There is significant opportunity to reduce the risk of getting cardiovascular disease. Changes in nutrition along with increased physical activity and learning to decrease stress can improve blood cholesterol and triglyceride levels.

Making dietary changes to improve blood cholesterol and triglyceride levels involves these steps: Maintain a desirable weight—A diet that is high in fat also can be unnecessarily high in calories and contribute to an unhealthy weight. Decrease the total amount of fat eaten.

Limit fat—saturated, polyunsaturated, and monounsaturated— to less than 30 percent of your total daily calories. Some individuals may need to restrict fats even more. Because all foods with fats contain a combination of these fats, it is important to reduce total fat.

Reduce saturated fat—The major dietary culprit in an increased blood cholesterol level and increased risk for coronary artery disease, saturated fat is typically solid or waxy at room temperature. Minimize your intake of saturated fat.

Foods high in saturated fat include red meats and dairy products as well as coconut, palm, and other tropical oils (check the ingredient portion of the food label). Replace saturated fat with unsaturated fat— Polyunsaturated and monounsaturated fats should make up the remaining fat allowance.

In the recommended amounts, polyunsaturated fats reduce LDL cholesterol, but at the expense of the protective HDL cholesterol, whose levels also may decrease. Polyunsaturated fats are usually liquid at room temperature and in the refrigerator. Vegetable oils such as safflower, corn, sunflower, soy, and cottonseed oil are high in polyunsaturated fat.

Monounsaturated fats tend to have the same effects on LDL cholesterol without lowering HDL cholesterol. Monounsaturated fats are liquid at room temperature but may start to solidify in the refrigerator. Olive, canola, and nut oils are sources of monounsaturated fats.

Limit trans fat—This fat is also called partially hydrogenated vegetable oil. This type of fat may be as harmful to your health as saturated fat because it increases blood cholesterol levels, among other effects. Major sources are hardened vegetable fat, such as margarine or shortening, and products made from these fats, such as cereals, cookies, and crackers.

Reduce dietary cholesterol—The daily limit for dietary cholesterol is 300 milligrams. Dietary cholesterol is found only in foods made from or containing animal products. A good way to lower dietary cholesterol is to limit the amount of meat and dairy products. Organ meats and egg yolks are also high in cholesterol.

Eat a plant-based diet—A diet that has generous amounts of grains, vegetables, and fruits is naturally lower in fat and has good sources of soluble fiber and antioxidants, which may protect blood vessels from damage and plaque buildup.

Fruits and vegetables and whole-grain products are also natural sources for folate—a B vitamin that controls the amount of homocysteine in the blood. Homocysteine is an amino acid (a building block of protein) normally found in your body. Your body needs homocysteine to manufacture protein to build and maintain tissue.

Problems arise when there is too much homocysteine, which can cause the tissues lining the arteries to thicken and scar. Cholesterol builds up in the scarred arteries, leading to clogged vessels and blood clots.

Adequate intake of this vitamin can help normalize homocysteine levels and may reduce the risk for cardiovascular disease. There is also accumulating evidence that vitamin E may reduce the risk of heart attack.

Cardiovascular Disease and Physical Activity

Unfortunately, most of the population of the United States is sedentary. Sedentary people have nearly twice the risk of having a fatal heart attack as active people of the same age when other factors—such as smoking and high cholesterol— are equal. Consult a physician before embarking on an exercise program.

Then, follow these tips for maximal results:

• Choose an aerobic activity. It can be something like walking, jogging, bicycling, or swimming.
• Gradually increase the time and frequency of the exercise. Work up to exercising for 30 minutes daily.

If changes in lifestyle have not brought lipid values into the goal range, medication may be necessary. Before recommending a medication, your physician will use careful judgment and weigh many variables—sex, age, current health, family history of early heart disease or abnormal lipids, and the side effects of medication.