| Managing Your Cholesterol
For many of us who have never felt better, taking action to manage cholesterol might seem unimportant. But feeling good today is no guarantee of a healthy heart. Heart disease can exist for years without symptoms and often affects people in the prime of their productive lives. Heart attacks strike approximately 1.2 million people in the United States each year. Almost half of them will die from their heart attacks. For many of these victims, there is no warning that anything is wrong.
This guide will help you:
- Learn how cholesterol can affect your health
- Identify ways to manage cholesterol
- Set a workable goal to maintain your cholesterol at a healthy level
Blood Cholesterol
The concentration of cholesterol circulating in your blood. It comes from both the cholesterol that is manufactured in the liver and from the food you eat. Cholesterol is needed for many bodily functions. The liver can make all the cholesterol the body needs, so it is not necessary to get cholesterol from food.
High Blood Cholesterol
This is one of the strongest predictors of heart disease. And, it is one that we can control. That's why all adults should learn their blood-cholesterol level and take steps to keep it down or get it down, if necessary.
Dietary Cholesterol
This is the cholesterol in food you eat. It is found only in animal products.
High-Density Lipoproteins (HDLs)
HDLs carry cholesterol away from cells and back to the liver for removal. They often are referred to as the good cholesterol.
Low-Density Lipoproteins (LDLs)
LDLs are responsible for depositing cholesterol in the artery walls and are often referred to as the bad cholesterol.
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Having a sense of what your risks are for heart disease may encourage you to make a stronger commitment to reducing them. Use this checklist to determine your level of risk.
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If you checked no to any of the items, there are steps you can take to manage your risk.
Adults age 20 and older should have their LDL cholesterol levels checked at least once every five years. All it takes is a simple blood test to have your cholesterol measured. The test will tell you the total concentration of cholesterol in your blood. Compare your number against the ranges below to determine your level of risk.
- Optimal range: less than 100 mg/dl
- Near optimal: 100-129 mg/dl
- Borderline high: 130-159 mg/dl
- High: 160-189 mg/dl
- Very high: 190 mg/dl and above
The cutoff points of each range are not magic numbers, but, in general, the lower your cholesterol, the lower your risk.
When you go to measure your cholesterol, consider the following:
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Pick the best time. Request that the test be done at the time of your routine physical exam.
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Get the real numbers. Don't settle for it's fine, or it's normal. Ask for the numbers and an explanation of what they mean in terms of your health.
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If your cholesterol is high, retest. Have your blood analyzed further for LDL and HDL cholesterol and triglycerides. (See the Healthy Heart Basics section for the definition of these terms.) Together, the results of these tests can more accurately predict your risk of heart disease than can total cholesterol alone.
There are ways to lower your cholesterol and doing so is worth the effort. Every 1-percent drop in blood cholesterol yields a 2-percent drop in risk of heart disease! Here's what you can do to get your cholesterol level down and keep it there:
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Modify your diet. Changing your diet will likely have the most effect on your blood-cholesterol level. Choosing a diet low in fat and cholesterol and high in complex carbohydrates (starch and fiber) are important principles of a heart-healthy diet.
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Maintain a healthy weight. People who are overweight frequently have a higher blood-cholesterol level than people at a healthy weight. You can reach and maintain a weight that is right for you by eating fewer calories and increasing your activity.
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Exercise regularly. Regular physical activity can help you control your weight, and increase your HDL cholesterol level. Experts report that doing 60 minutes of moderately intense activity such as brisk walking most days of the week, is beneficial to your health even when broken up into shorter 10-minute sessions throughout the day. This a great plan when you can't fit in 30 continuous minutes or you are just beginning to exercise.
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Manage stress effectively. Psychological stress has been shown to raise blood cholesterol. Learning to cope with stress effectively is a key factor to lowering your risk of heart disease.
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Be smoke-free. Smoking is a major risk factor for heart disease. If you smoke, quitting is the most important step you can take to improve your health.
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Follow your treatment plan. In special cases, your doctor might prescribe medication in conjunction with a low-fat diet and exercise program. Drugs may help to lower your cholesterol level, but they are not a substitute for the lifestyle changes you need to make.
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A healthful diet is your best weapon against high cholesterol. Here are guidelines for a heart-healthy diet:
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Reduce the total fat in your diet to no more than 30 percent of the calories you eat. Foods high in fat include fried foods, red meats and whole-milk products. Fat also lurks in many processed foods that we don't usually think of as fatty such as pastry, crackers, snack foods, nondairy creamers and fast foods. For a low-fat diet, choose lean meats, poultry (without skin), fish, and low-fat milk and milk products. Read food labels for fat content. Each gram of fat contains nine calories.
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Reduce saturated fat to less than 10 percent of the calories you consume. Saturated fat raises your blood cholesterol more than anything else you eat. Foods high in saturated fat include red meats, processed meats, hard cheeses, whole-milk products, and snacks containing coconut, palm and palm kernel oil. Also, avoid foods that contain hydrogenated and partially hydrogenated vegetable oils. Hydrogenation is a process that makes unsaturated fats saturated.
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Limit dietary cholesterol to less than 300 milligrams per day. Cholesterol is found only in animal products. Foods high in cholesterol include egg yolks, red meats, organ meats (such as liver), hard cheeses, whole- milk products and butter.
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Eat foods with adequate starch and fiber. Your daily diet should include: six to 11 servings of grain products (breads, cereals, pasta and rice), three to five servings of vegetables (and vegetable juices), and two to four servings of fruit (and fruit juices). Choose whole-grain products and vegetables served with the peel or skin for added fiber.
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Limit calories. Eat a variety of foods that are low in calories and high in nutrients. Eat less fat and fewer high-fat foods. Consume smaller portions and limit second helpings of foods high in fat and calories. Prepare the foods you eat without adding fats and sugars. Eat less sugar and fewer sweets (such as soda, cakes and candies). If you are overweight, losing even a little weight can help to lower LDL cholesterol and raise HDL cholesterol. Lose no more than 1/2 to 1 lb. per week for safe weight loss.
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When it comes to managing our cholesterol, goal-setting skills are the key to making positive changes we can live with. We can set ourselves up for success or failure depending on how we shape our goals. Smart goals are:
Specific. State what you plan to do and how you will do it.
Measurable. How will you know when you have achieved your goal?
Adequate. It must help you manage the problem effectively.
Realistic. It should be reasonable for you to achieve and maintain.
Timely. Decide on a time schedule that is specific but comfortable for you to sustain to achieve your goal.
Plan how you will put your goal into action. List two action steps to help you reach your goal.
Action step 1: ____________________________________________________
Action step 2: ____________________________________________________
Plan to make only one change at a time. Give yourself at least three weeks for the change you make to become a habit. With a consistent, earnest effort to lower fat and cholesterol, you can expect to see changes in your cholesterol level within two to three months.
Take our cholesterol quiz and see how much you learned.
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