cholesterol

Your heart beats an average of 100,000 times a day. With every beat, it sends 2 to 3 ounces of blood whooshing through your vascular system—some 60,000 miles of arteries, veins, and capillaries. The heart's an impressive organ, but it can’t send all that cargo on its way if your vascular highway is full of barriers. For millions of us, buildups of cholesterol and other fatty substances in our arteries restrict blood flow and promote the development of blood clots. Over time, this traffic jam can lead to heart attacks, strokes, and other vascular diseases.

Cholesterol itself isn't harmful; in fact, we need it. Your body produces this waxy substance every day to make cell membranes, bile acids, vitamin D, and a variety of sex hormones. But when cholesterol levels in the blood rise to unhealthy levels, there’s too much of a good thing.

We often talk about cholesterol as though it's a single substance, but there are two main types:

Low-density lipoprotein (LDL) or “bad” cholesterol. High levels of LDL cholesterol promote the development of a dense, fatty layer called plaque on artery walls. As the plaque layer gets thicker, it becomes harder for blood to squeeze through. Plaque also promotes the development of blood clots, blockages that can impede or stop the flow of blood. It's best to keep your LDL level under 100 mg/dL.

High-density lipoprotein (HDL) or “good” cholesterol. Because this fat removes excess LDL from your blood and carries it to your liver for disposal, higher equals better. Strive to keep this level above 40 mg/dL.

Also important are triglycerides. These blood fats can raise your heart disease risk. If levels are borderline high (150–199 mg/dL) or high (200 mg/dL or more), you may need treatment.

You should keep your total cholesterol number—the sum of your HDL, LDL, and other blood fats—below 200. Many of are overshooting that mark: The American Heart Association estimates that 106.7 million U.S. adults have total blood cholesterol values of 200 mg/dL and higher. And of these, about 37.2 million American adults have levels of 240 or above.

You have plenty of options to take control of your cholesterol profile, many of which don’t require a prescription from your doctor. If you are taking medication to keep your cholesterol levels under control, though, don’t change the dose without taking to your doc first.

• Lighten your load. Lugging around excess weight can increase your LDL level, lower your HDL, and increase your total cholesterol level. "If you're overweight, losing just 5 to 10 percent of your weight can lower LDL," says Nilo Cater, M.D., an assistant professor of internal medicine and a nutrition scholar at the Center for Human Nutrition at the University of Texas Southwestern Medical Center at Dallas.

• Get off the couch. It’s comfy there, we know. But regular exercise puts you into a win-win-win situation: it helps you lose weight, lower your LDL level, and raise your HDL level. Walking, swimming, jogging, and even lifting weights can raise beneficial HDL 10 to 15 percent, says Dr. Cater. If you integrate some physical activity into your daily routine—take the stairs instead of the elevator, park at the far end of the lot—you’ll slim down your carbon footprint, too. Think of the unneeded carbon emissions your car spews out when you’re circling the lot looking for the closest possible spot, wasting gas and dirtying the air.

• Quit smoking. Smoking lowers levels of HDL and increases LDL. It also damages LDL molecules in the blood, making them more likely to stick to artery walls. Kick the habit and spare your arteries—and stop exposing friends and loved ones to secondhand smoke.

• Phase out saturated fat. This type of fat is converted into cholesterol in your liver and raises your LDL cholesterol level more than anything else in your diet. It’s found in foods from animal sources, like egg yolks, meats, cheese, and butter, and in a variety of packaged foods. Cutting back on meat, especially, is good for the planet as well as your arteries. Research shows that worldwide livestock farming generates 18% of Earth’s greenhouse gas emissions. By comparison, the entire world's cars, trains, planes, and boats account for a combined 13% of greenhouse gas emissions. And most of the saturated fat in the American diet comes from meat. So now you have two excellent reasons to go vegetarian—or at least swap out a few steak dinners for some veggie-heavy meals.

• Fill up on fiber. Found in plant foods, dietary fiber—especially the soluble fiber in oats, beans, barley, and asparagus—is essential for lowering cholesterol. Eating more fiber-rich plant foods not only can lower your “bad” cholesterol but also helps you shed excess weight. Chose organic produce whenever possible; organic growing techniques add carbon to the soil, rather than releasing it into the atmosphere and contributing to global warming. If the food’s was produced locally, you’ll also cut down on the carbon emissions created by transporting it to your table.

• Boost fiber with psyllium. One tablespoon of this crushed seed, available in most drugstores, provides as much fiber as a serving of bran cereal.

• Eat like a horse. Oats have gotten a lot of attention for its cholesterol-lowering prowess and for good reason: The soluble fiber in oatmeal and oat bran help prevent cholesterol from getting into your bloodstream.

• Do something fishy. Fish contain omega-3 fatty acids, healthful fats that lower LDL and triglycerides—harmful blood fats that have been linked to heart disease—while raising HDL at the same time. Salmon is one great source of omega-3’s; choose wild-caught Alaskan salmon, which is better for the environment than farm-raised varieties.

• Eat flax. A nutty-tasting grain seed, flax is loaded with cholesterol-lowering omega-3 fatty acids.

• Steer clear of trans fatty acids (trans fats). These fats, formed when vegetable oil is hydrogenated to harden it, raise cholesterol levels. You’ll find trans fats in some prepared foods, so be sure to check the “Nutrition Facts” label on packages. Better yet, replace prepared packaged food with organic whole fruits and vegetables.

• Enjoy whole grains. Forget "white" anything—white rice, white bread, or white flour. Most of the cholesterol-reducing fiber has been stripped away during processing. Whole grains, on the other hand, are loaded with it.

• Switch to brown rice. It takes longer to cook than the white varieties, but it's higher in fiber and contains more rice oil, which is thought to have cholesterol-lowering effects, says Kristine Napier, R.D., author of Eat to Heal, and coauthor of Eat Away Diabetes.

• Drink green tea. It's rich in polyphenols, antioxidants that keep LDL cholesterol from sticking to artery walls.

• Wipe away those tears. Onions contain a powerful antioxidant called quercetin, which helps prevent LDL from accumulating in the arteries.

• Get checked. If you’re age 20 or older, you should have your cholesterol levels checked at least once every 5 years. You and your doctor can discuss how often you should be tested.