Making the change to a healthful diet is the first step in lowering cholesterol. Most important: Limit the amount of saturated fat and cholesterol in your diet.
Foods to avoid or limit include:
-- Whole milk, cream, and ice cream
-- Butter, egg yolks, and cheese -- and foods made with them
-- Organ meats, such as liver, sweetbreads, and kidney
-- High-fat processed meats, such as sausage, bologna, salami, and hot dogs
-- Fatty meats that aren't trimmed
-- Duck and goose meat (raised for market)
-- Baked goods made with egg yolks and saturated
-- Fried foods
-- Saturated fats, including coconut oil, palm oil, and palm kernel oil
-- Solid fats, such as shortening, partially hydrogenated margarine, and lard
Follow a Low-Fat Diet
Just as some foods increase cholesterol, others help lower it. Foods you should eat include:
-- Fruits and vegetables: 8 -- 10 daily servings, especially high-fiber items such as beans and peas
-- "Good fat" fish (i.e. salmon): 2 or more servings per week
-- Whole grains: 6 or more daily servings
-- Nuts and seeds: 4 -- 5 servings per week
-- Nonfat and low-fat dairy: 2 -- 3 daily servings
-- Lean meat and poultry without skin: 5 -- 6 ounces daily
-- Unsaturated vegetable oils: including canola, corn, olive, safflower, and soybean oils (but limit the amount of margarines and spreads made from them)
It's not just your grocery list that can influence your cholesterol levels -- your cooking method matters, too.
-- Use a rack to drain fat when you broil, roast, or bake.
-- Broil or grill instead of panfrying.
-- Cut visible fat from meat before cooking, and remove skin from poultry pieces. (If you're roasting a whole chicken or turkey, remove the skin after cooking.)
Make Healthy Substitutions
Try these tips and tricks to lighten up your favorite recipes:
-- Make recipes or egg dishes with egg whites or egg substitutes, not yolks.
-- Instead of regular cheese, use low-fat cottage cheese, part-skim milk mozzarella, and other fat-free or low-fat cheeses.
-- Use vegetable-oil spray to brown or sauté food.
-- Don't bake with drippings; use wine, fruit juice, or marinade.
Portion sizes are notoriously large in America. By balancing your portions, you can help lower your cholesterol and lose weight at the same time.
Serve smaller portions of higher-fat dishes, and serve bigger portions of lower-fat dishes, such as rice, beans, and vegetables.
Flaxseed can help reduce total cholesterol and LDL ("bad") cholesterol levels. Flaxseed oil also contains omega-3 fatty acids, but it doesn't have the beneficial fiber that the seeds have.
Ways to include flaxseed in your diet:
-- Add a tablespoon of ground flaxseed to your hot or cold breakfast cereal.
-- Add a teaspoon of ground flaxseed to mayonnaise or mustard when making a sandwich.
-- Mix a tablespoon of ground flaxseed into an 8-ounce container of yogurt.
-- Bake ground flaxseed into cookies, muffins, breads, and other baked goods.
Load Up on Fiber
Soluble fiber helps lower LDL ("bad") cholesterol by reducing its absorption in the intestines.
Soluble fiber can be found in:
-- fiber supplements
Eat Plant Sterols
"If you use [plant sterols] on a daily basis as directed, you can reduce your cholesterol by up to 10 percent," says Anne Carol Goldberg, M.D., an associate professor of medicine in the division of endocrinology, metabolism, and lipid research at Washington University School of Medicine in St. Louis.
Plant sterols, or phytosterols, are tasteless, odorless substances found in fruits, vegetables, legumes, nuts, seeds, and other plant sources.
When they're incorporated into fat-containing foods such as margarine spreads (i.e. Benecol, Take Control) or yogurt, our bodies can utilize them to lower levels of LDL ("bad") cholesterol. They even work in conjunction with prescription statin drugs.
Get Plenty of Exercise
Studies show that exercising up to three times a week for 30 minutes can reduce LDL cholesterol, elevate HDL ("good") cholesterol, and lower your risk of serious heart complications.
Walking is one of the best ways to get physical activity since it's low-impact and requires little equipment. Here's how to sneak in extra steps:
-- Use the stairs instead of the elevator or escalator.
-- Park farther away from your destination.
-- Walk to your coworker's office or cubicle instead of calling or sending an e-mail.
-- Take your dog out for a stroll.
-- Buy a pedometer to motivate yourself and keep track of your progress.
Get Active Without Sweating
If you think most fitness activities are a chore or you have been out of the gym for a little too long, there are other ways to get in shape.
Some no-sweat exercise ideas include:
-- Marching in place while watching TV.
-- Planting and watering flowers in your garden.
-- Washing your car.
-- Mowing the lawn.
-- Scrubbing the floors.
-- Dusting and vacuuming.
Consider a Prescription
If diet and exercise aren't enough to bring your cholesterol under control, your doctor may prescribe medication.
Statins block the effects of an enzyme that helps produce cholesterol. They also lower LDL cholesterol, lower triglycerides, and boost HDL cholesterol. (Crestor, Lescol, Lipitor, Mevacor, Pravachol, Zocor)
Niacin lowers LDL cholesterol and triglycerides while raising HDL cholesterol. (Niacor, Niaspan, Nicolar)
Bile acid resins stick to cholesterol in the intestines and prevent it from being absorbed. (Colestid, Lo-Cholest, Prevalite, Questran, WelChol)
Ezetimibe decreases the body's cholesterol absorption. When combined with a statin, ezetimibe may enhance the cholesterol-lowering effects. (Zetia)
Fibrates mainly reduce triglycerides and may also increase HDL levels. They have less of an affect on LDL cholesterol than other medications. (Atromid, Lopid, Tricor)
High Cholesterol 101
High cholesterol can cause deposits, or plaque, to form inside the arteries and block blood flow, increasing the risk of a heart attack and stroke.
A blood test is the only way to detect high cholesterol. Everyone older than 20 should get a cholesterol test at least once every five years.
There are two types of cholesterol:
LDL cholesterol: This is "bad" cholesterol. A lower number is linked to a lower heart attack risk.
HDL cholesterol: "Good" cholesterol appears to protect your heart. A higher number is linked to a lower heart attack risk.
Normal: less than 200 mg/dL
Borderline high: 200 -- 239 mg/dL
High: 240 mg/dL and up
Normal: less than 100 mg/dL
Borderline high: 100 -- 129 mg/dL
High: 130 mg/dL and higher
Normal: 60 mg/dL and higher
Borderline low: 40 -- 59 mg/dL
Low: 40 mg/dL and lower
Normal: less than 150 mg/dL
Borderline high: 150 -- 199 mg/dL
High: 200 mg/dL and higher
People at Risk
Cholesterol is a waxy, fatlike substance produced by the liver. It is found in every cell of the body. Some people produce too much cholesterol.
High cholesterol risk factors you cannot control:
Age and gender: As you age, your cholesterol levels rise. After menopause, women's LDL levels tend to rise.
Heredity: High cholesterol can be passed on. If high cholesterol runs in the family, you're at greater risk.
Risk Factors You Can Control
Risk factors for high cholesterol you can control:
Weight: Being overweight can increase cholesterol levels.
Exercise: Regular physical activity can lower LDL and raise HDL.
Type 2 diabetes: High blood glucose increases cholesterol levels and damages the lining of your arteries.
Smoking: Cigarette smoking lowers HDL and increases the likelihood of blood clots.
Medications: Certain medications can increase your cholesterol. Talk to your doctor about any medications you are taking.