Lifestyle Choices

So you’ve gotten your cholesterol measured, and you need to bring it down. Here are some of the best cholesterol-cutting measures you can take.

Cut meat intake. Most Americans get 13 percent of their total calories from saturated fat. Cardiologists would like to see that figure drop to about 7 percent. To that end, limit lean meat, poultry or fish to a 3-ounce portion (about the size of a deck of cards) no more than once a day. Only animal foods contain cholesterol and saturated fat. Therefore, the foods that drive up your blood cholesterol numbers most are red meats, the skin of poultry, whole dairy products and eggs. Fish, especially the white-fleshed ones, tend to be low in saturated fat.

Take a holiday from the fat flow. To make sure your cholesterol level goes down, cut all fat intake—including vegetable oils—to 25 percent or, even better, 20 percent of total calories. That will guarantee less saturated fat consumption. Here are ways to accomplish this.

Eat red meat no more than two or three times per week.

Eat at least two meatless meals a day.

Choose fat-free condiments, such as mustard, horseradish, nonfat salad dressings, catsup, chili sauce, relish and salsa, rather than fatty ones such as mayonnaise or regular salad dressing.

Go vegetarian. If your high cholesterol just won’t go down even though you’ve cut back on fat, go on a vegetarian diet of whole grains, fresh vegetables, beans, fruit and a limited amount of low-fat dairy products. Dean Ornish, M.D., director of the Preventive Medicine Research Institute in Sausalito, California, and author of Dr. Dean Omish’s Program for Reversing Heart Disease, has shown that a vegetarian diet, coupled with exercise and meditation, can dramatically lower blood cholesterol levels and reverse the atherosclerostic plaques that form the basis for heart disease.

Feast on high fiber. If you’re overweight and have high cholesterol, increasing your fiber intake to 20 to 35 grams of fiber each day may help lower cholesterol. (Most of us eat 10 grams or less a day.) Chow down on foods such as oats, brown rice, whole-grain products, legumes, apples and citrus fruits. The soluble fiber in oats and psyllium seeds are particularly effective in lowering cholesterol.

At Central Washington University in Ellensburg, researchers studied 26 men with blood cholesterol in the 200- to 250-mg/di range. Thirteen of the men added three fiber-rich apple cookies to their diets daily for six weeks. Final blood tests showed that the cholesterol level of the apple-fiber group was lowered by an average of 15 mg/dl, or about 7 percent, with no other dietary changes.

Eating about 2 ounces of oat bran (a medium-size bowl) or 3 ounces of oatmeal (a large bowl) once a day, in addition to eating a low-fat, low-cholesterol diet, can lower LDL cholesterol (the bad kind) 10 to 15 percent, concluded Michael H. Davidson, M.D., medical director of the Chicago Center for Clinical Research and assistant professor at Rush Presbyterian-St. Luke’s Medical Center, after observing 148 adults with high cholesterol levels.

Ease into the “good” oils. Choose monounsaturated or polyunsaturated oils from nuts and grains rather than saturated fats from animal sources. Olive oil is your best bet, but other good options include canola, safflower, corn and sunflower oils. Other less common choices are barley oil and amaranth oil. In a study by Joanne Lupton, Ph.D., chair of the graduate faculty in nutrition at Texas A&M University in College Station, the use of barley flour and barley oils reduced overall cholesterol by 7 percent and LDL by nearly 9.2 percent. Amaranth oils have a similar cholesterol-lowering effect. Remember that all forms of fat are laden with calories, however, and keep your intake of fat to a minimum.

Fish for the superfats. Almost all fish contain some omega-3 fatty acids, whose chemical makeup keeps these fats liquid even in very low temperatures (essential for cold-water fish). Omega- 3s help lower blood fat levels and heart disease risk. They also help prevent the development of blood clots, which can severely restrict blood flow to the heart.

Certain fish are particularly rich in omega-3s and low in fat. A 31/2-ounce serving of sea bass contains 595 milligrams of omega- 3s and only 2 grams of fat; 31/2 ounces of Atlantic pollack has 421 milligrams of omega-3s and just 1 gram of fat. Snapper and Pacific Rockfish are also very high in omega-3s and very low in total fat. Your efforts to cut down on fatty foods will get a big boost if you include low-fat, high-omega-3 fish in your diet.

Combine exercise with weight loss. If you take at least 30 minutes, three or four times a week, to enjoy an aerobic exercise such as walking, bicycling, swimming, tennis, running or golf, your heart will thank you. (For those with heart disease, walking is perhaps the safest aerobic exercise.)

For people who are overweight, aerobic exercise, when combined with weight loss, is known to lower total cholesterol levels and particularly LDLs. But more than that, it is one of the few things you can do to raise your HDL level. And you don’t need to work all that hard to benefit. “A brisk walk 20 minutes a day would make a major impact,” says Thomas Kottke, M.D., a cardiologist at the Mayo Clinic in Rochester, Minnesota.

Even the walking involved in playing a few rounds of golf each week may lower your LDLs, suggests a study by Edward A. Palank, M.D., director of the New Hampshire Heart Institute. He reported on 28 men with normal to mildly elevated cholesterol levels who golfed three times a week for four months. They averaged 14 miles of walking per week, while pulling a cart or carrying a light bag and avoiding the golf cart entirely. The result: “Their LDL cholesterol dropped significantly, while their HDL cholesterol stayed the same,” says Dr. Palank. A group of 16 men who played no golf saw no improvement.

Help your heart with vitamin C. Foods rich in vitamin C help keep your HDL cholesterol levels up. And if your diet includes such C-rich items as broccoli, cabbage, citrus fruits and strawberries, you also benefit from fiber, which can help remove LDL cholesterol.

People who consume significant amounts of vitamin C regularly have higher HDLs, according to findings of the Baltimore Longitudinal Study of Aging. Among the 800 men and women (ages 20 to 95) tested, those with the highest blood levels of C had HDL levels that were approximately 5 mg/dl higher than those with the lowest levels of C.

Puff no more. Smoking raises your LDL and total cholesterol, increases the formation of cholesterol plaque and lowers HDLs. If you continue to smoke, you’re twice as likely to have heart disease and a heart attack than nonsmokers. In 1989, smoking killed 115,000 people from heart disease (and 9,000 more from lung cancer).

The best advice is to avoid smoking if you haven’t started and stop if you have. For help in quitting, ask your doctor how you can locate a stop-smoking group approved by the American Lung Association.

Relax. “Emotions play a powerful role in affecting your body and especially your heart,” Dr. Ornish says. “I believe that it’s not enough to ask people to change their behavior without also addressing the emotional factors that underlie the behaviors.” He advises people to use relaxation techniques, including yoga, imaging routines and group therapy, to control stress and reduce cholesterol levels.

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