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PREVENTION
There are things you can do to try to keep your cholesterol levels within healthy ranges. In addition to getting your cholesterol screened regularly (every five years for individuals with no heart disease risk factors), take these steps:
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Be physically active for at least 30 minutes, most days of the week.
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Lose weight if you are overweight.
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Increase your intake of whole grains, with an emphasis on soluble fiber. Eat six or more servings of whole grains per day.
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Increase your intake of poly- and monounsaturated fatty acids and reduce your intake of saturated and trans fats. Choose fats and oils with two grams or less of saturated fat per tablespoon.
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Increase your intake of fruits and vegetables high in antioxidants. Eat five or more servings of fruits and vegetables per day.
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Consume moderate amounts of alcohol, defined as equal to or less than one drink a day for women (and two drinks a day for men).
You might think the key to lowering your blood cholesterol levels is to zero in on the amount of cholesterol in foods. But such an approach addresses only half the problem—and the lesser half at that. Reducing your cholesterol intake does indeed lower your risk of heart disease, but it has less impact on blood cholesterol levels than cutting back on saturated fat.
Saturated fat boosts your blood cholesterol level more than anything else in your diet. Saturated fat is found mainly in food that comes from animals, including whole-milk dairy products such as butter, cheese, milk, cream and ice cream, as well as the fat in meat and poultry skin.
A few vegetable fats—coconut oil, cocoa butter, palm kernel oil and palm oil—are also high in saturated fat. These fats may be found in cookies, crackers, coffee creamers, whipped toppings and snack foods, which also contain trans-fatty acids, another form of fat that acts like saturated fat in the body. It is important to read food labels, which detail total fat, saturated and trans fat levels.
Polyunsaturated fats, such as safflower and corn oil, and monounsaturated fats, such as olive and canola oil, may lower LDL cholesterol levels slightly and raise HDL cholesterol levels. However, don't try to boost your intake of these fats. Instead, concentrate on cutting back fat from all sources but with an eye toward using these "healthier" fats in place of saturated fats.
Omega-3 fatty acids, which are found in oily fish such as salmon and soybean and canola oil, appear to lower blood levels of triglycerides. You may want to add fish to your diet at least twice a week and choose these oils over others. However, because of high levels of mercury and iodine found in fish these days, a daily fish-oil supplement (which is generally cleansed of these toxins) might be a better bet.
Omega-6 fatty acids (such as linoleic acid, found in corn, soybean and safflower oil) may also have cholesterol-lowering effects when they're substituted for saturated fat in the diet.
Psyllium, a fiber supplement, also provides cholesterol-lowering benefits when taken in conjunction with a low-fat, low-cholesterol diet. In twice-daily doses of five grams, psyllium reduced total cholesterol an average of five percent and LDL cholesterol six to seven percent over a period of about six months.
Margarine-like spreads approved as foods by the FDA are available that can lower LDL cholesterol levels 15 to 20 percent. To get this effect, however, you have to up to three grams a day. These spreads include Benacol and Take Control). They both contain plant sterols (also called stanol esters), which work by blocking absorption of cholesterol in the digestive track. Recent studies find that plant sterols lower cholesterol even in patients already on statin medications.
If you don't have high cholesterol or heart disease, you're probably already on the right track when it comes to lifestyle. Be sure to stick with a program that keeps total fat to no more than 35 percent of daily calories, with saturated fat comprising no more than seven percent. You should also engage in regular physical activity (at least 30 minutes a day, most days of the week, every day if possible) to keep your weight in check and possibly lower high cholesterol levels.
If your cholesterol is elevated but you don't have heart disease, develop an action plan in consultation with a health care professional.
You can also call the American Dietetic Association's Consumer Nutrition Hotline at 1-800-366-1655 for more information about dietary strategies for lowering cholesterol and other heart-healthy considerations, or visit the Web sites produced by the American Heart Association and the National Cholesterol Education Program: www.americanheart.org and www.nhlbi.nih.gov.
