A Personal Maintenance Guide to Cholesterol

Managing your cholesterol may seem complicated these days, especially if you like to keep up with the latest research. Trying to remember the difference between "good" and "bad" cholesterol and maintaining the proper levels of each can seem intimidating.

To manage cholesterol men and women, adolescents, and children over age 2 should do at least two things:

• Follow a healthy diet. If your total cholesterol level is high, paying attention to what you eat can help to bring it down.

• Have your cholesterol level checked. If your total level is 240 or above, ask your health care provider to help you design a program to lower it. If your level is borderline—between 200 and 239, you can probably manage on your own unless you have two or more other risk factors for coronary heart disease, such as obesity or a sedentary lifestyle. If your level is below 200, continue eating a healthy, low-fat diet .

It's also important to know what your HDL and LDL cholesterol levels are, as well as your triglycerides. A higher level of HDL ("good") cholesterol can help prevent coronary disease, just as a higher level of LDL ("bad") cholesterol points to increased risks, the American Heart Association (AHA) says. An optimal LDL level is less than 100. A high triglyceride level appears to increase your risk for heart disease.

To lower total cholesterol:

• Cut down on dietary fat. The dietary guidelines from the U.S. Department of Agriculture (USDA) recommend a total fat intake of 20 to 35 percent of calories for adults and 25 to 35 percent for children ages 4 to 18 years. A fat intake of 30 to 35 percent of calories is recommended for children ages 2 to 3 years.

• Avoid foods high in saturated fats, such as prime beef; "dark meat" poultry and poultry skin; butter and other whole-milk dairy products; and tropical oils such as coconut, palm, and palm kernel. The USDA says that only 10 percent of daily calories should come from saturated fat.

• Limit your intake of trans fats to less than 1 percent of your daily calories. Trans fats are found in hydrogenated and partially hydrogenated vegetable oils that are used to make shortening and commercially prepared baked goods, snack foods, fried foods, and margarine. Trans fats are listed on food labels.

• Limit your consumption of high cholesterol foods such as eggs, butter, and cheese. You should have less than 200 mg of cholesterol per day.

• Replace most saturated fats (butter, lard) with polyunsaturated oils (safflower, soybean oil) and monounsaturated oils (olive oil). These oils should account for no more than 7 percent of your daily  calories.

To raise HDL cholesterol:

• Eat more fatty fish, such as salmon or cod. They contain omega-3 fatty acids, which may help raise HDL and lower total cholesterol.

• Include more soluble fiber in your diet. Fruits and vegetables, beans, and bran are popular sources.

• Get regular aerobic exercise. An inactive lifestyle is now considered a full-fledged risk factor for heart disease. Moderate exercise, such as walking, done for 30 to 60 minutes most days a week will lower your overall risk.

• Lose weight if you need to. Excess weight raises total cholesterol and lowers HDL levels. Fortunately, combining a low-fat diet with a regular exercise program (60 to 90 minutes of moderate exercise a day) makes it easier to take weight off—and keep it off.

• Stop smoking. Cigarette smokers have lower HDL levels and an increased risk of coronary disease.