automatically test you, request a lipid panel or profile (i.e. cholesterol test) during your annual physical. Here are the general guidelines for interpreting the results:

Total Cholesterol
Below 200 mg/dL Desirable
200 – 239 mg/dL Borderline high
240 mg/dL High

LDL Cholesterol
Below 70 mg/dL Optimal for people at very high risk of heart disease
Below 100 mg/dL Optimal for people at risk of heart disease
100 – 129 mg/dL Near optimal
130 – 159 mg/dL Borderline high
160 – 189 mg/dL High
190 mg/dL and above Very high

HDL Cholesterol
Below 40 mg/dL Poor
40 – 59 mg/dL Better
60 mg/dL and above Best

Below 150 mg/dL Desirable
150 – 199 mg/dL Borderline high
200 – 499 mg/dL High
500 or above Very high

In order to promote healthy cholesterol levels, follow these four steps:
1. Lose excess pounds
Excess weight contributes to high cholesterol. Losing even 5 to 10 pounds of excess weight can help lower total cholesterol levels. Start by taking an honest look at your eating habits and daily routine. Consider your challenges to weight loss — and ways to overcome them.

2. Eat heart-healthy foods
What you eat has a direct impact on your cholesterol level. In fact, researchers say a diet rich in fiber and other cholesterol-lowering foods may help lower cholesterol as much as medication for some people.

• Choose healthier fats. Saturated fat and trans fat raise your total cholesterol and LDL cholesterol. Get no more than 10 percent of your daily calories from saturated fat, and try to avoid trans fat completely. Monounsaturated fat – found in olive, peanut and canola oils – is a healthier option. Almonds and walnuts are other sources of healthy fat.

• Limit your cholesterol intake. Aim for no more than 300 milligrams (mg) of cholesterol a day — or less than 200 mg if you have heart disease. The most concentrated sources of cholesterol include organ meats, egg yolks and whole milk products. Use lean cuts of meat, egg substitutes and skim milk instead.

• Select whole grains. Various nutrients found in whole grains promote heart health. Choose whole-grain breads, whole-wheat pasta, whole-wheat flour and brown rice. Oatmeal and oat bran are other good choices.

• Stock up on fruits and vegetables. Fruits and vegetables are rich in dietary fiber, which can help lower cholesterol. Snack on seasonal fruits. Experiment with veggie-based casseroles, soups and stir-fries.

• Eat heart-healthy fish. Some types of fish — such as cod, tuna and halibut — have less total fat, saturated fat and cholesterol than do meat and poultry. Salmon, mackerel and herring are rich in omega-3 fatty acids, which help promote heart health.

• Drink alcohol only in moderation. In some studies, moderate use of alcohol has been linked with higher levels of HDL cholesterol — but the benefits aren’t strong enough to recommend alcohol for anyone who doesn’t drink already. If you choose to drink, do so in moderation. This means no more than one drink a day for women, and one to two drinks a day for men.

3. Exercise regularly
Regular exercise can help improve your cholesterol levels. With your doctor’s permission, work up to 30 to 60 minutes of exercise a day. Take a brisk daily walk. Ride your bike. Swim laps. To maintain your motivation, keep it fun. Find an exercise buddy, join an exercise group or hire a personal trainer.

4. Don’t smoke

If you smoke, stop. Quitting can improve your HDL cholesterol level. And the benefits don’t end there. Just 20 minutes after quitting, your blood pressure decreases. Within 24 hours, your risk of a heart attack decreases. Within one year, your risk of heart disease is half that of a smoker’s. Within 15 years, your risk of heart disease is similar to that of someone who’s never smoked.

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