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Heart Disease: How To Reduce The Risk

Do I Have High Cholesterol?

Last updated on:
01/04/2012

Contributing Author: Guy Slowik FRCS

The risk for coronary heart disease (CHD) increases with rising blood cholesterol levels. When blood cholesterol exceeds 220 ml/dl (milligrams per deciliter-the units blood cholesterol is measured in the United States), risk for CHD increases at a more rapid rate.

All adults should have their blood cholesterol level measured at least once every five years.

If your blood cholesterol level is:

  • Below 180-then your blood cholesterol level is ideal
  • 180-199-then your blood cholesterol level is acceptable
  • 200-219-then your blood cholesterol level is borderline high
  • 220 or higher-then your blood cholesterol level is too high

If your total blood cholesterol level is greater than 200 (and especially if it is over 220), you should have another test to see what type of cholesterol is high.

If your HDL cholesterol level is:

  • Under 35, then it is too low
  • 36-50, then it is acceptable
  • Over 50, then it is ideal

If your LDL cholesterol level is:

  • 130 or less, then it is ideal
  • 130 to 159, then it is borderline high
  • 160 or greater, it is too high

How much fat and cholesterol are you eating now?

How you can eat less saturated fat and cholesterol

How you can easily cut your fat intake

How you can eat more starches and fiber

How Much Fat And Cholesterol Are You Eating Now?

Below is a quick self-assessment to help you find out how much saturated fat and cholesterol you eat now and what changes you might need to make. Answer the following questions:

How many eggs do you eat weekly?

more than 3

2 to 3

1 or less

How often do you eat red meat (beef, pork, or lamb) weekly?

5 or more

3 to 5

2 or less

What kind of milk do you drink?

whole

low-fat

1% or skim

How often each week do you eat cheese or ice cream that is not low fat?

5 or more

3 to 4

2 or less

How often each week do you eat baked goods like doughnuts, pastries, or cookies?

4 to 5

2 to 3

1 or less

Including breakfast, lunch, and dinner, how many meals do you eat weekly which do not contain any red meat, eggs, or cheese?

5 or less

6 to 13

14 or more

As you can guess, the ideal way of eating is shown in the right-hand column. This type of diet may even be low enough in fat and cholesterol to help reverse artery blockage, and it will certainly help prevent the build-up from starting.

The eating patterns of most Americans fall in the center or left-hand columns. For some people, the right-hand column may look almost out of reach, but anything you can do to work toward the goal will be helpful. Remember that gradual change is more likely to be permanent, so don't feel you must make many drastic changes all at once.

How You Can Eat Less Saturated Fat And Cholesterol

To reduce your fat and cholesterol intake in your diet, start with changes that are relatively easy to make. For example, many people find it easy to switch from 2% milk to 1% or skim milk. Once you have adjusted to one change, pick another change to work on.

How-To Information:

Here are some simple changes that will help you greatly reduce saturated fat and cholesterol in your diet.

Egg yolks:

  • Eat no more than three eggs yolks weekly
  • Eat as many egg whites as you like-they contain no cholesterol

Meats:

  • Buy lean meats such as fish, poultry, veal cutlet, pork tenderloin, or flank steak.
  • Trim as much fat off meat as possible.
  • Broil, barbecue or roast meat on a rack rather than fry it. This allows some of the fat to escape during cooking.
  • Limit the amount of hamburger you eat, and buy the leanest type available.
  • Replace high-fat prepared meats like sausage and luncheon meats with lower-fat meats like lean turkey or chicken.
  • Remove the skin from chicken or turkey before you cook or eat it.
  • Try to eat fish twice weekly. Fish contains a type of fat called omega-3 fat that may help prevent CHD.

Dairy products:

  • Use margarine instead of butter, choosing a margarine that has a liquid oil rather than a hydrogenated oil listed as the first ingredient.
  • Choose lower fat milk. If you use whole milk, switch to 2%. If you use 2%, switch to 1% or skim milk. All types of milks have the same amount of calcium and other vitamins and minerals.
  • Use non-fat or low-fat yogurt.
  • Use plain non-fat yogurt instead of sour cream.
  • Cut down on the amount of regular cheeses you eat. Look for lower fat cheese, which contain less than 3 grams of fat per ounce.
  • Sprinkle a little Parmesan cheese on food to give it a cheesy taste. Parmesan cheese is strong tasting, so a little goes a long way.

