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	REDUCING YOUR CHOLESTEROL

What is Cholesterol?
 

Cholesterol is a fat-like substance found in all tissues. Every cell in your body contains cholesterol, which is needed for normal cell development and repair. Cholesterol is used by the liver to produce bile acids, which aid in food digestion, and by the glands to produce certain hormones.

Generally your body produces all of the cholesterol it needs, but you get more from the foods you eat, particularly if your diet includes foods containing saturated fats.

Too high a level of cholesterol in your bloodstream is a major risk factor for developing heart disease. Fatty deposits (plaque) can build up along the inside walls of blood vessels, a condition called atherosclerosis or hardening of the arteries. This accumulation can decrease or block the flow of blood in the coronary arteries, the vessels that serve the heart. The heart is then deprived of oxygen and nutrients.

The "Good" and "Bad" Cholesterol
 

LDL (low density lipoprotein) cholesterol is often referred to as the "bad" cholesterol because it tends to accumulate in artery walls. HDL (high density lipoprotein) cholesterol is "good" because it appears to protect against atherosclerosis by carrying excess cholesterol away from artery walls. If your LDL cholesterol level is too high or your HDL cholesterol level is too low, you are at greater risk for coronary heart disease.

Triglycerides are another form of lipid that provides fuel for the body. They are produced by the body and are contained in foods such as butter and chocolate. Many experts believe a hgh level of triglycerides and total cholesterol, along with a low level of HDL ("good") cholesterol may increase the risk of heart disease

Reducing Cholesterol Levels
 

If you have high blood cholesterol, making certain changes in your lifestyle will help you bring it to within normal ranges. Your doctor can help you set your goals.

• Lower your total fat and cholesterol intake. Eat more fruits, vegetables, grains, cereals and legumes. Choose poultry, fish, lean meats, and low-fat dairy products. Fat should account for less than 30% of your total calories daily.
• Broil, boil, poach or steam foods, rather than fry.
• Increase dietary fiber. Studies show that soluble dietary fiber can help lower blood cholesterol. Sources of dietary fiber include fruits, vegetables, dried beans and grains such as oats, corn, rice and bran.

What You Can Do
 

Bringing your cholesterol levels to within normal ranges will help to reduce this major risk to your cardiovascular health. Other risk factors for cardiovascular disease include heredity, age and gender. These are things you cannot change. However, there are things you can do:

• If you are a smoker, stop smoking.
• Exercise regularly. This is good for cardiovascular health, helps in weight control and may raise levels of HDL cholesterol. (Consult your doctor before starting an exercise program).
• Lose weight if necessary; then maintain your ideal weight.

Drug Therapy / Special Instructions
 

Many people can lower their blood cholesterol through diet. Others require the use of cholesterol-controlling drugs in addition to diet. Your doctor will determine the drug and dosage that is best for you.

You can do your part by taking your medicine exactly as prescribed. Do not take more or less during any one day. Be sure you understand how the medication is to be taken and what to do if you should forget a dose. If you have any questions, ask your doctor. Your pharmacist is also a valuable resource for information about the drug therapy your physician has prescribed.

	Patient Blood Lipids	Goal
Total Cholesterol		<200
Triglycerides		<200
HDL Cholesterol		>60
LDL Cholesterol		<100

