The odds are 1 in 2 that you will die because of too much cholesterol in your bloodstream. Fifty percent of all men and women will die of coronary heart disease (CHD), and elevated cholesterol levels are the major cause. Roll the dice — odds you live, evens you die. Flip a coin — heads you live, tails you die. Step on a crack, break your mother's back. So if you're happy with these odds, don't bother reading any further. Click over to ostrich.com — don't want to hear it, don't want to know, stick my head in the sand and it will all go away.

If you'd prefer to better your odds, take heart (pun #1). CHD is mainly a lifestyle disease, and lifestyles can be changed. There is absolutely no reason for anyone to have a cholesterol problem with what we currently know about diet, nutrition, and healthy living.

1. UNDERSTAND THE BASICS

There is so much terminology floating around with this issue that it is hard to make any sense of what it's all about. That's why you have to start by understanding what they're talking about: the "good," the "bad," and the ugly.

What is "coronary heart disease"?

Apart from being the #1 killer of both men and women in North America, CHD is a condition caused by a narrowing of coronary arteries (tubes that act as passageways in and out of the heart) which blocks the supply of oxygen and nutrients (carried in the blood) to the heart. Everybody has heard about "hardening of the arteries," which basically means that the arteries become clogged with cholesterol and fat deposits until blood flow is reduced or stopped. This is also called atherosclerosis. It happens slowly, quietly, and there are no symptoms. The first sign of it is usually a heart attack or stroke, at which time it is often too late. The coin toss has gone against you. So the only real way to fight it is with preventative action.

What is this "good and bad" cholesterol all about?

Cholesterol is a waxy substance found only in animals or animal products (meat, cheese, eggs). It is actually manufactured inside our bodies. The liver takes some of the fat and cholesterol we eat, and makes it into our own cholesterol, and ships it throughout the body. Cholesterol is part of the family of lipids, or fats, which includes certain "fatty acids," or triglycerides. The liver wraps up its cholesterol and triglyercides in proteins to form little transportation molecules and sends them out into the bloodstream. These transportation molecules are called lipoproteins (lipids and protein).

The main ones that concern us are low-density lipoprotein (LDL) and high-density lipoprotein (HDL). We know, we know, we're throwing lotsa medical terms at you. But it makes us feel important.

What's the difference, and which one is bad?

The Good

HDL cholesterol is "high density" because it has a high amount of protein and not very much fat. The HDL molecules find excess cholesterol in the blood stream and carry it back to the liver for disposal. This is why it is good. If HDL levels are too low, it means there aren't enough around to carry away excess cholesterol and you will be at risk for CHD.

The Bad

LDL cholesterol is "low density" because it has a low amount of protein and a lot of fat. The LDL molecules carry cholesterol from the liver to the other parts of the body, and if there are too many of them, they store the cholesterol and fat in various arteries throughout the body. When there is too much of it, it constantly builds up in the walls of your arteries until a blockage occurs. This is why it is bad. If LDL levels are too high, it means that too much cholesterol is being transported and deposited in your arteries, and you will be at risk for CHD.

The Ugly

The triglycerides are considered the ugly lipid. These are the fat cells that are stored all over your body, usually coming from dietary fat, being absorbed through the small intestine and transported through the bloodstream. If there isn't enough fat in your diet, your body will make the carbohydrate "sugars" into triglycerides for long term storage in your ass, thighs, love handles, or the fleshy places at the backs of your arms. It has many favorite storage areas, including the coronary arteries, making high triglyceride levels another suspect risk factor for CHD. And we have the liver to thank for it!

Can't I just have my liver removed?

…and if I have a headache, can't I just have my brain removed? Shut up. Why do we have cholesterol at all if it's bad, right? Strange evolutionary trait, to produce something which eventually kills us. You'd think that crap would die off, and everybody's arteries would be clean as a whistle. Unfortunately, we need cholesterol to live. It is present in cell walls or membranes everywhere in the body. It is needed to produce many natural hormones, including sexual hormones, as well as vitamin D and bile acids which help us to digest fat, all of which are required to sustain the body, and human life on the planet in general.

So, yeah, it's kind of important, and you have to keep your liver. But only a very small amount of cholesterol is needed in the bloodstream, and the excessive amounts present in the vast majority of adults in North America today are being systematically stored in the arteries, leading to CHD. The direct link between CHD and high blood cholesterol has been suspected and anecdotally known for some time, but it was finally confirmed in 1984 by the "Lipid Research Clinics – Coronary Primary Prevention Trial." (We believe Lance Ito was involved.) The evidence is in, and the facts have to be faced.

How does high cholesterol occur?

Plain and simple, high cholesterol, or hypercholesterolemia, comes from eating foods which are high in saturated fats and cholesterol. What is the most common source of both? Animal products: all meats, cheeses, milk, eggs, etc. We are eating more of them now than at any other time in the history of the world. Big mystery, huh?

There are other peripheral causes that are related to various diseases or disorders that your doctor would be all over like white on rice. We're talking very low numbers here. Do not delude yourself, the main cause of high cholesterol is eating the beasts of the world and their various ovulations and mammary secretions. Welcome to reality.

