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Dr. Helen is having some cholesterol hell. She wants to keep her LDL cholesterol low and HDL cholesterol high, and having suffered a heart attack in the past this is of the utmost importance. The product she was using was Benecol Smart Chews, which, judging by the nutrition facts, don’t seem to have anything particularly wrong with them. It uses plant sterols, proven to lower LDL cholesterol in the human body. Yet her LDL cholesterol and triglycerides level went up. What gives?

Whatever the reason, cholesterol is something you should try to keep in check whether young or old. Sometimes, triglycerides and LDL cholesterol come from crazy places you wouldn’t even think of. Below are my tips for getting your cholesterol under control through the use of a good diet, exercise, and supplements.

Avoid Processed Foods and Artificial Sweeteners

This is so hard to do nowadays because almost everything is processed and almost everything has corn syrup in it (even the chews!). Processed foods like corn syrup — and even white bread and white pasta — are turned into glucose (sugar) rapidly by the body. Excess sugar that your body doesn’t use fast enough will be turned into fat. In this case, most often these foods will be turned into triglycerides, a kind of fat that is easy to burn off but is detrimental to your health.

Buy truly whole grain products whenever possible to avoid this affect on the body.

Limit Your Alcohol Consumption

Certain alcohol beverages, such as beer and especially wine, have been shown to have incredible health benefits in moderation. A couple glasses of wine a day is no problem. However, when you drink alcohol, the liver prioritizes the metabolism of alcohol over other substances such as glucose. This results in even more glucose than usual being converted into triglycerides. This will happen especially when drinking cocktails that involve fruit juices and syrups. This is especially a warning to all the college students out there!

Eat Your Fiber

This can’t be stressed more. Fruits, vegetables, and legumes have so many different qualities that are amazing that they shouldn’t be passed up on. In terms of helping with your cholesterol, there are some benefits that your greens can give you that few foods can. The soluble fiber in fruits and legumes, as well as oatmeal, form gelatinous substances in the intestine and bind with cholesterol so that it is removed rather than absorbed. Eating just 15 grams of soluble fiber a day can reduce your LDL cholesterol by 10-15% over time.

Exercise and You Won’t Be Sorry

A regular regimen of exercise is extremely helpful in burning off triglycerides and reducing LDL cholesterol while boosting HDL cholesterol. There is no doubt that cardiovascular exercise as well as weight training reduces inflammation, excess fat, and LDL cholesterol. Truly, any amount of exercise is beneficial but those who do it regularly will see the most benefit. You need to remember though that the heart is also a muscle, and while it may seem strange, a whey protein shake after a jog is just what it needs to build itself stronger than ever before.

Get Acquainted with the Good Fats, Throw Out the Bad

A supplement with plant sterols alone is not going to do the trick — essential fatty acids have the most control over your cholesterol levels. Before I say anything, I just wanted everyone to know that I am extremely biased against low/no fat diets. I think they are ridiculous and led to a generation of people coming down with cardiovascular diseases. That’s because fat in your diet is so absolutely necessary that you can’t afford to cut it out. In terms of cholesterol, fat can save your life if you eat the right kinds. So what are they?

Monounsaturated fats are what you want the most of in terms of lowering LDL cholesterol. When eating a salad or some whole wheat pasta, feel free to drizzle a good helping of extra virgin olive oil. Salad dressings based on olive oil are also good. Seriously, olive oil is amazing and shouldn’t be passed up on.

You should also make sure to get a large amount of your essential oils from food sources. Fish have a lot of good fats in them, such as the polyunsaturated omega-3 and omega-6. Avocado is great. Some coconut oil, a medium-chain saturated fat, has been shown to be beneficial as well. You should also eat a decent amount of nuts, as they contain a great amount of oils that are beneficial to the body.

So what are the bad? Any kind of processed or refined oil. That giant, cheap gallon of vegetable oil should be thrown out immediately. There is no better way to raise your triglyceride and LDL cholesterol count than to cook everything in vegetable oil. When oils are heated they undergo a chemical transformation that makes them much less healthy for you. Basically, anything that says processed, hydrogenated, or partially hydrogenated should be thrown out especially if found in packaged food. These are generally trans fats — the biggest culprit in terms of bad cholesterol.

