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Cholesterol and lifestyle

Hyperlipidemia - cholesterol and lifestyle; CAD - cholesterol and lifestyle; Coronary artery disease - cholesterol and lifestyle; Heart disease - cholesterol and lifestyle; Prevention - cholesterol and lifestyle; Cardiovascular disease - cholesterol and lifestyle; Peripheral artery disease - cholesterol and lifestyle; Stroke - cholesterol and lifestyle; Atherosclerosis - cholesterol and lifestyle

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

Cholesterol is measured in milligrams per deciliter (mg/dL). Extra cholesterol in your blood builds up inside the walls of your blood vessels. This buildup is called plaque, or atherosclerosis. Plaque reduces or stops blood flow. This can cause a:

  • Heart attack
  • Stroke
  • Serious heart or blood vessel disease

Your Cholesterol Numbers

All men should have their blood cholesterol levels tested every 5 years, starting at age 35 years. All women should do the same, starting at age 45 years. Many adults should have their blood cholesterol levels tested at a younger age, possibly as early as age 20 years, if they have risk factors for heart disease. Children with risk factors for heart disease should also have their blood cholesterol levels checked. Some expert groups recommend cholesterol testing for all children ages 9 to 11 and again between ages 17 and 21. Have your cholesterol checked more often (probably every year) if you have:

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

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

Treatment includes:

  • Eating a healthy diet
  • Losing weight (if you are overweight)
  • Exercising

You may also need medicine to lower your cholesterol.

You want your HDL cholesterol to be high. Exercise can help raise it.

Eating Right

It is 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.

Eat foods that are 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, such as soy, fish, skinless chicken, very lean meat, and fat-free or 1% dairy products.
  • Look for the words "hydrogenated", "partially hydrogenated", and "trans fats" on food labels. DO NOT eat foods with these words in the ingredients lists.
  • Limit how much fried food you eat.
  • Limit how many prepared baked goods (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, and cholesterol and lifestyle.
  • Eat less fatty meat and smaller portions of meat, in general.
  • 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 (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.

Get plenty of exercise. And talk with your provider about what kinds of exercises are best for you.

References

American Diabetes Association. 9. Cardiovascular disease and risk management: standards of medical care in diabetes-2018. Diabetes Care. 2018;41(Suppl 1):S86-S104. PMID: 29222380 www.ncbi.nlm.nih.gov/pubmed/29222380.

Eckel RH, Jakicic JM, Ard JD, et al. 2013 AHA/ACC Guideline on lifestyle management to reduce cardiovascular risk: a report of the American College of Cardiology/American Heart Association Task Force on practice guidelines. J Am Coll Cardiol. 2014;63(25 Pt B):2960-2984. PMID: 24239922 www.ncbi.nlm.nih.gov/pubmed/24239922.

Grundy SM, Stone NJ, Bailey AL, et al. 2018 AHA/ACC/AACVPR/AAPA/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA Guideline on the management of blood cholesterol: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. J Am Coll Cardiol. 2018. pii: S0735-1097(18)39034-X. PMID: 30423393 www.ncbi.nlm.nih.gov/pubmed/30423393.

Heimburger DC. Nutrition's interface with health and disease. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 213.

Mozaffarian D. Nutrition and cardiovascular and metabolic diseases. In: Zipes DP, Libby P, Bonow RO, Mann DL, Tomaselli GF, Braunwald E, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 11th ed. Philadelphia, PA: Elsevier; 2019:chap 49.

Pencina MJ, Navar-Boggan AM, D'Agostino RB Sr, et al. Application of new cholesterol guidelines to a population-based sample. N Engl J Med. 2014;370(15):1422-1431. PMID: 24645848 www.ncbi.nlm.nih.gov/pubmed/24645848.

