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High Cholesterol (cont.)

High Cholesterol Treatment

Self-Care at Home

If you have high lipoproteins and thus high cholesterol, your doctor will work with you to target your levels with dietary and drug treatment. Depending on your risk factors for heart disease, your target goals may differ for lowering your LDL cholesterol.

Diet: The National Cholesterol Education Program has created dietary guidelines.

NCEP dietary guidelines
- Total fat - Less than 30% of calories
- Saturated fat - Less than 7% of calories
- Polyunsaturated fat - Less than or equal to 10% of calories
- Monounsaturated fat - Approximately 10-15% of calories
- Cholesterol - Less than 200 milligrams per day
- Carbohydrates - 50-60% of calories

The new guidelines are more stringent than previous ones, mandating more restriction on saturated fat and dietary cholesterol.
Some people are able to reduce fat and dietary cholesterol with vegetarian diets. Dean Ornish and his colleagues have shown the value of a very strict fat-reduction diet in unblocking coronary arteries. Whether these dietary restrictions are realistic for most Americans is debatable. Moreover, such a diet also reduces HDL and raises triglyceride levels.
Stanol esters can be included in the diet and may reduce LDL by about 14%. Products containing stanol esters include margarine substitutes (marketed as brand names Benecol and Take Control).
People with higher triglycerides may benefit from a diet that is higher in monounsaturated fat and lower in carbohydrates, particularly simple sugars. A common source of monounsaturated fat is olive oil.

Activity: Although exercise has little effect on LDL, aerobic exercise may improve insulin sensitivity, HDL, and triglyceride levels and may thus reduce your heart risk. People who exercise and control their diet appear to be more successful in long-term lifestyle modifications that improve their heart risk profile.