You will also want to trim as much fat off of red meat as possible as, unlike coconut oil which is a medium-chain saturated fat, these are long-chain saturated fats and do have a connection to higher LDL cholesterol. Replace some of your red meat meals with fowl and fish instead.

Some Supplements Do Wonders

There is a reason that bodybuilders and nutritionists are absolutely obsessed with certain supplement products. Their benefits are proven, visible, and effective in everyone.

Flax seeds and flax seed oil are one of nature’s best sources of omega-3 and omega-6 fatty acids. Taken as a supplement or whole, these little guys do wonders for your cholesterol and heart. Cod liver oil is a good alternative, containing these fats along with vitamins A and D naturally.

Like I said, bodybuilders and nutritionists take these because they work. AI put a bit of flaxseed oil in every protein shake I make. While I’m sure the Benecol Smart Chews has had some kind of effect given the plant sterols, I don’t believe that it can have nearly the effect as supplementing with essential fatty acids.

Conclusion

There are many lifestyle changes that you can make in order to boost your cardiovascular health and tackle cholesterol problems. As a natural substance that your body needs, dietary cholesterol itself has very little impact on the cholesterol in your body. When you eat more cholesterol, your body simply makes less. The terms HDL and LDL actually refer to lipoproteins that surround the cholesterol the production of which has much more to do with dietary fat than dietary cholesterol. A good exercise regimen, but most of all a healthy diet full of unprocessed foods and essential unsaturated fatty acids, are essential to raising your HDL and LDL levels, thus preventing the kind of arterial plaque that can lead to so many cardiovascular diseases.

These tips worked for me, and I hope that by following my suggestions you can successfully achieve your goals. Good luck Dr. Helen and everyone else!

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How to Lower Your Cholesterol?

Cholesterol Lowering Drugs and Cholesterol Lowering Diet

Whatever the reasons may be for your high blood cholesterol level - diet, heredity, or both - the treatment your doctor will prescribe first is a diet. If your blood cholesterol level has not decreased sufficiently after carefully following the diet for 6 months, your doctor may consider adding cholesterol-lowering medication to your dietary treatment. Remember, diet is a very essential step in the treatment of high blood cholesterol.

Cholesterol-lowering medications are more effective when combined with diet. Thus they are meant to supplement, not replace, a low-saturated fat, low-cholesterol diet.

Summary of Diet Guidelines for Lowering High Blood Cholesterol Levels

* Eat less high-fat food (especially those high in saturated fat)
* Replace part of the saturated fat in your diet with unsaturated fat
* Eat less high-cholesterol food
* Choose foods high in complex carbohydrates (starch and fiber)
* Reduce your weight, if you are overweight

Eat Less High-fat Food

Dietary Fat

There are two major types of dietary fat - saturated and unsaturated. Unsaturated fats are further classified as either polyunsaturated or monounsaturated fats. Together, saturated and unsaturated fats equal total fat. All foods containing fat contain a mixture of these fats.

Reduce Total Fat Intake

One of the goals in your blood cholesterol-lowering diet is to eat less total fat, because this is an effective way to eat less saturated fat. Because fat is the richest source of calories, this will also help reduce the number of calories you eat every day. If you are overweight, weight loss is another important step in lowering blood cholesterol levels (as discussed later in this brochure). If you are not overweight, be sure to replace the fat calories by eating more food high in complex carbohydrates.

Remember: When you decrease the amount of total fat you eat, you are likely to reduce the saturated fat and calories in your diet.

Saturated Fat

Saturated fat raises your blood cholesterol level more than anything else in your diet. The best way to reduce your blood cholesterol level is to reduce the amount of saturated fat you eat.

Animal Fats

Animal products as a group are a major source of saturated fat in the average American diet. Butter, cheese, whole milk, ice cream, and cream all contain high amounts of saturated fat. Saturated fat is also concentrated in the fat that surrounds meat and in the white streaks of fat in the muscle of meat (marbling). Poultry, fish, and shellfish also contain saturated fat, although generally less than meat.

