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Managing Your Cholesterol

Steps to heart-healthy living

Cholesterol: Putting Yourself in Charge

High cholesterol can creep up on you without warning.  In fact, a heart attack or stroke may be your first clue that the fatty, waxy substance has been quietly clogging your arteries.  But the good news is that you can manage your cholesterol and protect yourself from its hazards - without sacrificing your taste for life.  By taking the first steps now, you can take control of your cholesterol before it takes control of you.

Shattering Myths About Cholesterol
Many people think they needn't worry about cholesterol, or that controlling cholesterol means they'll have to give up a lot of things they love.  Read on to learn the fiction - and the facts - about cholesterol.

Only out-of-shape men over 40 year of age need to worry about high cholesterol.
Not true.  Even if you're thin, young, female and exercise regularly, you could still have high cholesterol.

My cholesterol is low, so I can eat whatever I want.
Even if your cholesterol level is low now, eating high-fat, high-cholesterol foods can cause it to rise.

My family has never had heart problems, so I don't have to worry about high cholesterol.
High cholesterol can cause you health problems - even if your family has had no history of heart disease.

But I'll have to give up most of the things I love to eat.
Lots of delicious foods are low in cholesterol and fat - and many foods you love can be prepared in low-cholesterol ways.

Getting Smart About Cholesterol
All it takes to keep your cholesterol in line is some knowledge and new and healthier habits.  The first step is to get a cholesterol "score," so you have an accurate measurement of your cholesterol level.  The next step is to make some simple, healthy changes in your diet and lifestyle to help keep your cholesterol from becoming a problem - for life.

Are You at Risk?
No matter how old you are or what shape you're in, you can still be at risk for high cholesterol.  If you answer "yes" to any of these questions, you could have high cholesterol without your even knowing it.

Do you eat a lot of processed, convenience and fast foods?
Do you regularly eat high-fat dairy products like whole milk, butter and cheese?
Do your often eat steaks, chops and other fatty meats?
Do you eat a lot of breaded or fried food?
Are you overweight?
Do you exercise infrequently?
Has anyone in your family had heart disease before age 55?

The Anatomy of Cholesterol

Cholesterol is a white, waxy, odourless substance that helps your body use fats, insulates your nerve and brain tissues, waterproofs your skin, and helps make hormones.  But too much of a good thing can lead to problems - too much cholesterol in your blood can clog your blood vessels, leading to heart disease, chest pain or even stroke.

What Cholesterol Does
Your liver makes all the cholesterol your body needs to carry digested fat through your blood vessels.  Your liver does this by forming two cholesterol-fat "packages":

LDL (low-density lipoprotein) is often called "bad" cholesterol.  When you have too much LDL, it can easily stick to blood vessel walls.
HDL (high-density lipoprotein) is considered to be "good" cholesterol.  It clears your blood vessels of stuck cholesterol, helping to keep your vessels unclogged.

1 Your body digests the fat you eat and sends it to your liver, where it is processed for distribution.
2 Your liver packages fat and cholesterol together and delivers the packages (LDL) through your blood vessels.
3 Once the fat is "unloaded", leftover cholesterol starts back to the liver.  However, cholesterol pieces can "break off," becoming stuck and clogging the blood vessels.
4 HDL "rescues" the stuck cholesterol and brings it back to the liver.  The cholesterol is either recycled or broken down and excreted.

The Triglyceride Threat
Triglyceride is a type of fat your body uses to store sugar until you need the sugar's energy.  But when too much triglyceride accumulates, it too may cause clogging in your blood vessels.

What High Cholesterol Can Do to You

Cholesterol - and fat-clogged blood vessels, a condition call atherosclerosis, can restrict blood flow to your heart, brain and other parts of your body.  This can result in life-threatening health problems.

Coronary Artery Disease.  More than half a million Americans die from heart attack each year, usually as a result of coronary artery disease.  This disease, caused by clogged heart vessels, often goes undetected until a person's first heart attack.

Angina.  A lack of blood flow to the heart can cause angina, or chest pain.  The pain usually occurs with exertion or excitement and subsides with rest.

Stroke.  A lack of blood flow to the brain can cause a stroke, resulting in death, paralysis or loss of speech.  Stroke is the third largest cause of death in the USA.

Getting Tested: The First Step

The first step in managing your cholesterol is finding out what your cholesterol level really is.  Have your cholesterol checked by age 20 and then get it checked again at least every five years.  The procedure is simple, often free or inexpensive, and can be done conveniently.  Once you know what your cholesterol "score" is and have learned what it means, you can take action either to reduce your cholesterol score or to keep it low.

Where You Can be Tested
You can have your cholesterol "screened" at a company health fair.  Or "testing" may be done at your doctor's office or at other locations recommended by your company's medical department, your doctor or another qualified health care professional.

How the Test Works
Screening - at a health fair, for example - usually requires no preparation.  A small sample of blood is taken from your finger, analysed and the results are given to you immediately.  Testing at your doctor's office or your company's medical department may require fasting (going without eating) before the test.  A blood sample is drawn from your arm and sent to a lab; it may take a few days to receive your score.

