Cholesterol smarts

Saturated fat is a bigger culprit than cholesterol in your diet. Meats, whole-fat dairy products, and other foods from animals can be loaded with it. It's also in some vegetable oils such as palm and coconut oil. But foods with cholesterol can also raise your cholesterol. So most people should cut cholesterol -- in foods such as organ meats, egg yolks, and whole milk -- to less than 300 mg a day.

Cheese has a lot of saturated fat. Just three slices of cheddar cheese, for example, has about 18 grams. That's more saturated fat than you should probably have in one day! In fact, cheese is the biggest source of saturated fat in the typical American diet. Choose low-fat or non-fat cheeses, or consider skipping cheese.

Before about age 50, men tend to have higher total cholesterol than women. But women's "bad" cholesterol tends to rise with menopause when the female hormone estrogen declines. After about age 50, women usually have higher cholesterol than men of the same age.

There are no specific symptoms of high cholesterol. To know if your cholesterol is too high, you have to have a blood test.

Although cholesterol levels generally rise with age, you don't have to be older to have high cholesterol. Even children can be at risk, especially if they have a family history of high cholesterol and heart disease. Everyone should start getting cholesterol tests at age 20, or earlier, according to the American Heart Association.

Cholesterol is waxy, fat-like material that your body needs to make hormones, vitamin D, and acids for digesting food. But your body makes all the cholesterol your body needs. You don't need to add to it in your diet.

HDL (high-density lipoprotein) cholesterol is actually the "good" cholesterol. An HDL level of 60 mg/dL (milligrams of cholesterol per deciliter of blood) or above helps lower the chance that you'll get heart disease.

Too much LDL (low-density lipoprotein) cholesterol raises your risk of heart disease. An LDL level of130 mg/dL or above is considered high. Excess LDL will contribute to the formation of thick, hard buildups, known as "plaque," on the walls of your arteries. Your arteries become narrower and harder, so less oxygen-rich blood can flow through. This is known as atherosclerosis, a leading cause of heart attacks and strokes.

Soluble fibers can lower blood cholesterol levels. Oatmeal is a good source of soluble fiber. So are beans and many fruits and vegetables. In studies, LDL cholesterol dropped 3%-5% in people who added five to 10 grams of soluble fiber a day to their diet. A bowl of oatmeal and a banana have about 2 grams of soluble fiber.

Eggs do have a lot of cholesterol. In fact, two scrambled eggs have more cholesterol than the total amount you should have in a day. But you should think about more than just the cholesterol grams in any food you're eating. For example, chocolate pie is loaded with calories and saturated fat, which can also increase cholesterol, so you wouldn't want to have a lot of it. Eggs may have cholesterol, but they're also a great source of protein and lots of other nutrients. The cholesterol is all in the yolk, so egg whites or yolk-free egg substitutes are a good alternative. If you're worried about your cholesterol levels, check with your doctor.

You need some fat in your diet. Fats supply energy and essential fatty acids, and they help absorb nutrients from the foods you eat. The trick is to eat the best kind of fats. When you can, replace animal fats with plant fats (like nuts, seeds, olive or canola oils), which can actually help lower cholesterol. Eat as little trans fats as possible, and cut saturated fat to less than 10% of your calories.

Exercise or other regular physical activity can help lower your "bad" LDL cholesterol and raise your "good" HDL cholesterol. Adults should get at least 30 minutes of moderate-intensity exercise on most days of the week. But any regular physical activity lowers your risk of high cholesterol and heart disease.

Shoot for a total cholesterol level of less than 200 mg/dl. A level of 200 to 239 mg/dL is considered "borderline high" and 240 mg/dL or more is high.
For LDL (bad cholesterol), anything under 100 mg/dL is best. Levels of HDL (good cholesterol) that are lower than 40 mg/dL raise men's chances of getting heart disease. HDL levels less than 50 mg/dL raise the chance of heart disease in women.

Statins are the best-known type of cholesterol-lowering medication. They can drop LDL cholesterol by 20% to 55%. Statins help the liver produce less cholesterol and boost its ability to remove LDL cholesterol already in the blood. They also help raise "good" HDL cholesterol.

Most people don't need drugs to lower their cholesterol. Diet, exercising, and losing weight can help do it. The TLC (Therapeutic Lifestyle Changes) program can guide you on the changes you should make, depending on your risk for heart disease. The main goals are to eat less saturated and trans fat and cholesterol, and get more physically active. If those things alone don't lower your levels, your doctor might suggest eating more soluble fiber, like beans and oatmeal, and adding plant stanols or sterols. The best sources for stanols and sterols are fortified foods, including margarine and orange juice. If you can't do that, you'll probably need to take medicine.


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