Hydrogenated Fat - Known As Trans Fatty Acids or Trans-Fats

Trans fats are created during the food manufacturing process when cheap vegetable oils undergo a process called “hydrogenation” - they have hydrogen added to them to make them solid and less likely to become rancid. Unfortunately, trans fats are even worse for our heart than saturated fat, as they encourage atherosclerosis (narrowing of the arteries).

Vegetable Fats

A few vegetable fats - coconut oil, cocoa butter (found in chocolate), palm kernel oil, and palm oil - are high in saturated fat. These vegetable fats are found in many commercially baked goods, such as cookies and crackers, and in nondairy substitutes, such as whipped toppings, coffee creamers, cake mixes, and even frozen dinners. They also can be found in some snack foods like chips, candy bars, and buttered popcorn. Because these vegetable fats are not visible in these foods (unlike the fat in meats) it is important for you to read food labels. The label may tell you how much saturated fat a food contains, which will help you choose foods lowest in saturated fats.

Remember: Saturated fats are found primarily in animal products. But a few vegetable fats and many commercially processed foods also contain saturated fat. Read labels carefully. Choose foods wisely.

Substitute Unsaturated Fat for Saturated Fat

Unsaturated fat actually helps to lower cholesterol levels when it is substituted for saturated fat. Therefore, health professionals recommend that, when you do eat fats, unsaturated fats (polyunsaturated and monounsaturated fats) be substituted for part of the saturated fat whenever possible.

Polyunsaturated fats are found primarily in safflower, corn, soybean, cottonseed, sesame, and sunflower oils, which are common cooking oils. Polyunsaturated fats are also contained in most salad dressings. But be cautious. Commercially prepared salad dressings also may be high in saturated fats, and therefore careful inspection of labels is important. The word “hydrogenated” on a label means that some of the polyunsaturated fat has been converted to saturated fat.

Another type of polyunsaturated fat is found in the oils of fish and shellfish (often referred to as fish oils, or omega-3 fatty acids). This type of polyunsaturated fat is found in greatest amounts in such fatty fish as herring, salmon, and mackerel. There is little evidence that omega-3 fatty acids are useful for reducing LDL-cholesterol levels. However, fish is a good food choice for this diet play anyway because it is low in saturated fat. The use of fish oil supplements are not recommended for the treatment of high blood cholesterol because it is not known whether long-term ingestion of omega-3 fatty acids will lead to undesirable side effects.

Olive and canola oil (rapeseed oil) are examples of oils that are high in monounsaturated fats. Like other vegetable oils, these oils are used in cooking as well as in salads. Recently, research has shown that substituting monounsaturated fat, like substituting polyunsaturated fat, for saturated fat reduces blood cholesterol levels.

Remember: Unsaturated fats when substituted for saturated fats help lower blood cholesterol levels.

Eat Less High-Cholesterol Food

Dietary cholesterol is a waxy, fat-like substance found in foods that come from animals. Although it is not the same as saturated fat, dietary cholesterol also can raise your blood cholesterol level. Therefore, it is important to eat less food that is high in cholesterol. While cholesterol is needed for normal body function, your liver makes enough for your body’s needs so that you don’t need to eat any cholesterol at all.

Dietary Cholesterol in Food

Cholesterol is found in eggs, dairy products, meat, poultry, fish, and shellfish. Egg yolks and organ meats (liver, kidney, sweetbread, brain) are particularly rich sources of cholesterol. High-fat dairy products, meat, and poultry all have similar amounts of cholesterol. Fish generally has less cholesterol, but shellfish varies in cholesterol content. Foods of plant origin, like fruits, vegetables, grains, cereals, nuts, and seeds, contain no cholesterol.

Since cholesterol is not a fat, you can find it in both high-fat and low-fat animal foods. In other words, even if a food is low in fat, it may be high in cholesterol. For instance, organ meats, like liver, are low in fat, but are high in cholesterol.

Because many foods such as dairy products and some meats are high in both saturated fat and cholesterol, it is important to limit the amount of these high-fat foods that you eat, choosing lean meats and low-fat dairy products whenever possible.