Tropical oils and processed oils:

  • Check food labels to see what the main type of fat in the food is. Limit foods that list contain palm oil, coconut oil, or hydrogenated oil as one of the first type of fats. (Food labels list ingredients in order from greatest to least by weight.
  • Be suspicious of commercial baked goods such as donuts, sweet rolls, brownies, and cookies, which are a major source of saturated fat.

Nice To Know:

About 60 percent of the saturated fat in the American diet comes from three food sources: hamburger, cheese, and whole milk. Cutting down on these foods, or cutting them out, can go a long way toward helping you cut down saturated fat and cholesterol.

How You Can Easily Cut Your Fat Intake

Ounce for ounce, fat contains more than twice the calories that protein or carbohydrate do. So although saturated fat is the type of fat most damaging for your heart, you should limit intake of all fats. Eating too much fat, no matter what kind, can make you put on excess weight. Eating too much fat can also increase your risk of certain types of cancer, such as breast or colon cancer.

How-To Information:

To limit your total fat intake:

  • Broil, bake, boil, or roast foods rather than fry.
  • Use non-stick pans or coat pans with a thin layer of non-stick spray.
  • Add less fat to food during both cooking and eating. Some examples include jam instead of margarine on toast, a non-fat or low-fat salad dressing instead of a high-fat dressing, lemon juice instead of butter on vegetables, or salsa instead of sour cream on baked potatoes.
  • Experiment with butter substitutes, spices, and other flavorings as alternative to fat.
  • Look for low-fat alternatives to foods, such as a bagel instead of a doughnut, pretzels instead of potato chips, or a round steak instead of a T-bone steak
  • Try new fat-free products like yogurt, cookies, or crackers.
  • Read labels, which offer excellent information to help you compare fat content of prepared foods.

How You Can Eat More Starches And Fiber

Including more starches and fiber in your diet can help you lower your cholesterol level as well as reduce your risk for obesity, cancer, high blood pressure, and other diseases.

Fresh fruits and vegetables and unprocessed grain products such as whole-grain breads and cereals are naturally low in fat, cholesterol-free, and rich in starches and dietary fiber.

For more information about fiber and your diet, go to Fiber: Its Importance In Your Diet.

A certain type of dietary fiber, called soluble fiber, may help lower cholesterol levels by sweeping cholesterol out of the body before it gets into the bloodstream. Foods rich in soluble fiber include oat bran, dried beans and peas, some fruits, and psyllium seeds (the main ingredient in the laxative Metamucil).

Fruits and vegetables also contain antioxidants, which are substances such as vitamin C (in citrus fruits), beta-carotene (in carrots), and vitamin E (in vegetable oils) that help protect body cells from damage. Antioxidants help prevent cholesterol from being moved out of the blood and into the lining of the blood vessels.

The U.S. Department of Agriculture's Food Guide Pyramid recommends that you eat the following number of servings of these plant foods daily:

  • 6-11 servings of grains (1 serving equals 1 slice of bread, ½ of a bun, ½ cup of pasta or rice)
  • 3-5 servings of vegetables (1 serving equals 1 cup of raw leafy vegetables or ½ cup cooked vegetables)
  • 2-3 servings of fruits (1 serving equals 1 medium apple, peach or orange; ½ cup of berries; or 3/4 cup juice)

How-To Information:

To include more starches and fiber in your diet:

  • Keep a food diary showing the number of servings of fruits, vegetables, and grains you get daily. If you are low, gradually try to increase servings of the groups lacking by adding fruits, vegetables, or whole grains as side dishes or snacks.
  • Buy breads and cereals that list a whole grain as the first ingredient. Whole grains contain more fiber and vitamins and minerals
  • Whenever possible, choose raw fruits and vegetables rather than processed ones.
  • Steam vegetables until crisp-tender rather than boiling them to death.
  • Whenever possible, leave skin on fruits and vegetables.
  • Add lemon juice, butter flavoring, or other seasoning to vegetables rather than fat.
  • Include several meatless meals weekly. Start with breakfasts, and then gradually add two or three lunches or dinners weekly.

Need To Know:

Sometimes these efforts to lower your cholesterol may not be enough. Your doctor may need to add medication.

For more detailed information on lowering your cholesterol, go to Lowering Cholesterol.

 

 
 

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From Andrew Maynard - Chair of the University of Michigan Department of Environmental Health Sciences, with help from David Faulkner - 2013 Master of Public Health graduate.