Foods That Lower Cholesterol

Oranges First up is a very common citrus fruit that contains pectin. Like other types of soluble fiber, pectin forms a gooey mass in your stomach that traps cholesterol and carries it out of your body before it can be absorbed into your bloodstream (where it contributes to clogged arteries). One medium orange provides about 2 to 3 g of soluble fiber, as well as other beneficial nutrients such as vitamin C, folate, and potassium. You have to eat oranges in order to benefit from their fiber content, so put your juicer aside, and choose thick-skinned varieties for the best taste and easiest peeling.

Oats Here's one you probably know about already, but you may not be aware of some of the less conventional forms and uses for this soluble fiber-rich grain. While oatmeal is an obvious winner, oat flour is another versatile option. If you can't find it in the places you typically shop, you can make your own by pulverizing rolled oats in a food processor. Oat flour can be substituted for up to half the all-purpose flour in most pancake and muffin recipes; I even use it in the low-fat oatmeal cookies my kids adore.

Beans and Lentils Beans and lentils are sky-high in fiber, a good portion of which is the heart-healthy soluble type. They're also a great low-fat replacement for animal protein, which is often full of saturated fat. Beans can be incorporated into breakfast, lunch, dinner, and even snacks. For breakfast, make a burrito with scrambled egg whites, black beans, and salsa. At lunch, a bowl of lentil soup with a few whole grain crackers hits the spot. For dinner, skip the typical side dish of pasta, potatoes, or rice and try seasoned beans instead.

Sardines Just like salmon, their more popular marine relatives, sardines are ridiculously rich in omega-3 fatty acids. Omega-3's not only lower LDL cholesterol, they're also potent anti-inflammatories, and they significantly reduce blood levels of artery-clogging triglycerides. I'm convinced that most people who turn up their noses at the mere mention of sardines haven't actually tried them. If that's you, consider this yummy open-faced sandwich: spread two slices of whole wheat bread with a little bit of low-fat mayo and top each half with a couple of canned sardines, a slice of tomato, and a few fresh basil leaves.

Pistachio Nuts I love pistachio nuts, so I was thrilled when a 2008 study revealed that eating one or two handfuls (1.5 to 3 ounces) per day for four weeks significantly reduced LDL cholesterol in people with elevated blood levels. Turns out, these little powerhouses are a great source of phytosterols, the natural plant compounds that block absorption of dietary cholesterol. They're also rich in monounsaturated fat, fiber, and antioxidants — all of which are good for heart health. I prefer pistachios in the shell because it forces me to eat them slowly and prevents me from overdoing it with these healthy — but caloric — treats.

Oil Spray Because losing weight is the best way to lower your LDL ("bad") cholesterol and boost your HDL ("good") cholesterol, cutting calories is important. One surefire way to cut back is to use an oil spray in place of butter or bottled oils when cooking. Instead of purchasing disposable nonstick spray canisters, I use a reusable oil mister and fill it with my favorite brand of olive oil. Replacing the saturated fat in butter with heart-healthy unsaturated plant oils, like olive and canola, helps to improve your overall cholesterol profile.

Niacin for Cholesterol

Most people who have undesirable cholesterol levels and can’t improve them sufficiently via diet and exercise are prescribed statin drugs. But there’s also a vitamin, niacin—known as B3—that in very large doses can improve cholesterol levels and reduce the risk of heart attacks. 

When niacin’s beneficial effect was discovered in 1955, it became the first treatment for high cholesterol.

Who wouldn’t prefer to take a vitamin over a prescription drug, you might ask. But it’s not that simple. Though classified as a dietary supplement, high-dose niacin, in effect, is a drug, whether you buy it over the counter or by prescription. And like any drug, it has potential side effects and should be taken under medical supervision. In addition, there are different forms of niacin on the market, which vary in effectiveness and risks, so shopping for it in the health-food store or drugstore can be confusing.

What’s more, niacin’s anti-cholesterol credentials were tarnished in May 2011, when disappointing results from a major study were released, making some people wonder if they should stop using niacin (see box below).

