How to Achieve
a Lower Cholesterol Level

Achieving a lower cholesterol level is one of the best ways to reduce your risk of heart disease and stroke. However, your total cholesterol level includes 2 major components: 1) The cholesterol found in low density lipoprotein (LDL), and 2) The cholesterol found in high density lipoprotein (HDL). LDL acts to deposit cholesterol in your arteries and is thus undesirable, while HDL serves to carry cholesterol away from your blood vessels and is thus desirable. That is why it is important, when you get your regular physical exam, to ask your doctor for a complete lipid profile that shows the levels of your different cholesterol components. The American Heart Association recommends keeping the ratio of total cholesterol to HDL under 5.0, with an optimal ratio of 3.5. The object then is to reduce your total and LDL cholesterol levels and increase your HDL level. The following methods have been proven most effective for achieving these goals:

Lower Your Total and LDL
Cholesterol Levels

To achieve a lower cholesterol level, cut down on the following foods and food components:

  • Trans fats: Avoid any product whose ingredient list includes partially hydrogenated oil, shortening, or margarine. Notable offenders include cookies, crackers, and cakes, cereal bars, and frozen dinners.

  • Saturated Fats: These are mainly found in meats, full-fat dairy products, and tropical oils. Therefore, you should limit meat intake to 8 oz per day, choose leaner cuts of meat such as chicken breast and top round steak, and trim visible fat before cooking. Use skim or 1% milk and low-fat or fat-free yogurt and other dairy products. Use cheese sparingly as even reduced fat cheese such as part-skim mozzarella and ricotta still contain a fair proportion of fat.

  • Cholesterol: All flesh food, including fish, meat, and poultry contain relatively large amounts of cholesterol. So do other animal products such as milk and eggs. Thus, to achieve a lower cholesterol level, these foods should be eaten in moderation, with vegetables, fruit, and whole grains making up a large proportion of the diet.

Follow the advice of The Mayo Clinic and add the following foods to your diet:

  • Foods containing soluble fiber such as oatmeal, oat bran, apples, and pears

  • Walnuts - All nuts are high in calories, so be careful not to increase daily caloric intake.

  • Fish rich in omega-3 fatty acids such as salmon, sardines, mackerel, tuna, lake trout, and herring

  • Olive oil - The Food and Drug Administration recommends 2 tablespoons a day. Of course, this is most palatable if used to sauté vegetables or as salad dressing.

  • Food fortified with plant sterols or stanols, including some orange juices, yogurt drinks and margarines (avoid those containing hydrogenated fats).

  • Consider red yeast rice as an alternative to statin drugs:

    Many Americans currently take statin drugs like Lipitor and Zocor in order to lower to achieve lower cholesterol levels, and there has been little downside evidenced for their use. Since these drugs act on the liver, your doctor must do a blood test to check your liver function before prescribing statins.

    Some men suffer from muscle pains and weakness when taking statins to lower cholesterol and other men have a general aversion to drugs and prefer natural alternatives. A food supplement called red yeast rice or red rice yeast, used for many years as a condiment in the Far East, effectively reduced LDL cholesterol levels an average of 27% among men who could not tolerate statins. The trial dosage was 1800 mg/day.

    Although red yeast rice is available in health food stores, it is advisable to get a liver function test before taking it to lower cholesterol because the substance appears to contain natural statins. If the supplement and other natural measures fail to lower total and LDL cholesterol to recommended levels, even men averse to taking medication should seriously consider statins if their doctor recommends them.

Raise Your HDL Level

  • Do aerobic exercise regularly: The evidence suggests that the amount of aerobic exercise (e.g. running, cycling, swimming, walking) you do is more important than the exercise intensity in raising your HDL level. So it‘s advisable to do aerobic exercise at least 3-4 times a week for at least 20 minutes but 30-40 minutes if you can. Make sure to check our Exercise Risk Questionnaire to determine whether you need a physician’s clearance before exercising.

  • Drop weight if you carry excess fat: This should raise your HDL level especially if your waist circumference at navel level is greater than your hip circumference at its widest point.

  • If you smoke, quit! In addition to the many other health problems smoking brings about, it also has the unfortunate effect of lowering your HDL level.

  • Eliminate trans fats from your diet: Avoid foods whose ingredient lists contain partially hydrogenated vegetable oil, shortening, or margarine.

  • Alcohol: One to two drinks per day seems to have a positive effect on HDL level. However, it is not recommended that men who do not drink or drink occasionally raise their alcohol intake because of the associated risk of motor vehicle accidents and violence. Also, alcohol tends to have a negative effect on a man‘s testosterone level, which is undesirable for most men.

  • Use olive oil: The monounsaturated fat in olive oil helps raise the HDL level. Canola oil is less expensive than olive oil and contains a high percentage of monounsaturated fat. However, it is also high in polyunsaturated fat, which appears to have a negative effect on a man’s testosterone level.

  • Eat more soluble fiber: In addition to lowering the LDL level, soluble fiber can raise your HDL level. Good sources include oatmeal, oat bran, apples, and pears. Soluble fiber is also recommended for colon health.

  • Talk to your doctor about niacin treatment: Niacin, a common B-vitamin, can raise HDL levels. However, in the doses required, niacin is considered a drug. Therefore, it is necessary to see a doctor and getting a liver function test before embarking on such treatment.

  • Do not follow a low-fat diet: Low-fat diets are not recommended because they both depress HDL level and deprive the body of essential fatty acids that cannot be manufactured by the body. Fats are also needed for testosterone production. Don’t be afraid to get 25-35% or your calories from fat, with the preferred forms being monounsaturated (e.g. from olive oil), and omega-3 (e.g. from fatty fish). However, because fats are high is calories, you must be careful not to overeat. The good new is that fats tend to reduce hunger.
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