Remember: Organ meats and egg yolks are high in cholesterol. High-fat dairy products, meat, and poultry have similar amounts of cholesterol. Some fish has less. Foods of plant origin like fruits, vegetables, vegetable oils, grains, cereals, nuts, and seeds contain no cholesterol.

Substitute Low GI Carbohydrates for Saturated Fat

Breads, pasta, rice, cereals, dried peas and beans, fruits, and vegetables are good sources of complex carbohydrates (starch and fiber). Low-GI varieties are excellent substitutes for foods that are high in saturated fat and cholesterol. The type of fiber found in foods such as oat and barley bran, some fruits like apples and oranges, and in some dried beans may even help reduce blood cholesterol levels.

Contrary to popular belief, high-carbohydrate foods (like pasta, rice, potatoes) are lower in calories than foods high in fat. In addition, they are good sources of vitamins and minerals. What adds calories to these foods is the addition of butter, rich sauces, whole milk, or cream, which are high in fat, especially saturated fat. It is important not to add these to the high-carbohydrate foods you are substituting for foods high in fat.

Remember: Foods that are high in complex carbohydrates, if eaten plain, are low in saturated fat and cholesterol as well as being good sources of vitamins, minerals, and fiber.

Maintain a Desirable Weight

People who are overweight frequently have higher blood cholesterol levels than people of desirable weight.

You can reduce your weight by eating fewer calories and by increasing your physical activity on a regular basis. By reducing the amount of fat in your diet, you will be cutting down on the richest source of calories. Substituting foods that are high in complex carbohydrates for high-fat foods will also help you lose weight, because many high-carbohydrate foods contain little fat and thus fewer calories.

Fat Contains Twice the Calories of Carbs and Protein

Fat has more than twice the calories as the same amount of protein or carbohydrate. Protein and carbohydrate both have about 4 calories in each gram, but all fat-saturated, polyunsaturated or monounsaturated fat - has 9 calories in each gram. Thus, foods that are high in fat are high in calories. And all calories count. So, to maintain a desirable weight, it is important to eat no more calories than your body needs.

Remember: To achieve or maintain a desirable weight, your caloric intake must not exceed the number of calories your body burns.

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High cholesterol affects about 17% of Americans ages 20 and older, contributing to atherosclerotic heart disease, which is the single leading cause of death and disability in the developed world. This medical dictionary covers the terms used in the report, What to do about High Cholesterol, and includes details on how to lower and watch your cholesterol through tests and diets.

* antioxidant: A substance that inhibits oxidation.

* apolipoproteins: Proteins that combine with cholesterol and triglyceride to form lipoproteins.

* atherosclerosis: Development of cholesterol-rich plaque on the inner walls of arteries, which can eventually obstruct blood flow.

* atherosclerotic plaque: A cholesterol-rich deposit on an artery wall.

* biological variability: Fluctuations that occur naturally over time in the levels of a substance such as cholesterol in a person’s body.

* cholesterol: A fatlike substance that is produced by the liver and found in all food from animal sources; an essential component of body cells and a precursor of bile acids and certain hormones.

* chylomicron: A large, extremely low-density lipoprotein that transports triglyceride from the intestine to fat tissue in the body.

* combined hyperlipidemia: A condition in which LDL and triglyceride levels are very high.

* familial combined hyperlipidemia: An inherited disorder in which the liver overproduces VLDL, causing high levels of cholesterol or triglycerides, or both.

* familial hypercholesterolemia: An inherited disorder in which the liver cannot properly remove LDL particles from the blood, causing a very high cholesterol level.

* fasting lipid profile: A laboratory test to determine the relative levels of HDL, LDL, and total cholesterol in the blood. Also referred to as a lipoprotein analysis, full lipid profile, or cholesterol profile.

* fatty acids: The primary building blocks of lipids.

* foam cells: Lipid-laden cells, named for their foamy appearance under the microscope, which contribute to the formation of atherosclerotic plaque.

* high-density lipoprotein (HDL): A lipoprotein that protects the arteries by transporting cholesterol from body cells to the liver for elimination.