Here are answers to some questions you may have.

What are niacin’s benefits?
The main goal of cholesterol treatment is to lower LDL (“bad”) cholesterol. Statins do this much better than niacin does. But niacin has the advantage of raising HDL (“good”) cholesterol much more than statins do. It also lowers triglycerides, fats in the blood that can increase the risk of heart disease. For these reasons, niacin may be a good option for people who can’t tolerate statins well and for those who have very low HDL and/or high triglycerides. Moreover, niacin helps people who have elevated levels of small, dense LDL particles, which increase coronary risk.

What are the risks of high-dose niacin?
The chief problem is that it often causes intense flushing (mostly on the face and upper body). This is not harmful or long-lasting, but many people find it hard to put up with and thus stop taking the pills. The flushing usually decreases with continued use. Niacin can, in rare cases, cause liver damage. It can raise blood sugar slightly, but is considered safe for people with diabetes. It can also increase the risk of gout and flare-ups of peptic ulcer disease.

What are the different forms of niacin? 
The form that improves cholesterol levels is called nicotinic acid. The standard dose for treating cholesterol is 1 to 3 grams daily, 50 to 150 times more than what’s in a basic multivitamin. But you’ll also find other forms for sale, such as niacinamide and inositol hexanicotinate, which have little or no effect on cholesterol.

In addition, there are three categories based on the rate of release of the niacin:

• Immediate-release niacin is effective and least expensive, but causes more flushing. It has to be taken two or three times a day.

• Sustained-release/extended-release niacin causes less flushing. However, some over-the-counter formulations may be less effective and increase the risk of liver toxicity. The extended-release form sold by prescription (Niaspan is the best-known brand) is effective, least likely to cause in­­tense flushing and safer for the liver—but it costs even more than brand-name statins. An over-the-counter sustained-release preparation called Slo-Niacin is similar to Niaspan but much less expensive.

• No-flush niacin (inositol hexanicoti­­nate) has no “free” nicotinic acid, so it has little or no effect on cholesterol. Still, some labels say “supports normal cholesterol.”

How can you reduce the flushing?
Besides taking an extended-release product, take niacin with food—preferably after dinner or a bedtime snack. Avoid hot drinks or alcohol near the time you take niacin. Also, take aspirin (or a related drug, such as ibuprofen or naproxen) before the meal; even a “baby” aspirin may help. But check with your doctor before taking aspirin regularly, since it is contraindicated for some people.

Bottom line:  Statins remain the first-line choice because they are most effective at lowering LDL, are proven to prevent heart attacks and rarely cause side effects. If you also have low HDL and/or high triglycerides, you and your doctor may decide to add niacin to your regimen. Talk to your doctor or pharmacist about the various forms, and take niacin under medical supervision. As with other cholesterol-lowering drugs, you’ll need to be monitored to make sure it is achieving the desired re­­sults and isn’t harming your liver.

Niacin + statin = surprising results Doctors often prescribe both a statin and niacin when either drug by itself fails to have sufficient effect, or when patients have low HDL and/or high triglycerides as well as high LDL. The combination improves cholesterol levels more than either drug alone, but it has not been clear whether it is better at preventing heart attacks than a statin alone. Preliminary results from a long-awaited federal study have now called into question the notion of adding niacin to statin therapy—at least in some people. The study, called AIM-HIGH, was halted early and has not been published yet; only sketchy data have been released. The study involved 3,400 people with a history of cardiovascular disease who were already taking a statin to lower their LDL but still had low HDL and high triglycerides. Their statin doses were adjusted so they achieved the LDL target of less than 80. Some subjects were then also given high-dose extended-release prescription niacin (Niaspan), with the expectation that it would offer extra protection by raising HDL and lowering triglycerides. The study was stopped after 32 months when, surprisingly, it became clear that the combination group, despite its higher HDL levels, did not have fewer heart attacks or other cardiovascular events than the statin-only group—and had slightly more strokes. If you are taking niacin, don’t stop be­­cause of this study, at least not without consulting your doctor. This was a select group of older patients with existing coronary heart disease who had already achieved very low LDL levels. It’s possible that once LDL is so low, raising HDL may not matter much—that is, there may be little room for further reduction in cardiac risk. Niacin may still provide added benefits for people with a different risk profile or those who have not reduced their LDL level so dramatically. Moreover, none of the previous studies on niacin found an increased risk of stroke, and many experts believe this was a statistical fluke in the new study. A much larger study of a niacin/statin combination is now underway and the re­­sults may clarify matters. Results are ex­­pected in 2013.

