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Cholesterol and lifestyle

Why Cholesterol Is Important

Your body needs cholesterol to work well. But cholesterol levels that are too high can harm you.

Extra cholesterol in your blood builds up inside the walls of your blood vessels. This buildup is called plaque, or atherosclerosis. Plaque reduces, or even stops, the blood flow. This can cause a heart attack , stroke , or other serious heart or blood vessel disease.

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Your Cholesterol Numbers

Cholesterol is measured in milligrams per deciliter (mg/dL). All men should have their blood cholesterol levels tested every 5 years, starting at age 35; all women should do the same, starting at age 45. Many people should have their blood cholesterol levels tested at a younger age, possibly as early as age 20 if they have risk factors for heart disease. Have your cholesterol checked more often (probably every year) if you have:

A blood cholesterol test measures the level of total cholesterol. This includes both HDL ("good") cholesterol and LDL ("bad") cholesterol.

Your LDL level is what doctors watch most closely. You want it to be low. If it gets too high, you will need to treat it.

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Treatment includes:

  • Eating a healthy diet that can lower your cholesterol
  • Losing weight (if you are overweight)
  • Exercising

You may also need medicine to lower your cholesterol.

  • If you have heart disease or diabetes, your LDL cholesterol should stay below 100 mg/dL.
  • If you are at risk for heart disease (even if you do not yet have any heart problems), your LDL cholesterol should be below 130 mg/dL.
  • Almost everyone else may get health benefits from LDL cholesterol that is lower than 160 to 190 mg/dL.

You want your HDL cholesterol to be high.

  • For men, it should be above 40 mg/dL.
  • For women, it should be above 50 mg/dL.
  • Exercise helps raise your HDL cholesterol.

It is still important to eat right, keep a healthy weight, and exercise even if:

  • You do not have heart disease or diabetes
  • Your cholesterol levels are in the normal range

These healthy habits may help prevent future heart attacks and other health problems.

Eating Right

Eat foods that are naturally low in fat. These include whole grains, fruits, and vegetables. Using low-fat toppings, sauces, and dressings will help.

Look at food labels. Avoid foods that are high in saturated fat. Eating too much of this type of fat can lead to heart disease.

  • Choose lean protein foods -- soy, fish, skinless chicken, very lean meat, and fat-free or 1% dairy products.
  • Look for the words "hydrogenated" or "partially hydrogenated" and trans fats on food labels. Do NOT eat foods with these.
  • Limit how much fried foods you eat.
  • Limit how many prepared baked goods (such as donuts, cookies, and crackers) you eat. They may contain a lot of fats that are not healthy.
  • Eat fewer egg yolks, hard cheeses, whole milk, cream, ice cream, butter, and fatty meats. Eat smaller portions of meats.
  • Use healthy ways to cook fish, chicken, and lean meats, such as broiling, grilling, poaching, and baking.

Eat foods that are high in fiber. Good fibers to eat are oats, bran, split peas and lentils, beans (such as kidney, black, and navy beans), some cereals, and brown rice.

Learn how to shop for and cook foods that are healthy for your heart. Learn how to read food labels to choose healthy foods. Stay away from fast foods, where healthy choices can be hard to find.

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Getting plenty of exercise will also help. Talk with your doctor about what kind of exercise might be best for you.

References

American Heart Association Nutrition Committee; Lichtenstein AH, Appel LJ, Brands M, Carnethon M, Daniels S, et al. Diet and lifestyle recommendations revision 2006: a scientific statement from the American Heart Association Nutrition Committee. Circulation. 2006 Jul 4;114(1):82-96.  

Heimburger DC. Nutrition’s interface with health and disease. In: Goldman L, Schafer AI, eds. CecilMedicine. 24th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 220.

Mosca L, et al. Evidence-based guidelines for cardiovascular disease prevention in women: 2011 update. Circulation. 2011;123:1243-1262.

Mozaffarian D. Nutrition and cardiovascular disease. In: Bonow RO, Mann DL, Zipes DP, Libby P, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 9th ed. Philadelphia, Pa: Saunders; 2011:chap 48. 

Updated: 9/6/2012

David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M. Health Solutions, Ebix, Inc.


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