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Public release date: 20 January 2008
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Your lower cholesterol toolbox
By Gina Shaw
Reviewed by Charlotte E. Grayson Mathis, MD
Get the tools you need to help lower cholesterol -- and reduce your risk of disease -- starting now.
If any of your cholesterol numbers are in the high risk category, you're at
an increased risk for heart disease -- which may lead to heart attack.
The good news is you have several options to help you get back in the
cholesterol safety zone. These four options can all work separately -- or
together -- to lower cholesterol, and keep it under control.
a.. Diet
b.. Exercise
c.. Weight loss
d.. Medications
Diet to Lower Cholesterol
The body gets cholesterol in two ways: by making it, and by what we eat.
Most of the cholesterol we eat comes from dietary fats found in foods like
butter, margarine, milk, and fish. One of the easiest ways to lower
cholesterol is to lower your intake of certain kinds of fats.
Just as there is "good" cholesterol and "bad" cholesterol, there are "good"
fats and "bad" fats. To keep your cholesterol low, your total fat intake
shouldn't be more than 25% to 33% of your diet -- and most of those fats
should be the good kind, like vegetable fats (monounsaturated fats and
polyunsaturated fats), and omega-3 fatty acids, found mostly in fish.
To help lower cholesterol, you'll want to avoid or reduce saturated fats
(usually found in animal products like meats, eggs, and dairy), and trans
fats, which are formed when hydrogen is added to vegetable oil (think French
fries and doughnuts).
"A quick way to tell the difference between animal fats and vegetable fats
is that animal fats are usually solid at room temperature, while vegetable
fats are liquid at room temperature," says Antonio Gotto, MD, the Stephen
and Suzanne Weiss Dean at the Weill Medical College of Cornell University,
in New York City.
So fill up on the healthy fats found in vegetable oils, nuts, avocados, and
salmon, and cut back on higher-fat foods like red meat, whole milk, and of
course, those tempting chips and pastries.
Exercise to Lower Cholesterol
Regular physical activity is key to keeping your cholesterol low. Studies
have found that even moderate exercise is enough to boost HDL (good)
cholesterol and lower LDL (bad) cholesterol. In a recent study of young and
middle-aged women in Spain, researchers found that the more calories a woman
burned through moderate exercise, the lower her LDL level and the higher her
HDL level.
Exercise, in combination with a healthy diet, is also important because
while a low-fat lower calorie diet helps lower total cholesterol and bad LDL
cholesterol, one study showed it can also drop good HDL cholesterol by 7%
over a year. That same study showed an increase in good HDL cholesterol (and
a decrease in LDL and total cholesterol) for those who walked or jogged
about 8 miles a week.
Weight Loss to Lower Cholesterol
Both a healthy diet and regular physical exercise can lead to another
important tool in lower cholesterol: weight loss.
Excess weight tends to increase your LDL cholesterol level. If you are
overweight and have high LDL cholesterol, losing weight may help you lower
it. Weight loss also helps to lower triglycerides (another form of fat in
your blood and one which you should aim to keep below 150 mg/dL) and raise
HDL ("good") cholesterol levels.
Medications to Lower Cholesterol
Some people find they can't lower cholesterol enough with lifestyle changes
alone. "There are genetic factors that affect cholesterol levels," says
Gotto. "One person may be able to keep their cholesterol low without much
effort at all, while someone else may eat right, exercise, keep their weight
down, and still have high cholesterol."
That's where medications come in. There are several types of
cholesterol-lowering medications, but the most commonly prescribed are
statins. There's a good reason for that, says Gotto. "They are very
effective in lowering LDL levels in the majority of patients." Studies have
shown that statins can lower LDL cholesterol by 20% to 60%.
Other medications to lower cholesterol include:
a.. Bile acid sequestrants
b.. Nicotinic acid (niacin)
c.. Fibric acids
d.. Cholesterol absorption inhibitors
Each of these drugs act in slightly different ways. For example, some lower
LDL cholesterol, while others treat high levels of triglycerides and/or
raise HDL cholesterol. Your doctor will help you decide which medications --
or combination -- is best for you.
However, medications may not help you as much if you don't help yourself.
"It's been found that if you continue to eat a high-fat diet, the effects of
cholesterol-lowering drugs like statins are diminished," Gotto says. So if
you start taking a cholesterol-lowering medication and figure it's OK to
load up on the Krispy Kremes -- it's not.
Diet, exercise, weight loss, and medications: Your cholesterol-lowering
toolbox has all you need to help you lower cholesterol -- and keep it low.
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