* hydrogenation: The addition of hydrogen to a compound, particularly to solidify unsaturated oils.

* lipids: Fats, oils, and waxes that serve as building blocks for cells or as energy sources for the body.

* lipoproteins: Protein-covered fat particles that enable cholesterol to move easily through the blood.

* low-density lipoprotein (LDL): A lipoprotein that transports cholesterol from the liver to the rest of the body, which can cause the buildup of plaque in the arteries.

* monounsaturated fats: Fatty acids; abundant in olive, peanut, sesame, and canola oils.

* oxidation: A process in which oxygen combines with a substance, altering its structure and changing or destroying its normal function.

* platelets: Minute, colorless disks in the blood that are instrumental in clotting.

* polyunsaturated fats: Fatty acids that are abundant in soybean, corn, cottonseed, safflower, and sunflower oils.

* saturated fats: Fatty acids that are abundant in red meat, lard, butter, cheese, and some vegetable oils, in which each molecule carries the maximum number of hydrogen atoms.

* trans fats: Fatty acids (such as those found in solid margarine) that have been reshaped by hydrogenation; also called trans fatty acids.

* triglyceride: The primary type of fat in the body and in the diet, formed from three fatty-acid molecules and one glycerol molecule.

* unsaturated fats: Fatty acids in which some of the hydrogen atoms in each molecule have been replaced by double bonds; includes monounsaturated and polyunsaturated fats.

* very-low-density lipoprotein (VLDL): A lipoprotein that transports triglyceride manufactured in the liver to fat tissue in the body; eventually becomes low-density lipoprotein (LDL) after the triglyceride has been removed.

In foods, cholesterol is found in eggs, dairy products, meat, and poultry. Egg yolks and organ meats (liver, kidney, sweetbread, and brain) are high in cholesterol. Fish generally contains less cholesterol than other meats, but some shellfish are high in cholesterol.

Foods of plant origin (vegetables, fruits, grains, cereals, nuts, and seeds) contain no cholesterol.

Fat content is not a good measure of cholesterol content. For example, liver and other organ meats are low in fat, but very high in cholesterol.

Therapeutic Lifestyle Changes (TLC) is a set of things you can do to help lower your LDL cholesterol. The main parts of TLC are:

* The TLC Diet. This is a low-saturated-fat, low-cholesterol eating plan that calls for less than 7% of calories from saturated fat and less than 200 mg of dietary cholesterol per day. The TLC diet recommends only enough calories to maintain a desirable weight and avoid weight gain. If your LDL is not lowered enough by reducing your saturated fat and cholesterol intakes, the amount of soluble fiber in your diet can be increased. Certain food products that contain plant stanols or plant sterols (for example, cholesterol-lowering margarines) can also be added to the TLC diet to boost its LDL-lowering power.
* Weight Management. Losing weight if you are overweight can help lower LDL and is especially important for those with a cluster of risk factors that includes high triglyceride and/or low HDL levels and being overweight with a large waist measurement (more than 40 inches for men and more than 35 inches for women).
* Physical Activity. Regular physical activity (30 minutes on most, if not all, days) is recommended for everyone. It can help raise HDL and lower LDL and is especially important for those with high triglyceride and/or low HDL levels who are overweight with a large waist measurement.

Foods low in saturated fat include fat-free or 1percent dairy products, lean meats, fish, skinless poultry, whole grain foods, and fruits and vegetables. Look for soft margarines (liquid or tub varieties) that are low in saturated fat and contain little or no trans fat (another type of dietary fat that can raise your cholesterol level). Limit foods high in cholesterol such as liver and other organ meats, egg yolks, and full-fat dairy products.

Good sources of soluble fiber include oats, certain fruits (such as oranges and pears) and vegetables (such as brussels sprouts and carrots), and dried peas and beans.

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Getting a free low fat diet plan from me is just the first step. You have to put in the work! Personally, I prefer the term ‘low saturated-fat diet plan’ since the plan I am about to give you is low in saturated fats, and rich in the ‘good fats’.

How can fat be good for you?