Please note:  Retina specialists at the New York Eye and Ear Infirmary of Mount Sinai (NYEE) have shown that severe vision loss from a self-prescribed high dose of over-the-counter niacin is linked to injury of a specific cell type in a patient’s eye. The experts report that discontinuing the vitamin led to reversal of the condition and have published their findings in the fall issue of Journal of VitreoRetinal Diseases.

Vitamin B3 Rich Foods List

• Wheat Bran

• Liver

• Kidneys

• Heart

• Pork chops

• Beef

• Roast Chicken

• Turkey

• Other Meats

• Sausage

• Veal (roast fillet)

• Peanuts

• Fish (fresh)

• Fish (oily)

• Instant Coffee

• Breakfast Cereal (fortified)

• Lean bacon

• Twiglets

• Potato Chips (crisp UK)

• Bovril

• Marmite

Foods that we eat every day that include vitamin B3 are tuna, salmon, beef, chicken, and eggs. Fruits and vegetables full of niacin benefits include avocados, carrots, dates, asparagus, and sweet potatoes.

Cholesterol – Niacin, if prescribed and followed closely by your physician, helps to lower bad cholesterol or LDL and increase good cholesterol HDL. It is also often more affordable than statin drugs like Lipitor®. Most doctors who choose this route to lower cholesterol will begin a patient at a 100mg dose per day and increase the dose slowly to up to 1500mg per day. Side effects include flushing and cramping in the legs and arms.

Other ways doctors use niacin to help reduce cholesterol is through a nicotinic acid powder that is added to water or juice. People with high-cholesterol levels who don’t benefit from statin drugs alone, often use B3 in this powder form as it works with your intestines to flush out bad cholesterol after each meal.

Depression – Some people who suffer from anxiety and depression, including panic attacks have achieved benefits from taking niacin. Niacin has been shown to help nerve cell function that causes anxiety, which often leads to depression.

Overdose/Side Effects/Toxicity

Large doses of niacin can cause liver damage, peptic ulcers, and skin rashes. Even normal doses can be associated with skin flushing. It can be prescribed as a treatment for elevated total cholesterol and other types of lipid disorders, but it should only be used with medical supervision due to its potential for severe side effects.

L-Lysine HCl

L-Lysine HCl supplies the essential amino acid L-lysine. 
L-Lysine has documented immuno-supportive properties‚ is important for proper growth‚ and it plays an essential role in the production of carnitine. Carnitine functions in assisting in the conversion of fatty acids into energy‚ and may also assist in normalizing cholesterol. Additionally‚ Lysine may aide in helping the body absorb calcium‚ and it plays an important role in the formation of collagen. Since Lysine and Arginine share common pathways in the body‚ high levels of arginine may lower lysine levels in the body.

Good sources of lysine are high-protein foods such as eggs, meat (specifically red meat, lamb, pork, and poultry), soy, beans and peas, cheese (particularly Parmesan), and certain fish (such as cod and sardines).

The "HCl" denotes that the lysine is present as the hydrochloride salt. Making salts changes the properties of the lysine - e.g., making it more soluble. Once dissolved in your stomach you will have free lysine and also HCl. So there is no difference than in taking lysine or lysine HCl.

Total blood or serum cholesterol - what the numbers mean

This is the sum of your HDL and LDL cholesterol scores and is generally a good indicator of whether you’re at risk for heart disease.

