Dr. Kerr: Need to lower your cholesterol? You have options

<p>If you have been told that you have high cholesterol, you have an increased risk of heart disease simply because there are too many low-density lipoproteins (LDLs) or triglycerides in your blood. </p><p>You may also have low levels of the “good guys” that actually decrease your risks — the high-density lipoproteins (HDLs).</p><p>Your cholesterol problem could be due to lifestyle, or it might be genetic. Either way, you have options if you want to lower your risks. </p><p>You can take medications and accept the need for that prescription indefinitely, as long as it continues to work for you. Or you can change your diet and exercise habits to effectively decrease your risk of heart disease.</p><p>A combination of lifestyle changes and medications are often recommended. </p><p>But for the past 10 years, the Adult Treatment Panel III of the National Cholesterol Education Program has recommended non-pharmacological treatment as first-line therapy for most patients with high cholesterol. It really works.</p><p>If you are serious about trying to avoid long-term medication and motivated to make lifestyle changes that can help you feel better and live longer, then there are some very clear actions you can take to improve your cholesterol panel.</p><p>First, take a look at what you eat and drink. The general advice is to adopt a Mediterranean diet that includes less red meat, dairy products, eggs and poultry.</p><p>[SUBHEAD_RAG_]<IP0>More specifically:</p><p><MC>Fat is not all bad and the good news is: While limiting fats to 7 percent of your total daily calories, you can shift to unsaturated fats while you cut back on the saturated and trans fats. Examples of good fats include olive oil and canola oil. Fats to avoid include coconut and palm kernel oil, margarine, butter and all hydrogenated oils.</p><p>Snack on tree nuts — walnuts, almonds, hazelnuts or pecans. Eating tree nuts can actually reduce LDL levels by 2 to 19 percent. Peanuts, which don't grow on trees, aren't as good for you. And remember: even plain nuts are high in calories, so watch your intake if you need to shed pounds.</p><p>Soy protein — soy milk, tofu and soy protein shakes — can replace foods high in saturated and trans fats. Of course, tofu is not going to replace that steak you love, but shifting to soy for some of your protein needs can help.</p><p>Good news for wine enthusiasts! Non-alcoholics can improve their lipid panel by drinking in moderation: men up to two drinks per day and women up to one drink per day.</p><p>Increase your intake of omega-3 fatty acids by eating wild salmon, tuna or sardines once or twice a week.</p><p>Increase the fiber in your diet by eating veggies and whole grains.</p><p>Eat an ounce each day of a fortified spread (instead of margarine) that provides plant sterols and stanols.</p><p>If considering taking a supplement, “red yeast rice” is a powerful traditional Chinese seasoning with effects almost identical to prescription statin medications. However, there are some concerns about the purity, safety and standardization of red yeast rice preparations currently on the market, so check with your physician before using this potent supplement.</p><p>Move your body! Two hours — 120 minutes — of exercise each week will significantly raise your levels of good HDLs. Just 20 minutes six days a week will make the difference.</p><p>To some, these changes appear impossible, but to many who want to avoid daily medication, they are attainable. Check with your physician. You may need to start on medication, but the medication might be temporary if you can adjust your lifestyle.</p><p>Don't try to do it all at once, but take it one step at a time. Julia Child said it best when she said: “Everything in moderation, including moderation.”</p><p>You'll find more web links and info at http://www.aafp.org/afp/2010/0501/p1097.html.</p><p>Dr. Stacey Kerr, a longtime Sonoma County family physician, graduated from UC Davis Medical School and is certified in her specialty by the American Board of Family Medicine. Her columns are not intended as a substitute for hand-on medical advice or treatment. Consult your health care provider before adhering to any recommendations in this column. E-mail comments to drkerr@the-doctors-inn.com.</p>