That’s exactly what I thought when I started out as a personal trainer. The answer lies in a series of hormones called eicosanoids. These hormones control every major function in the body. They are influenced by the type and amount of fat you eat, and your lifesyle.

A well designed, free, low fat diet plan combined with a healthy lifestyle (exercise, sound sleep, low stress) is the secret to weight loss. The food list below is an extension of the low cholesterol diet food list.

Important components of a low fat diet plan.

Fruits and vegetables - Fiber.

Eat at least 3 to 5 servings of fruits and vegetables each day. Fruits and vegetables are very low in saturated fat and total fat, and have no cholesterol. When shopping, remember to buy fruits and vegetables to eat as snacks, desserts, salads, side dishes, and main dishes.

Add a variety of vegetables to meat stews or casseroles or make a vegetarian (meatless) main dish. Raw vegetables are crucial to the success of my free low fat diet plan. Try carrots, broccoli, cauliflower, lettuce and store in the refrigerator for quick and easy use in cooking or snacking.

Serve fresh fruit for dessert or freeze (banana, berries, melon, grapes) for a delicious frozen treat. Display fresh fruit in a bowl in the kitchen to make fruit easier to grab as a snack.

To keep naturally lowfat vegetables low in fat and saturated fat, season with herbs, spices, lemon juice, vinegar, fat free or lowfat mayonnaise or salad dressing.

Breads, Cereals, Rice, Pasta, and Other Grains.

Breads, cereals, rice, pasta, and other grains, and dry beans and peas are generally high in starch and fiber and low in saturated fat and calories.

They also have no dietary cholesterol, except for some bakery breads and sweet bread products made with high fat, high cholesterol milk, butter and eggs.

Like fruits and vegetables, naturally low fat, low cholesterol breads and other foods in this group are also good choices. You should be eating 6 to 11 servings of foods from this group each day.

Choose whole grain breads and rolls often. They have more fiber than white breads and are an important component of the free low fat diet plan. Buy dry cereals, most are low in fat.

Limit the high fat granola, muesli, and oat bran types that are made with coconut or coconut oil and nuts, which increases the saturated fat content.

Add fat free milk or 1% milk instead of whole or low fat (2% milk) to save saturated fat and cholesterol.

Buy pasta and rice to use as entrees. Hold the high fat sauces (butter, cheese, cream, white). Limit sweet baked goods that are made with lots of saturated fat, mostly from butter, eggs, and whole milk such as croissants, pastries, muffins, biscuits, butter rolls, and doughnuts. These are also high in cholesterol.

Sweets and Snacks.

Some sweets and snacks, like baked goods (cakes and cookies) cheese crackers, and some chips are high in saturated fat and cholesterol.

The following foods are allowed in the free low fat diet plan, but please do not go overboard. fat free or low fat brownies, cakes, cheesecake, cupcakes, and pastries. Frozen lowfat or nonfat yogurt, fruit ices, ice milk, sherbet, and sorbet.

Caution - these treats may be low in fat, most are not low in calories. So indulge occasionally, especially if you are trying to control your weight with a low fat diet.

Low fat snack foods.

Every free low fat diet plan should include foods as snacks.

Soy chips.
Ready-to-eat cereals without added sugar.
Frozen grapes or banana slices; or other fresh fruit.
Low fat or fat free crackers.
No-oil baked tortilla chips.
Popcorn (air popped or “light”).
Pretzels.
Raw vegetables with nonfat or low fat dip.

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Oatmeal is the only whole grain food recognized by the FDA to help lower cholesterol to reduce the risk of heart disease. Oats contain a good variety of vitamins, minerals and antioxidants, and can also aid in maintaining a healthy weight as part of a diet rich in fiber.

When baking, quick or old fashioned oats can be substituted for up to one-third of the flour called for in recipes for muffins, biscuits, pancakes, coffee cakes and cookies. Oats can also be used in homemade granola, breads, pies, cakes, sticky buns, etc.

According to Quaker Consumer Relations, the only difference between old fashioned and quick oats is that the quick oats are cut into smaller pieces to shorten the cooking time. They also tend to absorb more into the other ingredients of a recipe, while the old fashioned (or rolled oats) hold their shape enough to make a noticeable difference in the recipe’s appearance.