• Optimal: Less than 200 mg/dL   
• Borderline high: 200-239 mg/dL               
• High: 240 mg/dL or higher

High-Density Lipoprotein (HDL)

High-Density Lipoprotein (HDL) is considered the “good” cholesterol because it helps keep the arteries clear of the clogging “bad” LDL cholesterol. In most people, high HDL helps protect against heart disease. Low levels of HDL are associated with a greater risk of heart disease. Therefore, the higher your HDL score is, the better. If your HDL falls in the “low” range, you are considered a major risk for heart disease.

• Low: less than 40 mg/dL for men and less than 50 mg/dL for women
• Normal: above 45 mg/dL for men and above 55 mg/dL for women
• Optimal: 60 mg/dL and above can lower your risk of heart disease

Low-Density Lipoprotein (LDL)

A high level of “bad” LDL cholesterol can clog the arteries and is a major risk factor for heart disease. Keeping your LDL as low as possible is a good way to protect your health.

• Optimal: Less than 100 mg/dL
• Normal/Near Optimal: 100-129 mg/dL
• Borderline High: 130-159 mg/dL
• High: 160-189 mg/dL
• Very High: 190 mg/dL and above

People with heart disease and those who are at very high risk of heart disease (such as those with metabolic syndrome) need to keep their LDL even lower than the optimal score (less than 70 mg/dL is recommended).

People with diabetes or multiple risk factors for heart disease (such as smoking or having low HDL levels) should aim for an LDL reading within the optimal category.

Triglycerides

Triglycerides are another type of fat found in the bloodstream. A high level of triglycerides is associated with a greater risk of heart disease. When it comes to your test results, the lower the number, the better.

• Normal: less than 150 mg/dL
• Borderline High: 150-199 mg/dL
• High: 200-499 mg/dL
• Very High: 500 mg/dL and above

No-flush niacin (inositol hexaniacinate) has no effect on HDL cholesterol

Niacin, also known as vitamin B3, comes in two forms — nicotinic acid and nicotinamide. Both boost protective HDL and lower harmful LDL and triglycerides. Most people who take the high doses of standard, immediate-release niacin that are needed to improve HDL experience a feeling of flushing or itching, usually in the face. It starts within 30 minutes of taking the medication, and lasts for an hour or so.

No-flush niacin doesn't contain either nicotinic acid or nicotinamide. Instead, it contains inositol hexaniacinate. In theory, the body should slowly convert this into nicotinic acid. In reality, it doesn't. An excellent study by researchers at the University of Washington School of Medicine showed that taking no-flush niacin generates virtually no free nicotinic acid, and has little or no effect on HDL. No-flush niacin lives up to the no-flush part of its name because it isn't providing the body with any niacin.

I also recommend staying away from extended-release niacin. Instead of delivering a big bolus of niacin, it generates a lower, steady dose of the medication for hours. Although this eases flushing, it keeps blood levels of niacin high all day. The liver never gets a break from processing niacin, which has led to cases of severe liver damage.

more at:

• https://www.health.harvard.edu/newsletter_article/is-no-flush-niacin-as-effective-as-other-kinds-of-niacin

Can your HDL or ‘good cholesterol' be too high?

High levels of HDL, or “good” cholesterol, are generally considered healthy. But can you have too much of a good thing?

Possibly so, a study in the European Heart Journal found. Danish researchers tracked more than 116,508 men and women, average age 57, for an average of six years. There were 10,678 deaths.

After adjusting for other factors, an HDL of 73 milligrams per deciliter in men and 93 in women was associated with the lowest all-cause mortality. Compared with that, men with HDL levels of 97 to 115 had a 36 percent increased risk for death, and twice the risk above 116. Women at greater than 135 had a 68 percent increased risk. (Only 2.3 percent of men had levels above 97, and 0.3 percent of women had levels above 135.)