What Your Cholesterol Scores Mean
Screening gives you a score for your total cholesterol.  Testing gives you a total score, and provides scores for HDL, LDL and triglyceride.  Once you know your scores, the next step is to see whether your total cholesterol level is "high," borderline high" or "desirable."  And you can also check to see if your HDL, LDL or triglyceride scores fall into healthy ranges.

Total cholesterol
High:  240 or higher.  You have increased risk for heart disease and stoke.  See your doctor right away and begin lowering your cholesterol by following the guidelines in the following text.

Borderline high: 200 to 239.  You may be at increased risk for heart disease.  Have a follow-up test to confirm the results, and start right away to lower your cholesterol by following the steps in this text.

Desirable: Less than 200.  Your cholesterol level is probably just where it should be.  Follow the suggestions in this text to keep your cholesterol low.

Your other scores.  If any of your other scores are not at a healthy level, see your doctor.
HDL - 35 or greater is a healthy level.
LDL - Less than 130 is a healthy level.
Triglyceride -  Less than 250 is a healthy level.

Your Strategy for Cholesterol Control

If your total cholesterol score was high or borderline high, you can make some simple changes, starting today, in your eating, exercise and lifestyle.  These changes can help bring your cholesterol back in line.  And even if your cholesterol is already desirable, by following this healthy strategy, you'll lower your risk for health problems and may improve how you look and feel, as well.

Eat Better
A good way to lower your cholesterol is to eat better.  Start by lowering the amount of fat and cholesterol and increasing the amount of fibre and starches you eat.  Try keeping a food diary for a few days to identify your eating patterns - and note areas where you need to make some changes.  Use this book to develop a plan for how you'll begin to eat better.

Start the Exercise Habit
Exercise seems to increase HDL ('good') cholesterol.  Regular exercise also has other heart-healthy benefits: It reduces your stress, can lead to weight loss and improves your cardiovascular fitness.  Make it a goal to exercise aerobically (for example, walking, jogging or swimming) three or four times a week for 20-30 minutes each time.  And remember to check with your doctor before starting an exercise programme.

Watch Your Weight
If you're overweight, your body is storing too much fat and cholesterol.  In fact, those extra kilograms may be all it takes to push your cholesterol score above the "desirable" level.  The best way to take off extra weight is to reduce the amount of fat in your diet and to exercise regularly.

Other Steps You Can Take
If your cholesterol level does not go down after three to six months of a low-fat, low-cholesterol diet and weight loss, your doctor may recommend cholesterol-lowering medication.  Remember, medication is in addition to your low-cholesterol eating plan.  To help lower your risk for heart disease and stroke, it's also wise to stop smoking, control high blood pressure and learn to manage stress.

Make a Plan
Don't set yourself up for frustration and failure by making too many big changes at once.  Instead, start with one goal - like eating better - that you can realistically accomplish.

Changing the Way You Eat

The best way to lower or maintain your cholesterol score is to change the way you eat.  The key is to cut back on foods high in fat and cholesterol and choose more starches and fibre-rich foods.  A low fat, low-cholesterol food plan can help you lose weight and feel better, too.  These guidelines can help you make the basic changes in your diet.  A qualified dietician can give you other helpful tips.

Cut Back on Fat
Most of us eat far more fat than we should.  Limit fats to less than one-third of your total calories.  Avoid saturated fats, such as fatty meats, butter, lard and some vegetable oils (palm, coconut and "hydrogenated" oils found in many processed foods).  When you do eat fats, pick monounsaturated and polyunsaturated fats like:

Olive oil
Rapeseed (canola) oil
Safflower oil
Sunflower oil

Keep an Eye on Cholesterol
Eating lots of high-cholesterol food can cause your cholesterol score to rise.  Cholesterol is found in all animal products, but is especially high in eggs, meat and dairy products.  Choose low-cholesterol alternatives, like:

Egg substitutes or egg whites
Skim milk

Eat More Fibre
Some types of fibre may help lower your cholesterol level by keeping your body from absorbing the cholesterol you eat.  Add foods rich in fibre to your diet, including:

Whole grains
Fresh fruits
Fresh vegetables

Choose More Starches
Starches, or complex carbohydrates, may help lower your cholesterol by "diluting" the fat you eat.  Make it a habit to eat more starches, such as:

Whole-grain cereals and breads
Root vegetables like potatoes and yams

Read Labels to Find Hidden Fat
Processed foods often contain lots of "hidden" fat.  By reading labels, you can see if the food you're buying is a healthy choice or a cholesterol risk.

Too much fat?  Ingredients are listed by weight.  If several fat-filled items (such as oil, butter or meat) are toward the top of the list, avoid this high-fat product.

Saturated fat?  If saturated fats are listed (such as lard, hydrogenated vegetable oil and beef), look for a product that uses mono- or polyunsaturated fat instead.

