Cholesterol is a waxy substance that's made naturally in the liver. In addition to being a component of cell walls, cholesterol is needed to make vitamin D (essential for strong bones) and create bile, which aids in the digestion of fat. Although a healthy liver makes all the cholesterol the body needs, extra cholesterol is often added through our diets. Many foods from animal sources that are often found on everyone's "most favorite" list including—steak, eggs, milk, cheese and other whole-fat dairy products—are loaded with cholesterol.

While age and genetics can contribute to high cholesterol levels, cardiologist John Teeters at the University of Rochester Medical Center says diet can definitely play a role. "It's entirely possible to eat yourself into high cholesterol," the doctor says. The good news is there is plenty of food you can eat. Fruit, veggies, and many whole grains don't contain any cholesterol at all.

How Do I Know If I Have High Cholesterol?

Having high cholesterol won't hurt or give you headaches. But overtime it slowly—and silently—collects in the bloodstream, narrowing the arteries and restricting the flow of blood and oxygen to the heart. The result can be coronary artery disease and ultimately a heart attack.

Even young men can be at risk of suffering a heart attack or myocardia infarction. "If you have high cholesterol, are overweight, and have a family history of heart disease, your risk of having a heart attack starts to tick up at the age of 40," says Dr. Teeters.

According to the Centers for Disease Control and Prevention (CDC), cardiovascular disease is the leading cause of death in the United States. One in every three deaths is from heart disease and stroke, which amounts to 2,200 deaths per day.

Fortunately, it's possible to survive a heart attack and—if treated in the early stages—Teeter says the vast majority of patients go on to live relatively normal lives. "It's essential to follow up on any new symptom you experience. Never ignore chest pain.  The heart is a muscle and considerable damage can be done if you delay treatment," says the expert who is also head of cardiology at Highland Hospital. "Immediate medical attention can reverse the affects of a heart attack and today the expectation is to make a full recovery."

A simple fasting blood test (also know as a lipoprotein analysis) can tell you if your cholesterol levels are high. Experts recommend having an initial test in your 20s and every five years after that. If you have a family history of heart disease and other risk factors including race, gender, and age your physician may recommend more frequent testing.

The test measures the total cholesterol levels in your blood. Cholesterol comes in two forms: LDL (low-density lipoprotein) and HDL (high density-lipoprotein). LDL cholesterol is known as the "bad cholesterol" because it's the type most likely to clog blood vessels. High levels of the "good cholesterol" (HDL) are beneficial as HDL acts like a vacuum to remove LDL from the blood and then from the body.

For good health, experts recommend keeping LDL levels down (less than 100mg/dL) and HDL levels up (60 mg/dL or higher). Total cholesterol should not exceed 200, according to Teeters. The cholesterol test will also reveal the amount of triglycerides (another fat) in your blood stream.

What You Can Do to Improve Your Numbers

If you have high cholesterol, your healthcare provider may recommend lifestyle changes such as following a cholesterol-lowering diet, losing weight, and becoming more active. Smoking and alcohol consumption also increase your risk of developing heart disease.

"Research shows that exercising 30 minutes a day, five days a week reduces your risk of heart attack or stroke by 40 percent," says the New York-based cardiologist. "There's not much you can do to change your genetics but you can accomplish a lot by making small adjustments to your lifestyle."

Here, some other tips from Dr. Teeters:

Watch your portion size and intake of dairy. Choose skim milk and low-fat dairy options.

Read labels and forgo products containing partially hydrogenated oil—that's code for trans fat. Trans fat is also found in meat and poultry. "It's bad because it reduces HDL and raises LDL—the opposite of what you should be doing to improve cholesterol numbers," says Teeters. Fortunately, the Food and Drug Administration (FDA) requires trans-fat to be listed on nutrition labels. Trans fat is also commonly found in many baked goods, cookies, cakes, and crackers, fried foods, and in some margarines and dairy products.

Decrease consumption of salt. "It contributes to high blood pressure—another risk factor for heart health," says Teeters.

Consume more soluble fiber. Good sources include beans, lentils, apples, peas, carrots, oats, and ground flax seed.

Avoid white food. "White in general means simple sugar and when we're talking simple sugar that means the body doesn't have to work very hard to break it down so it converts more easily to fat," Teeters explains.

Some experts also tout the benefits of green tea, soy protein, and healthy nuts—especially almonds and walnuts.

Know your numbers. Teeters says knowing your Body Mass Index (BMI), cholesterol profile, and blood pressure will give you a good prediction of where you are going to be in the next five to ten years in terms of heart attack risk.

If your numbers don't improve after making changes to your diet and lifestyle, your physician may recommend medication. Statins are the leading choice and have been shown to be effective in lowering LDL.




Interview with J. Chad Teeters, MD, Chief of Cardiology at Highland Hospital and Assistant Professor of Clinical Medicine at the University of Rochester

The Centers for Disease Control and Prevention

The National Institutes of Health, National Heart, Lung and Blood Institute

American Heart Association