Low HDL, too, was tied to higher mortality risk, consistent with other studies. At levels under 39, the lower the HDL, the greater the increased risk for death.
The senior author, Dr. Borge G. Nordestgaard, a clinical professor at the University of Copenhagen, said that until now, he would “congratulate” patients with very high HDL. “The higher the better!”

“But now we know that’s not so. These people should protect themselves — exercise, stop smoking, eat a healthy diet and so on.”

What is Cholesterol?

You already know that some cholesterol is good and some is bad. But did you know that there are clear guidelines for cholesterol levels for average Americans and newly established guidelines for high-risk patients?

Cholesterol is:

• Produced by the liver and other organs and also furnished in the diet through such food as meats, poultry, fish and dairy products.
• Required by the body to insulate nerves, make cell membranes, and produce certain hormones.
• Carried through the body by lipoproteins in the blood.

Two Types of Cholesterol

The Good	The Bad
HDL (High Density Lipoprotein) transports cholesterol from the body's tissues to the liver and other sites, where it may be broken down and excreted by the body. HDL cholesterol is commonly known as "good" cholesterol.	LDL (Low Density Lipoprotein) transports cholesterol from the liver to the rest of the body. LDL cholesterol is commonly known as "bad" cholesterol.

How to Control Your Cholesterol

Many Americans have succeeded in lowering their LDL "bad" cholesterol through lifestyle changes. Eating right, exercising, and relaxing are some of the basic lifestyle changes you can make to improve your overall health. Your doctor can test your cholesterol level, or you can test yourself with a kit you can purchase at your pharmacy.
The National Cholesterol Education Program (NCEP) identifies LDL cholesterol as the primary target of cholesterol management. Clinical research has shown that elevated LDL, the "bad" cholesterol, is the primary cause of coronary heart disease.
New Guidelines for High Risk Heart Patients Can Save Lives
Every year 1.2 million Americans have a new or repeat heart attack. A new set of guidelines has been released that specifically targets these high risk Americans. The new NCEP guideline determines that high-risk heart patients should lower their LDL "bad" cholesterol to a rock bottom 70. The previous NCEP guideline was 100.

LDL Cholesterol Level Guideline (mg/dl)
	Optimal
100-129	Near optimal/above optimal
130-159	Borderline high
160-189	High
>190	Very high
Total Cholesterol Level
	Desirable
200-239	Borderline High
>240	High
HDL Cholesterol Level
	Low
>60	High

Cholesterol

Cholesterol has a poor reputation, but it actually isn’t all bad. There is both good and bad cholesterol. HDL (high density lipoproteins) cholesterol is the “good” cholesterol that, when at healthy levels, can protect against heart attack and stroke. HDL also prevents LDL (low density lipoproteins) cholesterol (the “bad” cholesterol) from clogging your arteries. Too much of one of these or not enough of the other can have critical implications for your well-being. It can also put you at risk for heart attack, stroke and heart disease. 

How do you know whether you have too much “bad” (LDL) cholesterol or not enough “good” (HDL) cholesterol? There is a screening your doctor or healthcare professional can administer to detect your levels of HDL and LDL in your blood. It’s important to know this information because there typically aren’t any symptoms associated with high cholesterol, but the consequences of having this condition can be severe.

Start by taking the American Heart Association’s Cholesterol IQ Quiz.

How Do I Manage my Cholesterol?

Our liver and other cells create about 75% of blood cholesterol, while the other 25% comes from food we eat. LDL cholesterol is produced naturally by the body, but many people inherit genes from their parents or grandparents that can cause their body to make too much. Additionally, LDL cholesterol can increase from what you eat, such as foods high in cholesterol and saturated and trans fats. While lifestyle modifications can help you get your LDL and HDL levels in check, if high cholesterol runs in your family, you may have to work with your doctor for an additional treatment plan. 

Once you know what your LDL and HDL levels are, you can work on finding the balance needed to stay healthy. Lifestyle modifications can include increasing physical activity and reducing trans fats and/or adding more nutritious fruits and vegetables to your diet. You can also add a soluble fiber supplement such as Konsyl to help manage your cholesterol. Soluble fiber can help reduce LDL cholesterol beyond what you can achieve with a diet low in saturated and trans fats and cholesterol alone. 

