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Improving Your
Blood Cholesterol Levels: What You Need To Do
Take Action:
Here's How
Now that you understand why you should
lower your high blood cholesterol, this section details how to do it. It
covers:
- Action steps to take and the benefits
to expect
- Specific guidelines for diets to
lower high blood cholesterol
- Practical ways to change eating
habits
- Tips to increase your physical
activity
The section also describes medicines for
lowering high blood cholesterol. Medicines may become necessary for those who
cannot lower their blood cholesterol through diet and exercise.
Three Steps to
Reducing High Blood Cholesterol Levels
Three steps can help you
reduce your high blood cholesterol:
-
Follow the Step I or
Step II diet. Your doctor will first recommend one or the other. The diets
contain all the daily nutrients you need and emphasize eating foods that
are low in saturated fat, total fat , and cholesterol, and high in starch
and fiber. You will probably be asked to follow the Step I diet first to
see if it brings your blood cholesterol levels down sufficiently. If not,
you may have to move to the Step II diet. If you already have coronary
heart disease or a very high LDL level, your doctor may recommend starting
with the Step II diet.
-
Be more physically
active.
-
Lose weight if you are
overweight
Fortunately, these three
steps work together. For example:
-
Eating less fat,
especially saturated fat, also may help you decrease the amount of
cholesterol and calories you eat. Why? Foods high in fat and saturated fat
are high in calories and often high in cholesterol. In fact, all fats both
saturated and unsaturated fat have more than twice as many calories as
either carbohydrate or protein. They provide 9 calories per gram and the
other two provide 4 calories per gram.
-
Being more physically
active helps burn more calories which helps in weight loss. It may also
help you lower your LDL- cholesterol and raise your HDL-cholesterol, as
well as improve the health of your heart and lungs.
-
Losing excess weight if
you are overweight can help lower your LDL-cholesterol and increase your
HDL-cholesterol.
How Low
Will You Go?
By closely following your
diet , being more physically active, and watching your progress with regular
checkups,you can lower your blood cholesterol level. How much your cholesterol
levels change depends on:
-
How much fat,
especially saturated fat, and how much cholesterol you ate before you
changed your diet;
-
How closely you follow
the changes; and
-
How your body responds
to these changes. Usually the higher your blood cholesterol is to begin
with, the more the levels go down. However, sometimes due to heredity,
levels will not change enough no matter how well you change your habits.
For example: Your total
blood cholesterol level is 240 mg/dL, and you are eating a diet high in
saturated fat and cholesterol. By going on the Step I diet, you could reduce
your cholesterol level by 5-35 mg/dL; and 5-15 mg/dL more, if you then go on
Step II. Over time, you may reduce your cholesterol level by 10-50 mg/dL or
even more. This drop will slow the fatty buildup in your arteries and reduce
your risk of illness and death from heart attack. In fact, studies have shown
that, in adults with high blood cholesterol levels, for each 1 percent
reduction in total cholesterol levels, there is a 2 percent reduction in the
risk of heart attack. So if you reduce your cholesterol level by 10 percent
(for example, from 240 mg/dL to 216 mg/dL), your risk of heart disease could
drop by 20 percent. And many people will get even more of a drop in their
cholesterol level.
1. Learn About the Step I and Step II Diets
Step I Diet
On the Step I diet, you
should eat:
-
8-10 percent of the
day's total calories from saturated fat.
-
30 percent or less of
the day's total calories from fat.
-
Less than 300
milligrams of dietary cholesterol a day. Just enough calories to achieve
and maintain a healthy weight. (You may want to ask your doctor or
registered dietitian what is a reasonable calorie level for you.)
Step II Diet
On the Step II diet, you
should eat:
-
Less than 7 percent of
the day's total calories from saturated fat.
-
30 percent or less of
the day's total calories from fat.
-
Less than 200
milligrams of dietary cholesterol a day. Just enough calories to achieve
and maintain a healthy weight. (You may want to ask your doctor or
registered dietitian what is a reasonable calorie level for you.)
Practical Ways to Change
Your Diet
Here are some tips on how to choose foods for the Step I and Step II diets.
For more help, write for Step
by Step: Eating To Lower Your High Blood Cholesterol.
To cut back on saturated
fats, choose:
-
Poultry, fish, and lean
cuts of meat more often. Remove the skin from chicken and trim the fat
from meat.
