4 ways to eat your way to lower cholesterol

  October 20, 2016    Victor Jegede

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4 ways to eat your way to lower cholesterol Stick with unsaturated fats and avoid saturated and trans fats. Most vegetable fats (oils) are made up of unsaturated fats that are healthy for your heart. Foods that contain healthy fats include oily fish, nuts, seeds, and some vegetables. At the same time, limit your intake of foods high in saturated fat, which is found in many meat and dairy products, and stay away from trans fats. These include any foods made with "partially hydrogenated vegetable oils." Get more soluble fiber. Eat more soluble fiber, such as that found in oatmeal and fruits. This type of fiber can lower blood cholesterol levels when eaten as part of a healthy-fat diet. Include plant sterols and stanols in your diet. These naturally occurring plant compounds are similar in structure to cholesterol. When you eat them, they help limit the amount of cholesterol your body can absorb. Plant sterols and stanols are found in an increasing number of food products such as spreads, juices, and yogurts. Find a diet that works for you. When a friend or relative tells you how much his or her cholesterol level dropped after trying a particular diet, you may be tempted to try it yourself. If you do, and after a few months you discover that you're not getting the same benefits, you may need to chalk it up to genetic and physiological differences. There is no one-size-fits-all diet for cholesterol control. You may need to try several approaches to find one that works for you. Although diet can be a simple and powerful way to improve cholesterol levels, it plays a bigger role for some people than for others. Don't be discouraged if you have followed a diet but not reached your goal blood level. Keep it up. Even if you do end up needing medication to keep your cholesterol in check, you likely will need less than if you didn't make any dietary changes. For more on lowering cholesterol, buy Managing Your Cholesterol, a Special Health Report from Harvard Medical School.  Making sense of the statin guidelines These guidelines shifted from a numbers-based approach to a risk-driven approach. Instead of aiming for a specific cholesterol value, doctors were urged to look at a person's entire cardiovascular risk profile when considering treatment. This is a reasonable approach that can help simplify how doctors think about whom to treat.For years, doctors prescribed cholesterol-lowing statins based largely on cholesterol test results. The goal was to lower total cholesterol to under 200 mg/dL, and LDL (bad) cholesterol to under 100 mg/dL. But in late 2013, new guidelines on statin use issued by the American Heart Association (AHA) and the American College of Cardiology (ACC) proposed a major change to that strategy. The 2013 guidelines were met with more than the usual criticism, however. In fact, they've generated considerable debate over their departure from the approach of earlier guidelines. The new guidelines don't, for example, specify normal and abnormal levels for total cholesterol, LDL, HDL, and triglycerides, as past versions have done. Perhaps the best way to look at these guidelines is as a scientific statement reviewing what has been definitively established to date. Who should take a statin? The 2013 guidelines recommend a daily statin for individuals who fall into the following four categories: anyone age 21 or older with a very high level of harmful LDL cholesterol (190 mg/dL or higher) anyone who has cardiovascular disease, including stable or unstable angina (chest pain with exercise or stress); has had a heart attack, stroke, or transient ischemic attack ("ministroke"); has peripheral artery disease; or has had bypass surgery or angioplasty to treat a cholesterol-clogged artery anyone age 40 to 75 who has diabetes anyone age 40 to 75 who does not have cardiovascular disease but has a greater than 7.5% chance of having a heart attack or stroke or developing another form of cardiovascular disease in the next 10 years (as determined using the online risk calculator cited below). That last category represented a major shift. In principle, if doctors follow the guidelines and start treating people who don't have heart disease but are at risk for it, several million more people will take a statin every day. It's not yet clear if that has happened, however, as studies examining this question have offered differing results. To determine an individual's future risk of developing cardiovascular disease, the AHA/ACC panel created a risk calculator. It's available online at www.health.harvard.edu/heartrisk. The calculator takes into consideration your age, sex, race, total cholesterol, "good" HDL cholesterol, blood pressure, and whether you are being treated for high blood pressure, have diabetes, or smoke. To learn more about ways to treat high cholesterol and who should be treated, buyManaging Your Cholesterol, a Special Health Report from Harvard Medical School.