What You Must Know About Your Cholesterol

5. These foods are your best friends.
Certain classes of food chemicals can actively and powerfully lower a person’s bad cholesterol. Two—soluble fiber and phytosterols—have so much science behind them that they’ve become part of standard medical prescriptions for treating high cholesterol. But dietitian Janet Brill, PhD, RD, author of Cholesterol Down, also recommends regularly eating almonds, ground flaxseed, apples, soy protein, and olive oil. Preliminary research suggests they all have cholesterol-lowering powers. “Each one works in a slightly different way,” Brill says. “So together, you get a synergy that can dramatically lower cholesterol.”

Almonds and olive oil are high in monounsaturated fats, which are thought to blend with LDL molecules in a way that speeds LDL’s clearance from the blood by the liver. Flax is high in both soluble fiber, which lowers LDL by absorbing cholesterol from both food and bile inside the intestines, and omega-3 fatty acids, which studies show have anti-inflammatory effects. Other foods especially high in soluble fiber include oat bran, oatmeal, and apples. (Soluble fiber is different from insoluble fiber, the kind found in whole-grain bread and bran cereal. That’s good for you, too, but it won’t affect your cholesterol.) Soy may mimic natural estrogens in their LDL-clearing effects. Phytosterols are the plant version of animal sterols (a.k.a. cholesterol) and lower LDL by competing with it for absorption into the body. They’re found in supplements or phytosterol-enhanced margarine such as Benecol.

You don’t need any of these foods if your LDL is low, but experts still recommend them for everyone. What about steak, eggs, and cheese? They sure won’t help your cholesterol, because they all contain a lot of it. But it’s more important to focus on foods that lower your numbers rather than simply avoiding the bad stuff, experts say.

6. Good cholesterol may have a bad side.
The higher your HDL, the better, right? That’s been the current thinking, due to HDL’s protective effect. But here’s a surprise you may have read about in some news reports: Studies are showing that HDL may actually have harmful proteins capable of boosting heart disease risks. A test to determine if your HDL has the harmful proteins may be available in a few years. In the meantime, if your HDL is lower than 60, it’s still OK to raise it a little as long as you don’t go overboard. How? Try getting a lot of omega-3s from fish or fish oil, exercising regularly, controlling your weight, and avoiding smoking.

7. Your heart loves long walks.
Walking 10 miles a week brings lasting improvements in your heart health, according to researchers at Duke University Medical Center. The funny thing is, if you jog those 10 miles, you won’t get quite as much benefit. “Duration appears to be key,” says Duke’s Cris Slentz, PhD, an exercise physiologist. “Jogging or walking 10 miles both burned around 1,200 calories, but in our studies, one took about two hours and the other, three.”

Longer stints of exercise, even moderate exercise, may burn more belly fat—the little rolls of skin near your navel and the fat deep inside your abdomen. The latter is linked to metabolic syndrome, a condition associated with a host of cardiovascular risk factors including low HDL, high blood pressure, and high triglycerides (a kind of blood fat that contributes to heart disease).

Should you aim for weight loss as well as long walks? If you’re overweight, absolutely. But understand that shedding a few pounds will make only a small dent in your cholesterol. Canadian researchers recently found that overweight women who lost about 25 pounds—no easy task—saw their LDL drop about 10 percent and their HDL rise by the same amount.

How Often Do I Need a Checkup?
Starting at age 19 and continuing until menopause, a cholesterol test once every five years is plenty—as long as your numbers fall in the healthy range:

HDL > 60
LDL < 100
Total cholesterol (HDL plus LDL) < 200.

But any time your numbers stray into unhealthy territory (and during and after menopause, when heart disease risk rises), get tested annually and work out an action plan with your doctor.