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:
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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 people 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. 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.
- Eating a healthy diet
- Losing weight (if you are overweight)
You may also need medicine to lower your cholesterol.
You want your HDL cholesterol to be high. Exercise can help raise it.
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.
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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.
Stone NJ, Robinson J, Lichtenstein AH, et al. 2013 ACC/AHA guideline on the treatment of blood cholesterol to reduce atherosclerotic cardiovascular risk in adults: a report of the American College of Cardiology/American Heart Association Task Force on practice guidelines. Circulation. 2014;129(25 Suppl 2):S1-S45. PMID: 24222016 www.ncbi.nlm.nih.gov/pubmed/24222016.
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.
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