  • Understanding cholesterol results

    Animation

  •  

    Understanding cholesterol results - Animation

    LDL cholesterol has gotten a bad reputation, and for very good reason. Having too much of this fatty substance in your blood can clog up your arteries, preventing blood from getting to your heart and out to where it's needed in your body. Checking your LDL levels can help your doctor spot high cholesterol before it can cause a heart attack or stroke. Let's talk today about LDL tests. LDL stands for low-density lipoprotein. Lipoprotein is a type of protein that transports cholesterol, as well as fats called triglycerides and lipids, in your blood. When you eat too many fatty, cholesterol-rich foods, LDL cholesterol can start to collect in your artery walls. That's one collection you don't want, because if a chunk of that gunk breaks loose and gets lodged in a blood vessel, you could end up having a heart attack or stroke. To check your LDL cholesterol level, you'll need to have a blood test. Your doctor may tell you not to eat or drink anything for 8 to 12 hours before the test, so you can get an accurate reading. During the test, your doctor will draw blood from one of your veins. The needle might sting a little bit, but the feeling shouldn't last for any more than a few seconds. So, how do you know that you have high LDL cholesterol? Well, your LDL cholesterol level (think L for Lousy) will usually be measured along with your HDL, or good cholesterol (think H for Healthy), as well as your triglycerides and your total cholesterol level. Together, these measurements are called a lipid panel. You want your LDL level to be at least below 130 mg/dl, but ideally less than 100 milligrams per deciliter. If you're at high risk of heart disease, it should be even lower than that - less than 70 milligrams per deciliter. And for folks of average risk of getting heart disease, anything over 160 is considered a high LDL level. If you do have LDL cholesterol, you could be at risk for heart disease. Now, some folks have high cholesterol because they have an inherited condition that causes high cholesterol. If your LDL is low, it may be because you're not eating a well-balanced diet or your intestines aren't absorbing the nutrients from the foods that you eat. Ask your doctor how often you should have your LDL, and total cholesterol levels, checked. Depending upon your heart disease risks, you may need to be tested more often. If your LDL cholesterol is high, ask your doctor about cholesterol-lowering medications, diet, and other ways to bring it back down into a normal range.

  • Saturated fats

    Saturated fats - illustration

    Saturated fats are found predominantly in animal products such as meat and dairy products, and are strongly associated with higher cholesterol levels. Tropical oils such as palm, coconut, and coconut butter, are also high in saturated fats.

    Saturated fats

    illustration

  • Understanding cholesterol results

    Animation

  •  

    Understanding cholesterol results - Animation

    LDL cholesterol has gotten a bad reputation, and for very good reason. Having too much of this fatty substance in your blood can clog up your arteries, preventing blood from getting to your heart and out to where it's needed in your body. Checking your LDL levels can help your doctor spot high cholesterol before it can cause a heart attack or stroke. Let's talk today about LDL tests. LDL stands for low-density lipoprotein. Lipoprotein is a type of protein that transports cholesterol, as well as fats called triglycerides and lipids, in your blood. When you eat too many fatty, cholesterol-rich foods, LDL cholesterol can start to collect in your artery walls. That's one collection you don't want, because if a chunk of that gunk breaks loose and gets lodged in a blood vessel, you could end up having a heart attack or stroke. To check your LDL cholesterol level, you'll need to have a blood test. Your doctor may tell you not to eat or drink anything for 8 to 12 hours before the test, so you can get an accurate reading. During the test, your doctor will draw blood from one of your veins. The needle might sting a little bit, but the feeling shouldn't last for any more than a few seconds. So, how do you know that you have high LDL cholesterol? Well, your LDL cholesterol level (think L for Lousy) will usually be measured along with your HDL, or good cholesterol (think H for Healthy), as well as your triglycerides and your total cholesterol level. Together, these measurements are called a lipid panel. You want your LDL level to be at least below 130 mg/dl, but ideally less than 100 milligrams per deciliter. If you're at high risk of heart disease, it should be even lower than that - less than 70 milligrams per deciliter. And for folks of average risk of getting heart disease, anything over 160 is considered a high LDL level. If you do have LDL cholesterol, you could be at risk for heart disease. Now, some folks have high cholesterol because they have an inherited condition that causes high cholesterol. If your LDL is low, it may be because you're not eating a well-balanced diet or your intestines aren't absorbing the nutrients from the foods that you eat. Ask your doctor how often you should have your LDL, and total cholesterol levels, checked. Depending upon your heart disease risks, you may need to be tested more often. If your LDL cholesterol is high, ask your doctor about cholesterol-lowering medications, diet, and other ways to bring it back down into a normal range.

  • Saturated fats

    Saturated fats - illustration

    Saturated fats are found predominantly in animal products such as meat and dairy products, and are strongly associated with higher cholesterol levels. Tropical oils such as palm, coconut, and coconut butter, are also high in saturated fats.

    Saturated fats

    illustration

Talking to your MD

 

Self Care

 
 

Review Date: 7/25/2018

Reviewed By: Michael A. Chen, MD, PhD, Associate Professor of Medicine, Division of Cardiology, Harborview Medical Center, University of Washington Medical School, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. 03-25-19: Editorial update.

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., a business unit of Ebix, Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
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