1. Cholesterol Levels Slideshow Pictures
2. Lower Cholesterol Slideshow: Avoid Heart Disease
3. Take the Cholesterol Quiz

Medical Author:

Benjamin Wedro, MD, FACEP, FAAEM

Benjamin Wedro, MD, FACEP, FAAEM

Dr. Ben Wedro practices emergency medicine at Gundersen Clinic, a regional trauma center in La Crosse, Wisconsin. His background includes undergraduate and medical studies at the University of Alberta, a Family Practice internship at Queen's University in Kingston, Ontario and residency training in Emergency Medicine at the University of Oklahoma Health Sciences Center.

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Medical Editor:

Melissa Conrad Stöppler, MD, Chief Medical Editor

Melissa Conrad Stöppler, MD, Chief Medical Editor

Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

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High cholesterol is just one of several risk factors for coronary heart disease. A health care practitioner will consider a person's overall risk when assessing their cholesterol levels and discussing treatment options.

Risk factors are conditions that increase a person's risk for developing heart disease. Some risk factors can be changed and others cannot. In general, the more risk factors a person has, the greater the chance of developing coronary heart disease. Some risk factors can be controlled; however, some cannot be controlled.

• Risk factors that cannot be cannot control include:

• age (45 years or older for men; 55 years or older for women); and
  
  
• family history of early heart disease (father or brother affected before age 55 years; mother or sister affected before age 65 years).

• Risk factors that can be controled include:

• high blood cholesterol (high total cholesterol and high LDL [bad] cholesterol);
  
  
• low HDL (good) cholesterol;
  
  
• quit smoking;
  
  
• high blood pressure;
  
  
• diabetes;
  
  
• obesity/excess weight; and
  
  
• physical inactivity.

If a person has high lipoproteins and thus high cholesterol, their doctor will work with them to target their levels with dietary and drug treatment. Depending on a person's risk factors for heart disease, target goals may differ for lowering thier LDL cholesterol.

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

• NCEP dietary guidelines are:
  
  • total fat: less than than 30% of daily caloric intake
    
    
  • saturated fat: less than 7% of daily caloric intake
    
    
  • polyunsaturated fat (found in vegetables, nuts, seeds, fish, leafy greens): less than or equal to 10% of daily caloric intake
    
    
  • monounsaturated fat: approximately 10%-15% of daily caloric intake
    
    
  • cholesterol: less than 200 milligrams per day
    
    
  • carbohydrates: 50%-60% of daily caloric intake

• Some people are able to reduce fat and dietary cholesterol with vegetarian diets.
  
  
• 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 the risk of heart disease. People who exercise and control their diet appear to be more successful with long-term lifestyle modifications that improve their heart risk profile.

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