FOOD GROUP	CHOOSE	DECREASE
Lean meat, Poultry and Fish	Beef, pork, lamb - lean cuts well trimmed before cooking	Beef, pork, lamb - regular ground beef, fatty cuts, spare ribs, organ meats
5-6 oz per day	Poultry without skin	Poultry with skin, fried chicken
	Fish, shellfish	Fried fish, fried shellfish
	Processed meat - prepared from lean meat, e.g. lean ham, lean frankfurters, lean meat with soy protein or carrageenan	Regular luncheon meat, e.g. bologna, salami, sausage, frankfurters
Eggs = 4 yolks/week, Step I = 2 yolks/week, Step II	Egg whites (two whites can be substituted for one whole egg in recipes), cholesterol-free egg substitute	Egg yolks (if more than 4 per week on Step I or if more than 2 per week on Step II); includes eggs used in cooking and baking
Low-Fat Dairy Products	Milk - skim, ½%, or 1% fat (fluid, powdered, evaporated), buttermilk	Whole milk (fluid, evaporated, condensed), 2% fat milk (low fat milk, imitation milk)
2-3 servings per day	Yogurt - nonfat or low-fat yogurt or yogurt beverages	Whole milk yogurt, whole milk yogurt beverages
	Cheese - low-fat natural or processed cheese	Regular cheeses (American, bleu, Brie, cheddar, Colby, Edam, Monterey Jack, whole-milk mozzarella, Parmesan, Swiss, cream cheese, Neufchatel cheese
	Low-fat or non-fat varieties, e.g. cottage cheese - low-fat, nonfat or dry curd (0% -2% fat)	Cottage cheese (4% fat)
	Frozen dairy dessert - ice milk, frozen yogurt (low-fat or nonfat)	Ice cream
	Low-fat coffee creamer, low-fat or nonfat sour cream	Cream, half & half, whipping cream, nondairy creamer, whipped topping, sour cream
Fats and Oils = 6-8 tsp per day	Unsaturated oils - safflower, sunflower, corn, soybean, cottonseed, canola, olive, peanut	Coconut oil, palm kernel oil, palm oil
	Margarine - made from unsaturated oils listed above, light or diet margarine, especially soft or liquid forms	Butter, lard, shortening, bacon fat, hard margarine
	Salad dressings - made with unsaturated oils listed above, low-fat or fat free	Dressings made with egg yolk, cheese, sour cream, whole milk
	Seeds and nuts - peanut butter, other nut butters	Coconut
	Cocoa powder	Milk chocolate
Breads and Cereals 6 or more serv/day	Breads - whole-grain bread, English muffins, bagels, buns, corn or flour tortilla	Bread in which eggs, fat, and/or butter are a major ingredient; croissants
	Cereals - oat, wheat, corn, multigrain	Most granolas
	Pasta, rice, dry beans and peas
	Crackers, low-fat animal-type, graham, soda crackers, breadsticks, melba toast	High-fat crackers
	Homemade baked goods using unsaturated oil, skim or 1% milk, and egg substitute - quick breads, biscuits, cornbread muffins, bran muffins, pancakes, waffles	Commercial baked pastries, muffins, biscuits
Soups	Reduced- or low-fat and reduced-sodium varieties, e.g. chicken or beef noodle, minestrone, tomato, vegetable, potato, reduced-fat soups made with skim milk	Soup containing whole milk, cream, meat fat, poultry fat or poultry skin
Vegetables 3-5 servings/day	Fresh, frozen or canned, without added fat or sauce	Vegetables fried or prepared with butter, cheese or cream sauce
Fruits	Fruit - fresh, frozen, canned or dried	Fried fruit or fruit served with butter or cream sauce
2-4 servings/day	Fruit juice - fresh, frozen or canned	style="MARGIN: 0in 0in 0pt; TEXT-INDENT: 0in">
Sweets and	Beverages - fruit-flavored drinks, lemonade, fruit punch	style="MARGIN: 0in 0in 0pt; TEXT-INDENT: 0in">
Modified Fat Desserts	Sweets - sugar, syrup, honey, jam, preserves, candy made without fat (candy corn, gumdrops, hard candy), fruit-flavored gelatin	Candy made with milk chocolate, coconut oil, palm kernel oil, palm oil
	Frozen desserts - low-fat and nonfat yogurt, ice milk, sherbet, sorbet, fruit ice, popsicles	Ice cream and frozen treats made with ice cream
	Cookies, cake, pie, pudding - prepared with egg whites, egg substitute, skim milk or 1% milk, and unsaturated oil or margarine; ginger snaps, fig and other fruit bar cookies, fat-free cookies, angel food cake	Commercial baked pies, cakes, doughnuts, high-fat cookies, cream pies