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5 Ways to Lower Your Cholesterol

Cholesterol levels creep up as we age and can start causing problems in midlife

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Although cholesterol — a waxy, fatlike substance that can cause dangerous plaques to form in your blood, leading to a condition known as atherosclerosis — is more common among people in their 40s and beyond, high cholesterol isn’t an inevitable part of getting older. And having high cholesterol isn’t something you should ignore.

Like high blood pressure, high cholesterol — which affects about 38 percent of Americans — leaves a mark on the body: It raises a person’s risk for heart disease and stroke.

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Cholesterol levels typically plateau around the age of 65, research suggests. But even before that, those levels climb as we age, says Karol Watson, M.D., a cardiologist and professor of medicine at the David Geffen School of Medicine at the University of California, Los Angeles — and so do the risks for complications that can arise from high cholesterol.

In fact, Watson says, “atherosclerosis develops slowly every year, first [starting] in our teens.” If you let it go unchecked over the decades, “you’re going to end up having a problem in your early 50s or even sooner,” she says.

Cholesterol isn’t inherently bad, though. The body needs it to build cells and make vitamins and hormones. But in most people, the body, specifically the liver, makes all the cholesterol we need. (Some people — about 1 in 250 — inherit a genetic trait that affects how their body regulates and removes cholesterol, causing them to have high cholesterol from the get-go.)

The rest of the cholesterol circulating in the blood comes from food, which is why experts emphasize the importance of making healthy choices to help prevent or manage high cholesterol.

Even if your cholesterol is high, there’s still time to get it under control. Here are five ways to do that — and a few may surprise you.

First things first: Know your numbers

One tricky thing about high cholesterol: It doesn’t come with symptoms. So you’ll miss it if you’re not looking for it.

“People should expect that they may have high cholesterol, no matter the age, and should have a blood test to check [their] cholesterol,” says Connie Newman, M.D., an endocrinologist and adjunct professor of medicine at NYU’s Grossman School of Medicine.

Your annual exam is a great time to check these levels. If you have diabetes, or if it turns out that your cholesterol is too high, you’ll likely need to get tested more often.

Ask your primary care physician to run a full lipid profile. This tests for a few things, including the two different types of cholesterol — low-density lipoprotein (LDL), or “bad” cholesterol, which can lead to plaque buildup in the arteries; and high-density lipoprotein (HDL), or “good” cholesterol, which helps your liver get rid of cholesterol and can actually lower your risk for heart attack and stroke. The blood test will also check your triglycerides — a type of fat in the blood that your body uses for energy — and your total cholesterol.

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Optimal levels are as follows, according to the Centers for Disease Control and Prevention: about 150 milligrams per deciliter (mg/dL) for total cholesterol; about 100 mg/dL for LDL (“bad” cholesterol); and greater than or equal to 40 mg/dL in men and 50 mg/dL in women for HDL (“good” cholesterol). Triglyceride levels should be less than 150 mg/dL.

One interesting influence: Your cholesterol can rise and fall with the seasons, though “this is not something that’s learned in [medical] school,” Watson says. “Everyone’s cholesterol levels tend to be a little higher in the winter and a little bit lower in the summer,” she says, adding that this difference isn’t due to more decadent eating habits in the wintertime.

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“Even when they have a controlled diet, they see that there’s just this natural tendency ... [and it’s] not by a lot, you know, maybe 5 percent. But it could be noticeable.”

Regardless of the season, knowing your numbers can clue you in on your risks, some of which you can manage with everyday actions.

1. Make unfiltered coffee a treat

Espresso, Turkish and French press coffee can spike your cholesterol, because these drinks are prepared without a filter, which allows diterpenes, a chemical compound, to enter your body.

Watson says the impact can be “significant,” raising cholesterol “about 10 to 15 percent.” She describes one of her patients as a coffee connoisseur — but when she indulges herself with French press coffee, “her numbers go significantly up.” Once she starts drinking “drip coffee, they go down again,” Watson says. So it’s best to think of unfiltered coffee as a treat, not a mainstay.

2. Eggs are OK — cheese and butter, not so much

There’s good news about a different breakfast food: eggs. For decades, people watching their cholesterol were cautioned against eating them, due to their high cholesterol content. But now experts say that eating an egg a day likely won’t do much harm when it comes to your cholesterol levels.

Recent studies have found that some high-cholesterol foods, like eggs and shellfish, may not impact your risk for heart disease as much as others, like fried foods (see below).

Just remember to watch how those eggs are prepared. In omelets, for example, that cheese and butter are full of something that does raise cholesterol: saturated fat. The same goes for the bacon and sausage that are often served alongside your eggs.

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3. Help your body make more ‘good’ cholesterol

If you are overweight, smoke, or sit too much and move too little, your body will likely have less “good” (HDL) cholesterol.

On the other hand, if you quit smoking, maintain a healthy weight and get enough exercise — research suggests something like “moderate” activity, which is about 30 minutes a day, five days a week — your good (HDL) cholesterol levels will get better. No gym membership required: Walk the dog at a quick pace, ride your bike to work or try something else that you can stick with.

Like a lack of exercise, smoking lowers your “good” cholesterol (HDL); it can also raise your triglycerides.

4. Eat fewer fried and fatty foods

Unfiltered coffee and cheesy omelets aren’t the only hazard at brunch. Watch out for high-fat baked goods like muffins, waffles, pancakes and chocolate croissants. “Unfortunately, people often [drink] the French press [coffee] with the baked goods,” Watson points out.

Row after row of grocery store shelves is devoted to the type of tasty treats that are tempting but not good for your cholesterol: ice cream, cookies and the like.

Other seemingly innocuous foods are risky if you eat too much of them — take, for example, full-fat dairy and red meat. There are at least two reasons why: saturated fats and trans fats (which may be called partially hydrogenated oil on packaged foods). Both of these can raise the levels of bad cholesterol in your blood.

For people with high triglycerides, “eating the appropriate food (salmon, vegetables, foods low in sugar, for example) can reduce triglycerides by 30 percent or more,” Newman says. If you eat too many carbohydrates or drink too much alcohol on a regular basis, cutting back may also lower your triglycerides, though more research is needed.

A very high level of triglycerides “may lead to inflammation of the pancreas,” Newman notes, as well as liver and/or kidney disease, hypothyroidism and diabetes. High triglyceride levels have also been linked with heart disease.

5. Take your cholesterol-lowering medicine exactly as prescribed

Statins — medications used to lower bad cholesterol and reduce a patient’s risk of having a heart attack or a stroke — can be effective, “even in people over the age of 75,” Newman says.

“If your risk [for heart-related issues] is going up every year that you age and your cholesterol is going up every year that you age, most older people will be recommended to start a statin,” Watson adds.

It’s crucial to take these medications exactly as your doctor prescribes them, typically every day. What’s more, never stop a statin medication without consulting with your doctor, Newman says.

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