Cholesterol is a waxy, fat-like substance found in the bloodstream. It comes from two sources- your body and food. It is made by the liver and is used by the body to make hormones and other materials. Cholesterol is an essential part of the human body. It must be present for the body to function normally. However, the average high-fat/high-cholesterol diet tends to add too much cholesterol to the bloodstream. The excess cholesterol accumulates, along with other substances, in the walls of the blood vessels. Over time, this causes the arteries to become narrow and eventually cuts off the blood flow to the heart leading to a heart attack, or cuts off the blood flow to the brain leading to a stroke. Blood cholesterol is measured in milligrams per deciliter (mg/dl). The National Cholesterol Education Program (NCEP) has set guidelines for classifying blood cholesterol levels. They advise that a total cholesterol level less than 200mg/dl is a desirable level for adults.

Calorie:

A calorie is a unit that measures energy. Calories come from four sources: carbohydrate, fat, protein and alcohol. When nutrition information is listed on packaged foods, calories are listed for one serving.

The following list shows the caloric value of each source of energy:
1 gram of protein = 4 calories
1 gram of carbohydrate = 4 calories
(sugar or starch)
1 gram of alcohol = 7 calories
1 gram of fat = 9 calories

The following example shows how to apply the caloric value of each energy source:

A serving of cereal may have 16 grams of carbohydrate, 4 grams of fat, 5 grams of protein and contain 120 calories.
•    Carbohydrate: 16 grams x 4 calories per gram = 64 calories from carbohydrate
•    Fat: 4 grams x 9 calories per gram = 36 calories from fat
•    Protein: 5 grams x 4 calories per gram = 20 calories from protein
1 serving of cereal = 120 calories

Dietary Cholesterol:

Cholesterol is found in all animal products: meat, poultry, seafood, eggs and dairy products. It is especially high in egg yolks and organ meats such as liver, brains and kidneys. Eating foods high in dietary cholesterol tends to raise the level of blood cholesterol. The National Cholesterol Education Program (NECP) recommends eating less than 300 milligrams of dietary cholesterol per day.

Vegetable products do not contain cholesterol, but they may be loaded with fat. Labels stating “NO CHOLESTEROL” on food packages should alert you to look at the nutrition information to determine the amount of fat and saturated fat. Research has shown that saturated fat is the most potent determinant of blood cholesterol levels (more than dietary cholesterol!)

Fat:

Fat is a major source of calories or energy. Fat improves the taste and odor of foods and gives a feeling of fullness. Fats form the structures in our bodies, including muscles, nerves, membranes and blood vessels and are essential for the absorption of fat-soluble vitamins A, D, E and K in the body.

Although some fat in the diet is necessary, too much fat can lead to heart disease, obesity and other health problems. There are three kinds of fat: saturated fat, polyunsaturated fat and monounsaturated fat. Fats in the diet may be of animal (saturated) or vegetable (unsaturated) origin. Examples of fat in the diet are gravy, bacon, margarine, butter, cream, salad dressings and nuts. Meats and some milk products also contain significant amounts of fat. The guidelines recommended by the American Heart Association and the Surgeon General’s Office suggest that fat should contribute no more than 30% of total calories. For those adults with heart disease a diet of 20 percent or even 10 percent of calories from fat is advised. The fat we eat is saturated and unsaturated. These terms refer to the chemical structure of the fat molecules. A low total fat intake, with the majority of fat from unsaturated sources, appears to lower blood cholesterol levels. Too much of any of these fats will increase dietary fat intake, and excess body fat may increase cholesterol levels and the potential to increase body fat.

Fatty Acids:

The major parts of fat. Depending on their chemical structure, fatty acids are classified as either saturated or unsaturated. Fats found in foods are a mixture of saturated and unsaturated fatty acids. There are two types of unsaturated fats: monounsaturated and polyunsaturated.

Figuring Fat Intake:

Regardless of type, all fat has nine calories per gram. Food labeling laws in the U.S. now require the percentage of fat in a serving of food to be listed (called the “Percentage of Daily Value” or DV). If the DV isn’t listed, divide the number of grams of fat shown on the label by 65 (which is about the maximum grams of fat recommended in an average 2,000-calorie-a-day diet).

You can also figure the percentage of fat calories in a serving by the following steps:

1.    Check label for grams of fat per serving.
2.    Multiply grams of fat by 9 (1 gram of fat = 9 calories). This equals the calories from fat.
3.    Divide calories from fat by the total calories per serving, as listed on the label. The answer will be a decimal.
4.    Multiply the answer by 100. This equals the percent of calories from fat.

The American Heart Association Recommends Limiting Fat Intake to 30% of Daily Calories. Thus, a 2,000-calorie-a-day diet should not contain more than 65 grams or 585 calories of fat.

