Foods to avoid
“People still think the amount of fat in your diet is what matters when it comes to blood cholesterol levels,” says Walter Willett, M.D., chair of the Department of Nutrition at the Harvard School of Public Health. “The types of fat affect your cholesterol levels much more than the amount.” Specifically, a diet high in saturated fats from meat and higher-fat dairy products increases your blood levels of total and LDL cholesterol. Trans fats—commercially produced shortenings made from hardened vegetable oils—are also linked to cholesterol because they increase the number of smaller LDL particles and lower HDL cholesterol. A 2003 study in the American Journal of Clinical Nutrition found that LDL particle size was significantly smaller in people who consumed the most trans fats. Since 2006, the Nutrition Facts box on all food labels must include the amount of trans fats per serving. Sugars, especially table and refined sugars used in processed foods, also create plaque buildup, because the body uses them to produce fats called triglycerides, which make it easier for small LDL particles to stick to blood vessel walls. “No cardiologist focuses only on cholesterol anymore,” says Guarneri. “Triglycerides are just as much a risk factor as cholesterol.”
Maintain a good weight
Experts at the National Cholesterol Education Program (NCEP) say that being overweight can increase your total cholesterol and triglyceride levels and keep your protective HDLs at a low level. Losing just 5 to 10 percent of your weight will improve your cholesterol profile, says Karmally, who recommends controlling portions to get your weight within healthy limits.
Being sedentary has much of the same effect on cholesterol and triglyceride levels as being overweight. Researchers at Duke University Medical Center have found that all exercise improves cholesterol and triglyceride levels in both men and women. In a Duke study published in the New England Journal of Medicine in 2002, researchers showed that exercise also increases the size of HDL particles that protect against atherosclerosis. A 2002 study in the American Journal of Cardiology reported that when subjects who were following a low-cholesterol, minutes of aerobic and free-weight exercises to their daily routines, 89 percent lowered their total cholesterol.
A 2005 study published in Health Psychology found that a long-term effect of mental stress can be an increase in total cholesterol. Study participants with the greatest emotional response to stress were three times more likely to have high LDL levels than those who were able to cope with stress. Guarneri, who uses meditation, breath work, and yoga in her practice, has seen patients reduce their dosage of cholesterol-lowering medication after learning to manage stress.