Too many fat calories?  Find out how many calories come from fat by multiplying the grams of fat by nine (one gram of fat contains nine calories).  If the total is more than a third of the total calories, put the product back on the shelf - not in your cart.

Great Tastes to Live By

Low-cholesterol eating doesn't mean low-flavour eating.  Breakfast, lunch, dinner and snacks can be high-appeal meals that treat your taste buds while trimming your cholesterol score.  Here are some ideas for delicious, low-cholesterol menus and cooking tips that bring out great taste while cutting back on fat.

The Right Start at Breakfast
Your body uses food more effectively when you eat it earlier in the day.  So, enjoy one of these healthy, quick, and delicious morning meals.

Bagel with jam
Low-fat or non-fat yoghurt
Fresh fruit
Fruit juice
Whole-grain cereal
Skim milk
Toast with jam

Good Food On-the-Go
Even eating at your desk or on-the-run, you can enjoy one of these heart-smart, delicious lunches.

Turkey sandwich on whole-wheat bread with lettuce, tomato and mustard
Fruit salad
Pasta and vegetable salad with olive oil and vinegar dressing
Fresh fruit

Smart Snacks
Great low-cholesterol snacks are always in easy reach.  Try some of these.

Plain, air-popped popcorn
Frozen juice bar
Low-fat or non-fat yoghurt
Low-salt pretzels
Raw vegetables
Low-fat crackers
Fresh, dried or frozen fruit

Delicious Dinners
At the end of the day, try one of these healthy, high-flavour and satisfying meal ideas.

Turkey breast and fresh vegetable kabobs
Green salad with olive oil and vinegar dressing
French bread
Fresh fruit
Roast chicken breast without skin
Steamed vegetables
Skim milk
Baked apple

Treat Yourself
Once in a while, indulge your urge to splurge.  Occasionally, allow yourself a higher-fat snack as a treat.  Enjoy it - then return to your healthy way of eating without feeling guilty.

Tips for Low-Cholesterol Cooking
Steam, microwave, broil, grill or bake food without adding fat.
Use non-stick sprays or cookware.
Remove skin from poultry and trim extra fat from meat before cooking.
Substitute margarine for butter, and use less.
Use vegetable oil instead of lard or shortening, and use less.
Replace each egg in recipes with two egg whites.
Try non-fat, butter-flavoured powders.
Use reduced-fat salad dressings and mayonnaise.

Eating Well When You Eat Out

You don't have to stay at home to eat low-cholesterol meals.  Most restaurants now offer menu items that are low in both fat and cholesterol.  And if you request it, many restaurants are happy to prepare food for you in healthy ways.  Use these lists as a guide for dining out in heart-healthy style.

Salad with lots of fresh vegetables and just a little dressing
Broiled, grilled, or baked chicken, veal or seafood
Turkey sandwich with lettuce, tomato and mustard
Small hamburger with lettuce, tomato and mustard
Baked potato with a little margarine or herbal seasoning

Pasta with red marinara or clam sauce
Spaghetti with tomato-based sauce and lean meatballs
Pizza with half the cheese and vegetable toppings
Ravioli or tortellini
Potato gnocchi
Minestrone soup
Polenta (not fried)
Salad with olive oil and vinegar dressing

Fish a la Veracruzana
Chicken fajita
Soft taco
Burrito with beans (not refried) and just a little cheese
Beans (not refried) and rice
Baked cornmeal tamale
Ceviche (marinated raw seafood)
Steamed tortillas

Steamed vegetable dishes
Steamed vegetarian pot stickers or dumplings
Steamed rice or noodle dishes
Steamed entrees
Sushi or sashimi
Stir-fried tofu dishes
Chicken or fish steamed or cooked in broth
Hot and sour soup

Bouillabaisse (fish soup)
Fresh oysters and clams
Broth-based soup
Chicken stewed in tomatoes or wine sauce
Poached, steamed, broiled or grilled chicken, seafood or veal
Ratatouille (vegetable stew)
Poached pears or fresh fruit
Salad with olive oil and vinegar dressing

Fast Food
Grilled unbreaded chicken sandwich with lettuce and tomato
Salad with lots of fresh vegetables and just a little dressing
Hamburger with vegetable toppings and low-fat dressing
Baked potato with a little margarine or herbal seasoning

Speak up for Healthy Food
If you don't see a healthy preparation - like broiling, grilling or steaming - on the menu, don't be afraid to ask your waiter to special-order it for you.

A Change for the Better
A low-cholesterol lifestyle means eating right, watching your weight, exercising and quitting smoking.  Not only is this a good way to bring your cholesterol down to a healthy level, but this can also reduce your risk of heart disease and stroke.
Your cholesterol score may not come down "overnight."  But gradually your score should lower.  And in the meanwhile, you'll probably notice other benefits as well.  A heart-healthy way of life can make you better - and even stay healthier overall.  It's a positive change that you and your whole family can make for life.


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