2. GET YOUR LEVELS CHECKED

So, needless to say, we should all be keeping tabs on this situation regularly. If your doctor hasn't suggested this test to you already, then you should probably find a new doctor. Go and make him or her do this test, and make sure that (s)he tests total cholesterol as well as LDL, HDL, and triglyceride levels. If you are over 20 years old and don't currently suffer from heart disease or a related disease or condition, then the following levels will apply:

Total Cholesterol – in milligrams per deciliter (a tenth of a liter) of blood

    Desirable less than 200 mg/dl
    Borderline between 200-239 mg/dl
    Death Wish over 240 mg/dl

If you are in the "borderline" category, you should be taking immediate action if more than one of the following risk factors also applies to you:

    - Cigarette smoking
    - Low HDL cholesterol
    - High blood pressure (should be watching sodium intake)
    - Diabetes
    - Overweight
    - Physically inactive
    - Family history of heart disease
    - Men who are over 45
    - Women who are over 55

For the LDL cholesterol level, less than 130 mg/dl is desirable. For the HDL level, anything over 60 mg/dl is what you want. There is no hard data on acceptable triglyceride levels (it ranges from 250-500 mg/dl), but your doctor will be able to advise you if it is high enough to be considered a CHD risk factor.

If your levels are in the "high/death wish" category, or you are subject to several risk factors, you are going to have to take action now to prevent yourself from becoming part of the 50% statistic. Even if your levels are fine, the average North American could benefit from eating a heart healthy diet. Too often we try to treat symptoms once they hit us, when we should try to be more preventative, proactive, and pre-emptive. Stop the problem before it starts.

3. MAKE A CHOICE

North Americans are addicted to meat and all kinds of animal products — cheesy pizza, fried chicken, Big Macs, steaks, milkshakes, and on and on. And they talk about the "war on drugs?" This is an addiction that has a 50% chance of KILLING YOU. You'd have better odds using crack. So you're going to have to make a choice… are you going to go on like you've been doing, or are you going to make a change? Are you willing to cut down on your abuse of animal products, or even better, become a vegan? Only you can decide.

4. LOWER YOUR CHOLESTEROL

We're glad to see you're still with us and you made the right choice. Lowering cholesterol is actually quite simple, and doesn't require surgery or drugs or incantations. The changes you have to make in your lifestyle boil down to the same thing that any doctor, nutritionist, or health professional would tell you: exercise more, and eat a low fat, high fiber diet.

  • You want to eat foods that are low in total fat, but especially low in saturated fats or hydrogenated oils. It's okay to have food with monounsaturated fats, such as olive and canola oil; or foods with polyunsaturated fats, such as safflower, sunflower, corn or soybean oil. Foods to cut down on are foods with animal fats, which are all saturated (yes, this means meat, eggs, and whole milk products).

  • Cut out foods that are high in cholesterol, and keep in mind that this is only found in animal products, as covered earlier. This will make it easy to remember.

  • And get up off the couch and move that body around.

(Click here to learn more about the technical-ish, biological-ish definitions of saturated fat and hydrogenated fat.)

Even if your levels are in the desirable or safe range, this is the healthiest diet around. You can keep your cholesterol levels in check before they become a problem, and have more energy, feel healthier, and not have to eat at McDonald's ever again.

A low fat, high fiber diet has:

Lots of…

  • Fruits and vegetables (especially the leafy ones)
  • Legumes (peas, beans, soy products)
  • Whole grains (whole wheat bread, brown rice, etc.)
  • Monounsaturated and polyunsaturated oils
  • Flaxseed oil (tbsp. per day)
  • Non-fat or skim milk products
  • Exercise (especially aerobic, even just a walk per day)

So cut out…

  • Meats (especially the fat, and the skin)
  • Nuts (especially cashews, pistachios, brazil, and macadamia)
  • Saturated fats (butter, cheese, lard)
  • Hydrogenated fats (margarine, shortening, tropical oils)
  • Whole milk products
  • Eggs
  • Fatty desserts, including sweets with lots of refined sugar
  • Fried foods and fast food
  • Smoking
  • Caffeine

Start reading the labels on the food you buy and watch the fat and cholesterol content, as well as the kinds of fat. The vast majority of people will be fine with an improved diet and exercise regime, as per the above.

A word is now necessary about different drugs that can lower your cholesterol. We believe that you should try to take a more natural approach to lowering your cholesterol (diet and exercise), because people who take medicine often think that the medicine will take care of the problem. This is untrue. Drugs should only be a supplement to your lifestyle changes, not a replacement for those changes. There are many drugs that can aid your body in the lowering of bad cholesterol (many of these drugs are completely natural, for all you out there who don't like the idea of ingesting chemicals). Lipitor is often referred to as an effective supplement, as are Questor and Niasin (is it just us, or do these all sound like the archenemies of He-Man?…). However, the proper way to use drugs to lower your cholesterol is to: 1- Do all of the lifestyle changes first, 2- Talk to your doctor about the possibility of drugs and whether you really need them, and 3- Consider the side effects. Niasin, one drug, can help lower your cholesterol, but it also can turn your skin to a nice sun-burny red. To become more knowledgeable about the drug options out there, check out American Heart Association. It lists many high-cholesterol drugs, as well as their potential side effects.

5. FIND MORE INFORMATION

To find a registered dietician that's local:
  • call the National Center for Nutrition and Dietetics Consumer Nutrition Hotline at 1-800-366-1655
  • call your local hospital or public health department
  • consult your doctor for a referral

For more cholesterol information and a catalogue of publications, write to:

    The National Cholesterol Education Program
    NHLBI Information Center
    P.O. Box 30105
    Bethesda, MD 20824-010

Or phone the American Heart Association at:

  • 1-800-AHA-USA1 (1-800-242-8721)

And check the following links: