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10 Ways to Lower Cholesterol
The Ten Commandments of Cholesterol Control
What to do if your cholesterol levels are high
You've been diagnosed with high cholesterol. Now what? It's a perfectly valid question, the same one facing
millions of Americans at this very moment. Your doctor has probably recommended dietary changes, perhaps
more exercise, maybe even medication. But you know you can do more. You're just not sure what, or when, or
how. That's why we've created the Ten Commandments of Cholesterol Control. They're the basic steps anyone
can follow, no matter what their current cholesterol profile, to get the numbers they want. Some of the
commandments may seem more important to you than others, depending on your current health status. For
now, feel free to focus on those most relevant to your situation. You can return to the others later; at the very
least, they'll help you stay informed and inspired as you wage your own cholesterol war. Just remember that by
adopting all ten commandments, you establish a solid foundation for lifelong cholesterol control. They'll support
whatever treatment plan you ultimately choose to follow. There's no better time to get started than now!
1. Know Where You Stand
You've heard the old saying about no news being good news? Well, it doesn't apply to cholesterol. Getting it
checked on a regular basis is essential to your long-term good health. After all, high cholesterol has been
linked to cardiovascular disease, the number one cause of death in the United States. In fact, according to the
American Heart Association, people who have a total cholesterol of 240 mg/dL (milligrams per deciliter) are
twice as likely to experience a heart attack as people who have a cholesterol level of 200 mg/dL. Knowing your
level, and tracking it as you begin treatment, just makes sense. In a nutshell, all adults age 20 and over should
have their cholesterol checked at least once every 5 years as recommended by the National Heart, Lung, and
Blood Institute of the National Institutes of Health. You may require more frequent screening if you have certain
risk factors for heart disease or if your test results are cause for concern.
Generally, doctors like to see total cholesterol below 200 mg/dL, with LDL (bad cholesterol) below 130--the high
end of the "near-optimal" range--and HDL (good cholesterol) above 40. If your test results aren't consistent with
these levels, your doctor may recommend a retest. If they're still not where they should be, your doctor may want
to discuss treatment options. The truly good news is that in many cases, cholesterol is easily managed, even
without medication. But you need to know your starting point, and you need to monitor your progress toward
healthy levels. Even for those whose cholesterol is within the range considered normal, knocking a few points
off their readings can slow fatty buildup in the arteries and possibly reduce any buildup that's already there. The
bottom line: In the pursuit of cholesterol control, knowing your numbers is an absolute necessity.
2. Learn All You Can
Once you've been diagnosed with high cholesterol, your instinct may be to jump right into whatever treatment
plan your doctor recommends. Unless your cholesterol has gone through the roof, which may require
immediate intervention, you're better off taking time to think through your situation and your treatment options. By
exercising some control up front, you're more likely to develop a cholesterol management plan you can truly live
with. Perhaps a good place to begin is with an assessment of your personal risk factors for heart disease
beyond high cholesterol. Which ones are within your control? For example, you may not be able to change your
age, gender, or family history. But you can improve your eating habits, get more exercise, and quit smoking.
These are the sorts of lifestyle changes that should become part of your cholesterol management plan, no
matter what other treatments you may choose. Likewise, you'll want to learn as much as you can about
cholesterol itself. Your body needs cholesterol to perform certain vital functions. In fact, lowering one type of
cholesterol, HDL, can be bad for your heart. What's more, while many foods contain dietary cholesterol, most of
the blame for elevated cholesterol levels rests squarely on the shoulders of saturated fat. Of course, you'll also
want to educate yourself about the available treatment options. Conventional medicine has much to offer to
people with high cholesterol--but so do alternative therapies. Indeed, the choices can seem overwhelming.
Before you settle on a specific treatment or combination of treatments (in consultation with your doctor), you
should know whether it's effective and safe and how soon you can expect to see results.
3. Get Rid of Those Extra Pounds
If you weigh more than you should, slimming down may produce a significant drop in your cholesterol level.
Research suggests that being overweight disrupts the normal metabolism of dietary fat. So even though you
may be eating less fat, you may not see a difference in your cholesterol profile until you unload the excess
In fact, shedding just 5 to 10 pounds may be enough to improve your cholesterol level. Just don't go the
crash-dieting route. A slow but steady loss of 1/2 to 1 pound a week is healthiest and easiest to maintain. Since
1 pound equals 3,500 calories, you could meet the pound-per-week rate by eating 500 fewer calories per day,
burning 500 more calories per day through exercise, or--the best option--a combination of the two. Findings
from the landmark Framingham Heart Study confirm that such modest weight loss is worth the effort, for
reasons beyond cholesterol control. According to the study, taking off--and keeping off--just 1 to 2 pounds a year
may reduce your risk of high blood pressure by 25 percent and your risk of diabetes by 35 percent. Incidentally,
many of the lifestyle strategies that help rein in unruly cholesterol can also take off unwanted pounds, and vice
versa. If you're significantly overweight, be sure to consult your doctor before embarking on any weight loss
4. Lace Up Your Walking Shoes
Whether your goal is to lower your cholesterol, shed some extra pounds, or both, regular exercise can help you
get there. We're not talking about high-intensity workouts, either, though boosting your intensity can elevate HDL
cholesterol. Walking and other, more moderate physical activities are good for your heart, too. In fact, one study
suggests that walks of any duration may help reduce heart disease risk. For the study, British researchers
recruited 56 sedentary people between ages 40 and 66, then divided them into three groups. One group took a
long, 20- to 40-minute walk each day; another group walked for 10 to 15 minutes twice a day; and the third group
took 5- to 10-minute walks three times a day. Over the 18 weeks of the study, the once-a-day walkers saw their
LDL cholesterol drop by 8.3 percent; the twice-a-day walkers by 5.8 percent. The researchers concluded that
walks of any length can be beneficial, as long as they're done at a moderate intensity--that is, a brisk pace at
which you can still carry on a conversation. We mention walking because it's the most convenient form of
physical activity. But really, any form of aerobic exercise--running, bicycling, swimming, whatever gets your heart
pumping--can help lower heart disease risk. Whichever activity (or activities) you choose, just make sure you're
doing it for 30 minutes at least 5 days a week. If you've been relatively inactive, check with your doctor before
launching any exercise regimen. Your doctor may be able to help you choose an activity that suits your current
5. Become Acquainted with the Good Fats
When you were diagnosed with high cholesterol, your doctor likely advised you to reduce your fat intake. In
general, cutting your dietary fat will lower cholesterol. But as with any rule, this one has exceptions. Evidence
suggests that eating more of some fats and less of others is better than simply cutting way back on all fats.
Peanut butter, avocados, olive and canola oils, and most nuts are mostly monounsaturated fat. Research has
shown that monounsaturated fat can help lower LDL and triglycerides (another type of blood fat) while raising
HDL. It's a much healthier choice than saturated fat, found primarily in animal products--meats, butter, full-fat
milk and cheese. Saturated fat can elevate your cholesterol level more than anything else you might eat. Also
included in the good fats category are the omega-3 fatty acids, found in abundance in fish such as mackerel,
albacore tuna, and salmon. The omega-3s appear to lower levels of VLDL (very low density lipoprotein) and
triglycerides. Studies have shown that when people cut back on saturated fat and consumed more fish oil, their
LDL dropped. The American Heart Association recommends eating at least 2 servings of baked or grilled fish a
week. That said, omega-3s are not a magic bullet. When study participants consumed more fish oil without
altering their saturated fat intake, their LDL levels stayed the same or increased. In order to reap the
cholesterol-cutting benefits of omega-3s, you need to limit your saturated fat consumption. Remember, too, that
eating foods low in total fat can help restrict saturated fat.
6. Discover Fiber's Cholesterol-Cutting Capacity
It's no secret that vegetarians have lower cholesterol levels and lower heart disease rates than meat eaters.
That's in part because vegetarians consume so much fiber, which is found exclusively in plant foods--fruits,
vegetables, whole grains, and beans. Fiber comes in two forms: soluble and insoluble. The soluble kind
appears to pack the greatest cholesterol-lowering punch. Research has shown that consuming about 15 g of
soluble fiber a day can lower LDL cholesterol by 5 to 10 percent. It works by binding with cholesterol-containing
bile acids in the intestines and escorting them out of the body. A specific kind of soluble fiber, pectin, not only
lowers cholesterol but also helps curb overeating by slowing the digestive process. Munch on apples and other
pectin-rich fruits, and you're likely to eat less, lose weight, and rein in your cholesterol. Coincidentally, foods high
in fiber tend to be low in saturated fat and cholesterol, as well as calories. Just make sure you don't top your
fiber-rich whole grain toast with a huge dollop of butter.