Alongside the basic recipe for breakfast oatmeal, two of our favorite specialty recipes for oatmeal are homemade granola and baked oatmeal. I recently received a new recipe for baked oatmeal/granola, which was shared by David Alleman. David says this recipe can be varied considerably to suit your preference, and that he seldom makes it the same from one time to the next. He also mixes the dry ingredients the night before so he can quickly prepare it the next morning for a 6:45 study group. The original “All American” recipe calls for black walnuts and real maple syrup. However, English walnuts and honey may be substituted if desired. The cereal reheats well in the microwave, and David usually makes a double portion while the ingredients are out and the oven is hot, so he has extra for other meals. These recipes contain a variety of healthy ingredients, which help to get your day off to a good start nutritionally.

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Although cholesterol drugs are in the news lately, what is getting lost in the discussion is the fact that it’s possible to lower your cholesterol without drugs. It’s just not as easy.

In fact, many doctors think dietary changes are too difficult for most of their patients. While they typically encourage better eating and a diet low in saturated fat, they also prescribe cholesterol-lowering drugs called statins as a faster way to lower bad cholesterol.

But many people can’t tolerate statins and their side effects. Others simply don’t want to take a pill every day or shoulder the cost of a prescription. For those patients, dietary changes may be a better option.

In 2006, The American Journal of Clinical Nutrition reported on a study of 55 patients with high cholesterol who, over the course of a year, started eating a diet rich in soy proteins, fiber and almonds. All those foods may have cholesterol-lowering properties. Twenty-one patients managed to lower their cholesterol by 20 percent or more by the end of the year. The researchers noted that whether the patient was motivated and actually stuck with the diet most of the time was key.

Journalist Tom Burton, a former colleague, wrote about his own efforts to lower cholesterol without drugs for The Wall Street Journal. He found that many doctors don’t really know how to advise patients about dietary changes to lower cholesterol. He found one who did and used him as a nutrition “coach” to help him figure out which changes would be most effective for him.

The problem for Mr. Burton was that he already had a pretty healthful diet. He ran four miles most days and had given up red meat and most cheese. But his bad cholesterol was 169 mg/dL — far above the 100 mg/dL most doctors recommend. Doctors were telling him statin drugs were in his future.

After documenting his eating habits, Mr. Burton was advised by his doctor to cut out a favorite dish — roast chicken with the skin on. He was told that more of his protein should come from fish, beans and nuts. He phased out the chicken as well as shrimp and squid, which are high in dietary cholesterol. He began including steel-cut oatmeal, eggplant, roasted soybeans, whole-wheat pasta and Brussels sprouts in his diet. He also increased his exercise. His cholesterol numbers were slow to move, but eventually they did, dropping 33 percent.

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There’s new scrutiny of  statins, which are the most popular prescription drug ever that’s been marketed as a cholesterol-lowering medication.

As Businessweek reports: “The drugs are thought to be so essential that, according to the official government guidelines from the National Cholesterol Education Program, 40 million Americans should be taking them. Some researchers have even suggested-half-jokingly-that the medications should be put in the water supply, like fluoride for teeth.”

This week, CBS News partnered with Businessweek, which reported today that statins don’t necessarily help patients in the way they are thought to. Read our partner story from Businessweek here.

While it is possible that it is in your best interest to use cholesterol-lowering medication, medical experts suggest ways to lower your cholesterol without drugs - making simple lifestyle changes.

The American Heart Association’s Web gives simple recommendations in a checklist for lowering cholesterol. It suggests taking simple measures: exercising regularly, eating a heart-healthy diet and making certain lifestyle choices, such as avoiding tobacco smoking.

Eating healthy

The American Heart Association offers some information on cholesterol, your body and your diet.

Some of your cholesterol is made by your body. The food you eat is responsible for the rest. Food products from animals contain cholesterol - including meats, poultry, shellfish, eggs, butter, cheese and whole or 2 percent milk. And any type of food can also contain saturated fats and trans fats, which cause your body to make more cholesterol.

