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Keep Cholesterol in Check

By Dennis Thompson Jr. | Medically reviewed by Pat F. Bass III, MD, MPH

Keep Cholesterol in CheckControlling your cholesterol is key to preventing heart disease. For some, this can be accomplished through the same healthy diet and exercise plan that keeps a whole host of illnesses at bay. You might not love the idea of cutting back on cheeseburgers and steak sandwiches, but for men who plan to live a long and healthy life, it could be a sacrifice worth making.

Cholesterol is a soft, waxy substance found in all cells of the body and in the bloodstream. The body uses cholesterol to form cell membranes, make hormones, and produce vitamin D, among other functions. Your body makes all the cholesterol it needs, with your liver and other cells in the body creating about 75 percent of your blood cholesterol. The other 25 percent comes from food.

Cholesterol causes health problems when high levels exist in the bloodstream. Cholesterol starts to build up in the walls of your arteries, forming plaque deposits that narrow the arteries and force your heart to work harder to pump blood. This hardening of the arteries can lead to heart attack or stroke.

For a long time, high cholesterol has been a principal concern in maintaining a man's health. Statistics show that a slightly greater percentage of women have high total cholesterol than men. But because men have a statistically greater heart attack risk than women do, and suffer attacks earlier in life, controlling cholesterol levels can have a huge impact on preventing heart attacks in men. 

Cholesterol: A Numbers Game

Doctors measure your cholesterol by drawing blood after you've gone through a 9- to 12-hour fast without food, liquid, or medication. They look for three numbers:

  • Total cholesterol levels
  • Low density lipoprotein (LDL) or "bad cholesterol" levels, which is the type of cholesterol that forms plaque in your arteries
  • High density lipoprotein (HDL) or "good cholesterol" levels; HDL helps sweep the bloodstream of LDL and return the bad cholesterol to the liver — the higher your HDL levels, the better your chances of avoiding heart disease.

People are considered to be at high risk of heart disease if they have:

  • Total cholesterol levels above 239
  • LDL levels above 190
  • HDL levels below 35

People are considered at borderline risk for heart disease if they have:

  • Total cholesterol between 200 and 239
  • LDL levels between 130 and 159
  • HDL levels between 35 and 60

Some 98.6 million adults in the United States have total blood cholesterol levels that put them at risk of heart disease, and of those about 34.4 million American adults have cholesterol levels considered high risk. You should have your cholesterol levels checked every one to two years.

Cholesterol: How to Lower Your LDL

People normally have high cholesterol levels because they've been eating too much fatty food. However, health problems like diabetes, obesity, genetic disorders, or a dysfunctional thyroid gland also can increase a person's of cholesterol level.

Lifestyle and diet changes are the first actions doctors recommend when you're trying to lower your cholesterol levels. That mainly involves altering your diet to reduce your intake of saturated fats — fats that are usually solid at room temperature, like butter, lard, or the white fat contained in red meat. Research has found that eating saturated fat increases LDL levels. On the other hand, eating unsaturated fats — fats that are liquid at room temperature, like olive or vegetable oil — lowers bad cholesterol levels if they are used in place of saturated fats.

To limit cholesterol and promote heart health, the American Heart Association recommends these diet guidelines:

  • No more than 25 to 35 percent of your total daily calories should be from fat.
  • Up to 7 percent of your total daily calories should be from saturated fat and just 1 percent from trans fat.
  • No more than 300 milligrams of cholesterol should be eaten daily. Since one egg has 300 mg of cholesterol, don't plan on eating any other cholesterol that day if you have an egg. If your cholesterol is already high, that daily max comes down to 200 mg.
  • Reduce your sodium intake to less than 2,300 mg to avoid high blood pressure and for overall cardiovascular health.
  • Eat lots of vegetables and fruits. Whole grains and high-fiber foods are also good, as are lean meats, poultry, and fish. Choose fat-free or 1 percent milk-fat dairy products for the calcium and vitamin D benefits without the saturated fat.

You should get at least 30 minutes of exercise every day or at least on more days than not each week. Some people find that regular exercise affects their blood cholesterol level by increasing their levels of the good HDL cholesterol. Exercise can also help control weight, diabetes, and high blood pressure, all known risk factors for heart disease. Aerobic exercise in particular can help train your heart to work more efficiently and condition your lungs.

If you still have trouble lowering your cholesterol levels, there are medications available that can slow down the rate at which LDL is made or improve the ability of the liver to destroy LDL. Talk with your doctor about when to consider these prescription drugs; your doctor can also help you tailor the right diet and exercise plan, lifestyle must-dos even if you are on medication to lower cholesterol.

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