7. Take a Good Multivitamin
Even if you're getting more good fats, avoiding bad fats, and filling up on fiber, your diet may have some
nutritional gaps. A multivitamin/mineral supplement can help cover your nutritional bases and possibly lower
your risk for heart disease and stroke. Look for a multi that delivers 400 micrograms of folic acid, 2 mg of vitamin
B6, and 6 micrograms of vitamin B12, advises Robert Rosenson, MD, director of the preventive cardiology
center at Northwestern University Medical School in Chicago. In studies, all three of these B vitamins have
played important roles in protecting heart health. In a Harvard study involving 80,000 nurses, for example, those
with the highest intakes of folic acid were 31 percent less likely to develop heart disease. Folic acid works by
decreasing blood levels of homocysteine, an amino acid that's an emerging risk factor for heart disease and
stroke. While many foods contain folate (the naturally occurring form of folic acid), including orange juice, kidney
beans, broccoli, and spinach, you'll be certain that you're getting the recommended amount by taking a
The same study found that the women who consumed the most vitamin B6 reduced their risk of heart disease
by one-third. Like folic acid, B6 helps to hold down levels of homocysteine. In older people, effectively controlling
levels of homocysteine may depend on adequate stores of vitamin B12. After age 50, the human body
sometimes absorbs less B12 from food. According to Johns Hopkins researchers, older people who took a
multivitamin containing B12 had lower levels of homocysteine. When you're shopping for a multivitamin, steer
clear of those that contain iron. According to Rosenson, men and postmenopausal women don't need extra
iron. Iron stores have been linked with a higher rate of heart attacks and strokes.
8. Explore Your Treatment Options
When you were diagnosed with high cholesterol, you and your doctor probably discussed an appropriate course
of treatment. It's important that you continue to work with your doctor and inform him of any therapies that you
decide to try on your own. The fact is, both conventional and alternative medicine have a range of
cholesterol-combating strategies available. Which ones you choose depends on your current cholesterol
profile, your general health, your lifestyle, even your perspective on treatment. Some people feel perfectly
comfortable taking cholesterol-lowering medication, while others do all they can to avoid it. For people who have
advanced heart disease or who've already had a heart attack, conventional therapies such as drugs and surgery
are vital, at least at the start of treatment. Later, you and your doctor can discuss lifestyle strategies and
alternative therapies that may support your recovery and possibly stop the disease from progressing. For those
with mild to moderately elevated cholesterol, lifestyle strategies and alternative therapies may make drugs and
surgery unnecessary, Rosenson says. These days, many physicians urge patients in the mild-to-moderate
category to try controlling their cholesterol through dietary changes and increased physical activity. If those
measures alone aren't enough, or if a patient already has coronary heart disease or is at high risk for it,
physicians reach for the prescription pad. Together, you and your doctor can come up with a treatment plan that
matches your needs and lifestyle--and that delivers the results you want.
9. Find Ways to Short-Circuit Stress
To win the cholesterol war, managing stress is as essential as eating healthfully and exercising regularly.
When you're tense and anxious, you're more likely to neglect the actions that help lower cholesterol in the first
place. After spending 12 hours at the office working frantically to meet a deadline, do you really want to devote
another hour to preparing a nutritious meal or walking on a treadmill? Probably not.
What's more, stress and its companion emotions--tension, anxiety, anger, depression--trigger the release of
chemicals that constrict arteries, reduce bloodflow to the heart, raise blood pressure, and elevate your heart
rate. These changes, in combination with uncontrolled cholesterol, can put you on course for a heart attack. To
block your body's stress response, simply removing yourself from the stressful situation can help. Go for a short
walk, practice deep breathing, perform a few simple stretches, meditate--whatever enables you to relax and
regroup. You'll feel better, you'll think more clearly, and you'll spare your heart from harm. No matter how busy
you are, set aside a few minutes every day to reflect on yourself and your life. Are you satisfied with the direction
you're taking? Are your needs being met? By tuning out the world and turning inward, you remind yourself of
what matters most, and you rise above the stressful distractions that undermine your health in so many ways.
While staying in touch with yourself can help you set priorities and adjust your life's course, don't sacrifice family
and social relationships. They give your life balance and enable you to cope with stressful situations. Of course,
maintaining ties to family and community takes some effort, especially in an era when technology drives our
interactions. But it's worth doing, since research has shown that people with fewer social connections are more
prone to illness and more likely to die young. On the bright side, the more social connections you have, the
better your chances of living longer--free of heart disease and other life-threatening illnesses.
10. Make a Commitment
Several men and women manage to take charge of their cholesterol and achieve their ideal numbers. Many of
these people had experienced some life-changing event that forced them to commit themselves to a healthier,
cholesterol-lowering lifestyle. To win the cholesterol war, you must make that same commitment--resolving to
take care of yourself, to make necessary changes, to live healthfully every day. Your family and your friends can
support you, but ultimately, you're the one making the decisions that will have an impact on your health, for better
For more information, please visit the
Prevention website. Click the link.
This article was courtesy of Prevention.
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