The American Heart Association recommends that you keep your intake of total fat to between 25 percent and 35 percent, your saturated fat consumption to less than 7 percent and your intake of trans fat to less than 1 percent of your total daily calories.

At the same time, limit your intake of cholesterol from food to less than 300 mg per day. People with high LDL (bad) blood cholesterol levels or who are taking cholesterol medication should consume less than 200 mg of cholesterol per day.

Eat at least 25 to 30 grams of dietary fiber each day - preferably from whole grains, fruits, vegetables and legumes. To combat high blood pressure and for overall cardiovascular health, also limit sodium to 2,300 mg or less per day.

But a heart-healthy diet isn’t just about what you shouldn’t eat. It also means eating a diet rich in vegetables and fruits, with whole grains, high-fiber foods, lean meats and poultry, fish at least twice a week, and fat-free or 1 percent fat dairy products. Also, the diet should be low in saturated fat, trans fat and cholesterol.

But can a bowl of cereal help prevent a heart attack? The Mayo Clinic suggests the best foods to lower your cholesterol and protect your heart. A partial list from the Mayo Clinic is below.

Oatmeal

Oatmeal contains soluble fiber, which reduces your “bad” cholesterol. Soluble fiber is also found in such foods as kidney beans, brussels sprouts, apples, pears, psyllium, barley and prunes.

Walnuts and almonds

Studies have shown that walnuts can significantly reduce blood cholesterol. Rich in polyunsaturated fatty acids, walnuts also help keep blood vessels healthy and elastic. Almonds appear to have a similar effect, resulting in a marked improvement within just four weeks.

Fish including omega-3 fatty acids

Studies in the 1970s showed that Greenland Eskimos had a lower rate of heart disease than did other individuals living in Greenland at the same time. Analysis of dietary differences between the groups showed that the Eskimos ate less saturated fat and more omega-3 fatty acids found in fish and whale and seal meat. Research since that time has supported the heart-healthy benefits of eating fish. If you can’t dine with the Eskimos, other good sources of omega-3 fatty acids include flaxseed, walnuts, canola oil and soybean oil.

Soy

Long thought to have cholesterol-lowering effects, a recent meta-analysis by the American Heart Association’s Nutrition Committee showed soy protein actually has very little impact on reducing cholesterol levels. In January 2006, the American Heart Association issued a statement saying the cardiovascular health benefits of soy protein are minimal at best. No benefit was seen on HDL, triglycerides, or blood pressure and even with a large intake of soy, only a small impact on LDL was seen.

Stay away from smoke

The American Heart Association advises the following:
Cigarette and tobacco smoke, high blood cholesterol, high blood pressure, physical inactivity, obesity and diabetes are the six major independent risk factors for coronary heart disease that you can modify or control. Cigarette smoking is so widespread and significant as a risk factor that the Surgeon General has called it “the leading preventable cause of disease and deaths in the United States.”

Cigarette smoking increases the risk of coronary heart disease by itself. When it acts with other factors, it greatly increases risk. Smoking increases blood pressure, decreases exercise tolerance and increases the tendency for blood to clot. Smoking also increases the risk of recurrent coronary heart disease after bypass surgery.

Keep up physical activity

Physical inactivity is a major risk factor for heart disease, according to The American Heart Association, which recommends getting at least 30 minutes of physical activity, preferably every day but at least more days than not.

You don’t need to get your minutes all at once - it’s fine to break up your activity into 10-minute sessions or 15-minute sessions. For some people, regular physical activity affects blood cholesterol level by increasing the level of HDL (good) cholesterol. A higher HDL level is linked with a lower risk of heart disease. Physical activity can also help control other risk factors for heart disease: weight, diabetes and high blood pressure. Aerobic exercise (exercise that uses oxygen to provide energy to large muscles) raises your heart and breathing rates, which help your heart to work more efficiently at rest as well as during physical activity. Vigorous, regular physical activity such as brisk walking, jogging and swimming also condition your lungs.

Even mild activities, if done daily, can help. You can benefit from simple things like walking, gardening, housework or dancing. Talk to your doctor about getting started, especially if you’ve been inactive.

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