-
Skim or 1 percent milk,
instead of 2 percent or whole milk.
-
Cheeses with no more
than 3 grams of fat per ounce (these include low-fat cottage cheese or
other low-fat cheeses). Cut down on full-fat processed, natural, and hard
cheeses(like American, brie, and cheddar).
-
Liquid vegetable oils
that are high in unsaturated fat (these include canola, corn, olive, and
safflower oil). Use tub or liquid margarines that list liquid vegetable
oil as the first ingredient (instead of lard and hydrogenated vegetable
shortening which are high in saturated fat). Choose products that are
lowest in saturated fat on the label.
-
Fewer commercially
prepared and processed foods made with saturated or hydrogenated fats or
oils (like cakes, cookies, and crackers). Read food labels to choose
products low in saturated fats.
-
Foods high in starch
and fiber, instead of foods high in saturated fats.
Cutting back on saturated
fat helps you to control dietary cholesterol as well. Two additional points to
remember when cutting back on dietary cholesterol are:
-
Eating less organ meat
(such as liver, brain, and kidney).
-
Eat fewer egg yolks as
whole eggs or in prepared foods (try substituting two eggs whites for each
whole egg in recipes, or using an egg substitute).
To included more foods high
in starch and fiber, choose:
-
More whole grain breads
and cereals, pasta, rice, and dry peas and beans.
-
More vegetables and
fruits.
2. Make Physical
Activity Work for You
Regular physical activity
by itself may help reduce deaths from heart disease by:
-
lowering LDL levels
-
raising HDL levels
-
lowering high blood
pressure
-
lowering triglyceride
levels
-
reducing excess weight
-
improving the fitness
of your heart and lungs
If you have been inactive
for a long time, start with low-to- moderate level activities such as walking,
taking the stairs instead of the elevator, gardening, housework, dancing, or
exercising at home. Begin by doing the activity for a few minutes most days,
then work up to a longer programat least 30 minutes per day, 3 or 4 days a
week This can include regular aerobic activities such as brisk walking,
jogging, swimming, bicycling, or playing tennis.
If you have heart disease
or have had a heart attack, talk with your doctor before starting an activity
to be sure you are following a safe program that works for you. Otherwise you
may experience chest pain or further heart damage. If you have chest pain,
feel faint or light-headed, or become extremely out of breath while
exercising, stop the activity at once and tell your doctor as soon as
possible.
3. Lose Weight If
You Are Overweight
Two action steps are key.
You May Need To
Take Medicine
If you have successfully
changed your eating habits for at least 6-12 months, and your LDL-cholesterol
level is still too high, you may need to take medicine. Some people will need
to take medicine from the start of their treatment because of a very high LDL
level or the presence of heart disease.
If you doctor prescribes
medicine, you also will need to:
-
Follow your
cholesterol-lowering diet.
-
Lose weight if
overweight.
-
Be more physically
active.
-
Stop smoking.
Taking all these steps
together may lessen the amount of medicine you need, or make the medicine work
better. And that reduces your risk of heart disease.
Medicines Your Doctor
May Prescribe
Sever types of medicine
help lower blood cholesterol levels. These include:
Major Drugs
Bile acid sequestrants (cholestyramine and colestipol)
Nicotinic acid
HMG CoA reduces inhibitors ar "statins" (e.g., lovastatin,
pravastatin, and simvastatin)
Other Drugs
Fibric acid derivatives (gemfibrozil)
Probucol
In addition, if you are a
woman going through or past menopause, your doctor may talk with you about
estrogens. Sometimes called Estrogen Replacement Therapy, this can lower blood
cholesterol levels, and may make it unnecessary to take a cholesterol-lowering
drug.
Drugs that lower blood
cholesterol work in different ways. Some may work for you while others may
not. Before the doctor prescribes any medicine, be sure to state what other
medicines you are taking. And once a medicine is prescribed, take it exactly
the way our doctor tells you so. If you have any side effects from a medicine,
tell you doctor right away. The amount or type of drug can be changed to
reduce or stop unwanted side effects. Whatever medicine you take, continue
to follow the Step I or Step II diet and to be more physically active. This
will help keep the dose of medicine as low as possible.
National Heart, Lung, and Blood Institute
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