Resource Library

Your body needs cholesterol to work properly. But cholesterol levels that are too high can be life threatening.

When you have extra cholesterol in your blood, it builds up inside the walls of your heart’s arteries (blood vessels). This buildup is called plaque. It narrows your arteries and reduces, or even stops, the blood flow. This can cause a heart attack, stroke, or other serious heart disease.

See also: Cholesterol - drug treatment

Cholesterol is measured in milligrams per deciliter (mg/dL). Starting between the ages of 20 and 35, most people should have their blood cholesterol levels tested at least every 5 years. If you have diabetes, heart disease, have had a stroke, or have blood flow problems to your feet or legs, you should have your cholesterol checked more often -- probably every year.

A blood cholesterol test measures the level of total cholesterol, HDL ("good") cholesterol, and LDL ("bad") cholesterol.

Your LDL level is what doctors watch most closely. You want it to be low. If it gets too high, you will need to treat it. Treatment includes eating a healthy diet that can lower your cholesterol, losing weight (if you are overweight), and exercising. You may also need medicine to lower your cholesterol.

• If you have heart disease or diabetes, your LDL cholesterol should stay below 100 mg/dL.
• If you are at risk for heart disease (even if you do not yet have any heart problems), your LDL cholesterol should be below 130 mg/dL.
• Almost everyone else may get health benefits from LDL cholesterol that is lower than 160 - 190 mg/dL.

You want your HDL cholesterol to be high.

• For men, it should be above 40 mg/dL.
• For women, it should be above 50 mg/dL.
• Exercise helps raise your HDL cholesterol.

Even if you do not have heart disease or diabetes, and your cholesterol levels are in the normal range, it is still important to eat right, stay at a healthy weight, and exercise. These healthy habits may help prevent future heart attacks and other health problems.

Eat foods that are naturally low in fat. These include whole grains, fruits, and vegetables. Keep them low in fat by using low-fat toppings, sauces, and dressings.

• Look at food labels, and pay special attention to the level of saturated fat. Avoid or limit foods that are high in saturated fat (more than 20% of the total fat). Eating too much saturated fat is one of the major risk factors for heart disease.
• Choose lean protein foods -- soy, fish, skinless chicken, very lean meat, and fat-free or 1% dairy products.
• Look for the words "hydrogenated" or "partially hydrogenated" on food labels. Do NOT eat foods that contain these because they are loaded with saturated fats and trans fats.
• Limit how much fried foods, processed foods, and commercially prepared baked goods (donuts, cookies, and crackers) you eat. They may contain a lot of saturated fats or trans fats.
• Eat fewer products that are high in saturated fats. Some of these are egg yolks, hard cheeses, whole milk, cream, ice cream, butter, and fatty meats (and large portions of meats).
• Pay attention to how foods are prepared. Healthy ways to cook fish, chicken, and lean meats are broiling, grilling, poaching, and baking.

Eat foods that are high in soluble fiber. Some of these are oats, bran, split peas and lentils, beans (kidney, black, and navy beans), some cereals, and brown rice. Learn how to shop for and cook foods that are healthy for your heart. Learn how to read food labels to make sure you are choosing healthy foods. And stay away from fast-food restaurants, where healthy choices can be hard to find.

See also:

• Butter, margarine, and cooking oils
• Dietary fats explained
• Fast-food tips
• How to read food labels
• Mediterranean diet

Getting plenty of exercise will also help you. Talk with your doctor about what kind of exercise might be best for you.

American Heart Association Nutrition Committee; Lichtenstein AH, Appel LJ, Brands M, Carnethon M, Daniels S, et al. Diet and lifestyle recommendations revision 2006: a scientific statement from the American Heart Association Nutrition Committee. Circulation. 2006 Jul 4;114(1):82-96.

Krauss RM. Nutrition and cardiovascular disease. In: Libby P, Bonow RO, Mann DL, Zipes DP, eds. Libby: Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 8th ed. Saunders;2007:chap 44.

Mosca L, Banka CL, Benjamin EJ, Berra K, Bushnell C, Dolor RJ, et al. Evidence-based guidelines for cardiovascular disease prevention in women: 2007 update. Circulation. 2007 Mar 20;115(11):1481-501.