It
is
important
for
people
of
all
ages
to
lower
their
blood
cholesterol.
We
now
know
that
1
of
every
2
men
and
1
of
every
3
women
will
develop
heart
disease
during
their
lifetime.
Whether
you
already
have
heart
disease
or
want
to
prevent
it,
you
can
reduce
your
risk
for
having
a
heart
attack
by
lowering
your
blood
cholesterol.
Use
the
Coronary
Risk
Calculator
to
calculate
your
risk
for
having
a
heart
attack
in
the
next
10
years.
The
Calculator
can
also
be
used
to
calculate
what
your
risk
would
be
if
you
made
some
important
changes,
such
as
lowering
your
cholesterol
or
lowering
your
blood
pressure
or
stopping
smoking.
Levels
of
Cholesterol
Total
cholesterol
and
HDL-cholesterol
("good"
cholesterol)
may
be
measured
in
a
nonfasting
blood
sample.
However,
to
have
an
LDL-cholesterol
("bad"
cholesterol)
determination,
a
fasting
blood
sample
must
be
taken
so
that
triglyceride
can
be
measured
and
LDL-cholesterol
can
be
calculated.
Fasting
for
these
tests
means
nothing
to
eat
or
drink,
except
plain
water,
for
12
to
14
hours.
Use
the
table
below
to
determine
if
your
cholesterol
is
at
a
desirable
level
or
needs
attention
|
Cholesterol
|
Desirable
|
Needs
Attention
|
| Total
cholesterol |
Less
than
200 |
200
to
239
240
or
higher |
Borderline
highHigh |
| LDL-cholesterol |
Less
than
100 |
100
to
129
130
to
159
160
to
189
190
or
higher |
Near
or
above
optimal
Borderline
high
High
Very
high |
| HDL-cholesterol |
Higher
than
60 |
40
or
lower |
Low
(increased
risk
for
heart
disease) |
| TC:HDL
ratio
|
Less
than
4.5* |
5
or
higher |
High |
| LDL:HDL
ratio |
Less
than
3 |
3.5
or
higher |
High |
*
Value
obtained
by
dividing
TC
(total
cholesterol)
by
HDL.
Causes
Related
to
Elevated
Cholesterol
The
major
dietary
contributors
to
elevated
cholesterol
are:
saturated
fat,
trans
fat,
dietary
cholesterol,
and
an
imbalance
between
calorie
intake
and
energy
expenditure
leading
to
obesity.
Heredity
also
plays
an
important
role
in
this
disorder,
although
usually
it
is
lifestyle
choices
that
"turn
the
key"
of
a
genetic
susceptibility.
In
some
cases
elevated
cholesterol
may
be
due
to
an
underlying
medical
condition
or
to
use
of
certain
drugs.
Your
physician
can
help
you
determine
the
possible
causes.
A
dietitian
can
help
you
change
your
eating
pattern
to
control
the
first
"possible
cause"
listed
below.
- Diet
rich
in
saturated
fat,
trans
fat,
dietary
cholesterol,
and
excessive
calories
leading
to
obesity
- Hyporthyroidism
(low
thyroid
function)
- Nephrotic
syndrome
(a
kind
of
kidney
disease)
- Chronic
liver
disease
(mainly
primary
biliary
cirrhosis)
- Cholestasis
(stopped
or
suppressed
flow
of
bile)
- Monoclonal
gammopathy
(disturbed
immunoglobulin
synthesis)
- Cushing's
syndrome
(high
corticosteroid
levels)
- Oral
contraceptive
use
(birth
control
pills)
- Anorexia
nervosa
(an
eating
disorder)
- Acute
intermittent
porphyria
(a
liver
enzyme
deficiency)
- Protease
inhibitor
use
(drugs
for
the
treatment
of
HIV
infection)
Diet
to
Lower
Cholesterol
Dietary
therapy
is
the
cornerstone
of
cholesterol
lowering.
The
first
step
in
diet
therapy
is
assessment
of
current
eating
habits.
A
diet
to
lower
cholesterol
emphasizes:
The
primary
goal
of
a
diet
to
lower
blood
cholesterol
is
to
reduce
risk
for
coronary
heart
disease
by
decreasing
saturated
fat,
trans
fat,
and
dietary
cholesterol
and
restore
appropriate
calorie
balance,
while
promoting
good
nutrition.
Medication
to
Lower
Cholesterol
If
a
safe
level
of
LDL-cholesterol
is
not
achieved
with
diet
and
other
lifestyle
change,
your
physician
may
prescribe
a
cholesterol-lowering
medication.
Medication
is
in
addition
to
the
diet-not
in
place
of
it.
SLIM
is
the
System
for
Lifestyle
Internet
Management.
It
provides
everything
you
need
to
know
about
a
diet
to
lower
cholesterol,
and
easy-to-follow
steps
for
making
dietary
changes.
Your
diet
to
lower
cholesterol
will
be
based
on
the
calorie
level
you
need
to
lose
weight
or
to
maintain
your
current
weight.
It
is
available
to
you
as
a
Living
Heart
Member.
Click
to
learn
about
Benefits
of
Membership,
Membership
Plans,
and
Steps
for
Enrollment.
In
addition
to
a
diet
for
lowering
blood
cholesterol,
you
may
wish
to
contact
a
dietitian
for
Nutritional
Counseling.
If
you
would
like
to
have
a
cholesterol-lowering
diet,
click
here.
Adapted
from
Executive
Summary
of
the
Third
Report
of
the
National
Cholesterol
Education
Program
(NCEP)
Expert
Panel
on
Detection,
Evaluation,
and
Treatment
of
High
Blood
Cholesterol
in
Adults
(Adult
Treatment
Panel
III).
Journal
of
The
American
Medical
Association,
Vol.
285,
No.
19,
May
16,
2001.
|
