When your cholesterol is too high, it’s usually due to lifestyle choices that need your attention: Diet, exercise, weight and the use of tobacco. And, while your gender, heredity and getting older can also affect cholesterol levels, you can’t change those characteristics like you can your diet and exercise.

Your body produces all the cholesterol it needs to make hormones, vitamin D, bile acids and other substances it needs. Cholesterol is a waxy fat-like substance found in the walls of cells in all parts of the body. Cholesterol travels throughout your body in “packages” called lipoproteins. There are two kinds of lipoproteins:

–Low-density lipoprotein or LDL, is “bad” cholesterol because it increases your risk for heart disease by carrying cholesterol through your arteries. Ideally, your LDL should be below 100 mg/dL; 160 mg/dl is considered high.

–High-density lipoprotein or HDL, is “good” cholesterol because it carries cholesterol to your liver where it is removed from your body. A good HDL is 60 mg/dL; less than 40 mg/dL is considered a major risk for heart disease.

If your cholesterol is high, it’s because there’s too much cholesterol circulating in your blood. Cholesterol can become trapped in artery walls where it builds up and turns into plaque. Plaque narrows blood vessels and makes them less flexible—called hardening of the arteries (atherosclerosis). Plaque build-up also restricts the amount of oxygen and other nutrients that replenish your heart. If you don’t improve your lifestyle, the result can be chest pain (angina), blood clots, and eventual heart attack.

STEP 1:  Improve your diet:  What you eat–or don’t eat–is the main cause of a high LDL cholesterol level.

  • Reduce the amount of saturated fat (e.g., from red meats, fatty meats, cheese) and trans fats (from processed foods like stick margarine, crackers, cookies, doughnuts, French fries and foods fried in shortening or lard).
  • Eat more soluble fiber (whole grains, fruits with the skin on, vegetables, beans and peas).
  • Choose lean meats, chicken without the skin and fish (salmon, albacore tuna and mackerel).
  • Slowly reduce your salt intake, especially from processed or salty foods.
  • Limit alcohol to no more than one drink a day for women; two drinks a day for men. Always drink plenty of water.

STEP 2: Get regular physical activity. At least 30 min. a day can increase good HDL cholesterol, help you lose weight and, in turn, lower your LDL cholesterol and blood pressure. Moderately intense activities include dancing, bowling, gardening, house cleaning or golfing without a cart. Three, 10-min. sessions are as helpful as 30 min. at one time.

STEP 3: Maintain a healthy weight. Excess pounds increase your LDL and lower your good HDL. To control your weight:

  • Slow down your meal times and chew slowly. It takes your brain 15 min. to know you’ve eaten.
  • Slowly decrease your portion sizes; try using smaller plates and bowls so portions look bigger.
  • Eat more fruits and veggies. They provide a sense of fullness without the calories and fat.
  • Don’t skip meals because it causes you to overeat. Skipping meals slows your metabolism so you’re burning fewer calories, making it harder to lose weight. Eating four to six small meals helps control weight better than two or three regular meals.
  • Identify your overeating triggers, such as eating when stressed, watching TV or eating out with friends. Avoid your triggers by focusing on another activity or monitor what you eat when triggers arise.

STEP 4: Quit tobacco. Check with your doctor about medications and other resources that can help you quit for good.

Get checked. High cholesterol rarely has symptoms. That’s why it’s important to have it checked at least every five years. A small sample of blood is drawn after a 9-12 hour fast. If your cholesterol is already elevated, ask your doctor how often it should be checked.

Statin therapy. Your doctor may prescribe a statin drug because they’re highly effective in lowering LDL and preventing heart disease. Statins are especially important for people who already have heart disease, diabetes, or who have a high LDL cholesterol level and are over age 40.