If we assume a daily intake of 2000 calories, then no more than 600 calories per day (30%) should come from fat. Since each gram of fat contributes nine calories, then about 66 grams of fat would be the suggested upper limit of fat intake per day (600 ? 9). If you’re not careful, it’s very easy to go way over that with just one meal!

So what is a reasonable limit per meal or per entree? If we divide the day’s allotment (66 grams) into three equal meals, then a reasonable limit per meal is 22 grams of fat. Main entrees usually contribute the largest amount of fat to the meal.

Hydrogenated Fats:

Hydrogenated/Partially hydrogenated. Unsaturated fat that has hydrogen added to make it saturated. Hydrogenation turns liquid vegetable oils into solid fats. For instance, soybean oil is “hydrogenated” to become a solid vegetable shortening. Also, hydrogenated vegetable oil may be added to margarine to make it solid at room temperature and easier to spread. Hydrogenation also helps increase product shelf life. On the label, the term “hydrogenated” is listed before a blend of fats and oils. For example: “Hydrogenated vegetable oil (contains the following: soybean, cottonseed, palm oil).”

Lipids:

The general name for fats. Lipids include triglycerides, phospholipids and sterols. Cholesterol is the best known of the sterols. The two kinds of lipids in foods that most affect heart disease are dietary fat (triglycerides, saturated and unsaturated) and dietary cholesterol. About 95 percent of the lipids in foods and in our bodies are triglycerides.

Lipoproteins:

In the blood, cholesterol attaches to protein molecules of different densities to be carried through the blood vessels by special types of proteins, called lipoproteins. The amounts and types of lipoproteins are an important indicator of your heart disease risk.

Low-density lipoprotein, LDL, is commonly termed “bad” cholesterol, because an excess of cholesterol carried by them can lead to the build up of plaque in the arteries. High LDL levels (above 160mg/dl) increase heart disease risk because they keep cholesterol in blood circulation and carry it to the arteries to be deposited. Excess body fat and a diet high in saturated fat tend to increase LDL levels. LDLs are not found in food, only in the body.

High-density cholesterol, HDL, is considered “good” or protective cholesterol, because they carry cholesterol away from the arteries to the liver to be excreted from the body. Individuals with high HDL levels (above 35mg/dl) have a lower risk of heart disease. Regular exercise helps to increase HDL levels. HDLs are not found in food, only in the body.

Monounsaturated Fats:

Monounsaturated fats typically remain liquid at extremely low temperatures. These fats are also found in vegetable oils such as olive oil, peanut oil and canola oil. ) Monounsaturated fat lowers total blood cholesterol by lowering LDL cholesterol without lowering HDL cholesterol. Research as shown that substituting monounsaturated fat for saturated fats (and polyunsaturated fats) reduces blood cholesterol levels without affecting the HDL levels. Too much of any of these fats will increase dietary fat intake, and excess body fat may increase cholesterol levels and the potential to increase body fat.

Omega-3 Fats:

Some types of fish contain unique polyunsaturated fats called Omega-3 fatty acids. These fatty acids seem to make blood platelets less likely to clot, thus decreasing risk of artery blockage and heart attacks. Fish with high amounts of Omega-3 include salmon, albacore, tuna, mackerel, sardines, herring and rainbow trout.

Polyunsaturated Fats:

Polyunsaturated fats are usually liquid at room temperature. Polyunsaturated fats are found in vegetable oils such as corn oil, safflower oil, soybean oil, and sunflower oil. Polyunsaturated fats are also present in fish and fish oils, which help to decrease triglyceride levels. Polyunsaturated fats lower LDL cholesterol and total cholesterol but they also lower HDL cholesterol (remember HDL cholesterol is the good stuff). Therefore, this fat should be limited to a certain degree. Too much of any of these fats will increase dietary fat intake, and excess body fat may increase cholesterol levels and the potential to increase body fat.

Saturated Fats:

Saturated fats are usually solid or almost solid at room temperature. All animal fats, such as those in meat, poultry, and dairy products are saturated. Processed and fast foods are also saturated. Vegetable oils also can be saturated. Palm, palm kernel and coconut oils are saturated vegetable oils. (Fats containing mostly unsaturated fat can be made more saturated through a process called “hydrogenation.” See the definition for hydrogenated/partially hydrogenated.”)

Saturated fats are the very unhealthy fats. They make the body produce more cholesterol, which may raise blood cholesterol levels. Excess saturated fat is related to an increased risk of cardiovascular disease. The amount of cholesterol found in foods is not as important as the amount of saturated fat. Of all the fats, saturated fat is the most potent determinant of blood cholesterol levels. Saturated fats stimulates the production of LDL cholesterol (”bad” cholesterol) and therefore increases blood cholesterol levels and the risk of heart disease. Saturated fats raise cholesterol levels and LDL-cholesterol levels more than dietary cholesterol itself.