Diagnosis and Monitoring

While high cholesterol can lead to heart disease, heart attack or stroke, there usually are no symptoms. That’s why it’s important to talk to your doctor so he or she can test and monitor your cholesterol levels on a regular basis. Even if your levels are good, staying aware and maintaining good habits is essential to continued good health.

Prevention and Treatment

If you have been diagnosed with high cholesterol, being educated and managing your lifestyle are steps in the right direction. Work with your doctor for a specific treatment plan and you should also take these positive steps.

• Lead a healthy lifestyle
  • Participate in regular physical activity
  • Eat a heart-healthy diet
• Watch your fat intake
  • Know which fats raise LDL cholesterol and limit your intake of them
  • Keep overall fat intake to a healthy level

Fiber and Cholesterol

Fiber is a natural way to help lower or maintain your cholesterol levels, thereby reducing the risk of coronary heart disease. Adding 7 grams of soluble fiber from psyllium seed husk per day, along with sticking to a diet that is low in saturated fat and cholesterol, can lower LDL (bad) cholesterol levels. 

Is drinking coffee made with a paper filter healthier than drinking boiled coffee or other types of coffee?

Coffee contains a substance called cafestol that is a potent stimulator of LDL cholesterol levels. Cafestol is found in the oily fraction of coffee, and when you brew coffee with a paper filter, the cafestol gets left behind in the filter. Other methods of coffee preparation, such as the boiled coffee common in Scandinavian countries, French press coffee, or Turkish coffee, are much higher in cafestol. So for people who have high cholesterol levels or who want to prevent having high cholesterol levels, it is better to choose paper filtered coffee or instant coffee, since they have much lower levels of cafestol than boiled or French press coffee. Espresso is somewhere in the middle; it has less cafestol than boiled or French press coffee, but more than paper filtered coffee.

The Latest Guidelines on Statins for High Cholesterol

The FDA’s advice to patients and healthcare professionals include:

• a warning that statins may cause cognitive impairment. These issues include memory loss, confusion, and forgetfulness.
• a notice that routine liver enzyme monitoring is no longer necessary. Liver enzyme tests were used for decades as a way to catch potential liver damage. However, the FDA has found that these checks are not effective. The new recommendation: doctors should perform a liver enzyme test before statin use begins. Then patients should be checked again if symptoms of liver damage appear.
• a warning that people taking statins may experience increased blood sugar levels and may develop type 2 diabetes. People taking statins should have their blood-sugar levels checked regularly.
• a warning that patients taking lovastatin, a type of statin medication, are at risk for muscle damage. Patients taking this type of medicine should be aware of this possible drug interaction.

Is my cholesterol too high?

Selenium supplements linked to high cholesterol

Taking selenium supplements may increase cholesterol levels by as much as 10 per cent, according to a new study.

Writing in the Journal of Nutrition, scientists at the University of Warwick Medical School said consuming too much selenium can have adverse effects.

Selenium is considered a health ingredient because of its antioxidant properties, and the perception that it can reduce cancer risks. The body naturally absorbs selenium from vegetables, meat, and seafood but it is also found in higher quantities in supplements.

Health benefits may be linked to selenium but according to a team led by Dr Saverio Stranges at Warwick University, the balance can be tipped and high levels of selenium in the diet are associated with increased cholesterol.

The link

The scientists reached this conclusion after examining the relationship between plasma selenium concentrations (levels of selenium in the blood) with blood lipids (fats in the blood).

A cross-sectional study of the1042 participants in the 2000-2001 National Diet and Nutrition Survey revealed that among those with higher plasma selenium (more than 1.20 µmol/L) there was an increase in the average total cholesterol level of 8 per cent (0.39 mmol/L (i.e. 15.1 mg/dL).

Researchers also found a 10 per cent increase in non-HDL cholesterol levels, which is the bad cholesterol most closely linked to heart disease.