Trans Fats:

These fats are called hydrogenated fats. These are fats that are created when oils are “partially hydrogenated” The process of hydrogenation changes the chemical structure of unsaturated fats by adding hydrogen atoms to make the fats more saturated. Hydrogenation is what turns liquid oil into stick margarine or shortening. Manufacturers use this process to increase product stability and shelf life. Thus, a larger quantity can be produced at one time, saving the manufacturer money. Unfortunately, this money-saving process is what contributes to elevated blood cholesterol levels and increases heart disease risk.

Triglycerides:

Triglycerides are another type of fat. Triglycerides are the main form of fat in foods. Triglycerides are produced by the body and stored as fat from excess calories from any source (protein, carbohydrates, or fat). Drinking alcohol can also increase levels of triglycerides. Having high triglyceride levels is not necessarily a risk factor of heart disease but the risk goes up when coupled with other risk factors.

• Reduce the amount of meat in your diet – eat smaller portions and plan some meals around grains, lentils and vegetables, instead of meat
• When you do buy meat, choose leaner cuts – trim off all visible fat
• Take the skin off turkey and chicken before you eat it
• Eat fish more often -          cold-water fatty fish, such as salmon and mackerel, contain high amounts of a type of polyunsaturated fat called omega-3 fatty acid, which may lower your triglyceride levels
• Add soy products to your diet – the isoflavones in soy help to regulate cholesterol levels
• Eat fewer egg yolks – they’re a highly concentrated source of cholesterol. But egg whites don’t contain any cholesterol, so eat as many of those as you like – try substituting 2 egg whites for one egg in your baking
• Choose low-fat milks and cheeses – use low-fat yogurt as a topping on baked potatoes and fruit desserts
• Avoid store-bought goodies, such as brownies, donuts, chips, buttered popcorn – they’re all high in saturated fats
• Read labels – don’t buy foods that contain hydrogenated oils
• Use low-fat salad dressings or try a mix of virgin olive oil mixed with lemon or balsamic vinegar for a special taste treat
• In restaurants, avoid foods that are fried, breaded or covered in creamy sauces – choose foods that are steamed, roasted, baked or boiled, instead

1. Eat less fat and cholesterol

Your body naturally produces all the cholesterol you need to stay healthy. But you also get dietary cholesterol through the food you eat. Every food that comes from animals (e.g. meat, butter, eggs, cheese) contains some cholesterol. Eating a high-cholesterol diet can significantly raise your LDL cholesterol levels.

The type of fats in your diet can also affect your cholesterol. “Good” or unsaturated fats can lower cholesterol levels and “bad” or saturated fats  can raise them. As a matter of fact, a diet high in saturated fats is one of the main causes of high blood cholesterol. Try to limit all types of fat to no more than 30% of your total daily calories.

2. Eat more Fiber

Foods high in fiber, such as fruits, vegetables, grains and legumes, can help lower your blood cholesterol levels. Everyone should eat 5 to 10 servings of fruit and vegetables and 5 to 12 servings of grain daily. That may sound like a lot of food but it’s more manageable than you might think. Add a slice of whole wheat bread and an apple to your lunch, a cup of brown rice and some peas to your dinner and you’re already well on your way to achieving the recommended targets.

3. Control your weight

Carrying excess weight increases your triglycerides and lowers your HDL levels. The best way to lose weight is to cut down on the amount of sugar and fat in your diet and increase your activity levels. A safe and sensible approach to weight loss will help you keep those extra pounds off for good.

4. Be more active

Being inactive can lower the amount of good cholesterol in your blood and increase the bad cholesterol levels. In addition to keeping your cholesterol levels under control, a regular exercise program has many other health benefits. It will help you control your weight, lower your stress levels, reduce your blood pressure – and, best of all, it’s fun! Aim for at least 30 minutes of physical activity every day. You’ll find lots of good ideas for making exercise a regular part of your day by exploring the section on “Feeling Fit.”

5. Don’t smoke

Cigarette smoking damages the walls of your blood vessels, making them more susceptible to cholesterol deposits. Smoking may also lower your HDL levels by as much as 15%. If you don’t smoke, don’t start. If you do smoke, it’s time to quit.

6. Drink alcohol in moderation

High triglyceride levels have been associated with high levels of alcohol consumption. If you’re a woman, try to limit your alcohol intake to one drink, a day – if you’re a man, your limit should be two drinks daily.
7.  Take your medication as prescribed

Lifestyle changes are often very effective in lowering cholesterol levels. However, changing eating and exercise habits may not be enough for you. If your blood cholesterol levels are high, your doctor may suggest stricter dietary controls or specific drugs to help keep your cholesterol under control.

If your doctor recommends medication for you, always take it just as prescribed. Do not skip doses or stop taking it without consulting your doctor. Buy a pill organizer and ask family members to help you remember to take each dose on time. Make a note on your calendar to renew your prescription before you run out. Remember that medication is not enough on its own. You must also follow a low-fat diet and exercise regularly to reduce your risk of heart attack and stroke.