Making the final step linking high selenium intake, supplementation, and high cholesterol, the scientists noted that among the participants, 48.2 per cent admitted they regularly took dietary supplements.

Supplement warning

Dr Saverio Stranges said high levels of selenium were not exclusively caused by supplementation, but the conclusions of the study do raise concerns given the increased use of selenium supplements in recent years.

Stranges said: “The cholesterol increases we have identified may have important implications for public health. In fact, such a difference could translate into a large number of premature deaths from coronary heart disease.


“We believe that the widespread use of selenium supplements, or of any other strategy that artificially increases selenium status above the level required, is unwarranted at the present time.” Stranges called for further research to examine the full range of health effects from increased selenium in the diet.

In a recent opinion on selenium, the European Food Safety Authority (EFSA) concluded that it could offer “protection of DNA, proteins and lipids from oxidative damage, normal function of the immune system, normal thyroid function and normal spermatogenesis.” But the EFSA Panel on Dietetic Products, Nutrition and Allergies (NDA) dismissed claims linking the mineral to normal cognitive function, normal prostate function and normal function of the heart and blood vessels


Source: Journal of Nutrition

Cholesterol

Blood cholesterol is a risk factor for coronary artery disease and heart attack, so reducing your risk of high cholesterol is a worthy goal.

However, the next time you brag that your cholesterol is nice and low -- or lament that your number is in the mid-200s -- know this:

"Your total cholesterol is a pretty meaningless number," says Maureen Mays, M.D., a preventive cardiologist and lipid specialist at Oregon Health & Science University in Portland.

"Not only does the general public not know this, some doctors don't either."

Here's why "the number" is so misleading.
Total cholesterol is calculated by adding LDL (bad cholesterol), HDL (good cholesterol), and one-fifth of your triglyceride total.

"We have been using this formula of adding a bad thing to a good thing and factoring in one-fifth of a bad thing, and it's not useful," Dr. Mays says.

A smarter way of looking at cholesterol risk is by component.

LDL, or bad cholesterol, is very responsive to good nutrition and exercise. The target number is less than 100 mg/dL. It's not uncommon for LDL to swing up by 40 percent in response to a sedentary lifestyle and a diet high in saturated and other unhealthy fats, according to Dr. Mays.

It can also drop by up to 40 percent in response to a heart-healthy diet and regular exercise.

When should you have a cholesterol test?
One in 500 people has an inherited risk of extremely high LDL and should be put on statins to control their risk of heart disease.

Being overweight can also raise your triglycerides, for which the goal is 150 mg/dL or under.

High triglycerides put you at risk for type 2 diabetes, which is a coronary heart disease risk equivalent; this means that if you have diabetes, you have the same risk of dying from cardiovascular problems as someone who already has coronary heart disease.

While increasing age and stress will slightly change your cholesterol panel, "stopping smoking is the best way to raise your good cholesterol," says Dr. Mays.

It is critical for women nearing menopause to maintain a healthy diet and exercise plan to counteract the effects of estrogen loss.

Because estrogen suppresses LDL levels, women who reach menopause may notice a surge of bad cholesterol, says Denise Janosik, M.D., a cardiologist and professor of internal medicine at Saint Louis University School of Medicine.

Effect of drugs and alcohol
Certain medications, including the steroid prednisone and HIV drugs, can affect your cholesterol panel negatively, so much so that people who are on protease inhibitors for HIV need to be concerned about developing heart disease, according to Dr. Mays.

One to two drinks a day is fine for keeping your cholesterol in check. More than that may raise triglycerides because of the high sugar and calorie content of alcoholic drinks. Alcohol also raises HDL slightly, but this increase in good cholesterol isn't as great as that caused by a healthy lifestyle.

Hypothyroidism, too, can result in skewed cholesterol numbers.

"If you are fatigued and have sudden weight gain, it is good to have a thyroid screening," says Dr. Mays. "If your thyroid isn't working properly, your lipid panel will make no sense."