Your risk of developing arteriosclerosis and coronary heart disease (narrowing down and blockage of the arteries that supply blood to your heart muscle) is directly related to the amount of cholesterol in your blood. The higher the level, the greater your risk of coronary heart disease and heart attacks.


But the risk can be reduced by making changes that lower the cholesterol level. If you have high blood cholesterol, you can reduce your risk of heart attack "up to a point " by two percent for every one percent reduction in your cholesterol level. For example, lowering your cholesterol level by 15% could reduce your risk of heart attack by 30%.


Most people can lower their cholesterol levels into the desirable range (under 200) by reducing their dietary intake of cholesterol and fat (especially saturated fat), increasing the amount of soluble fiber they consume and maintaining ideal body weight. For those who require more intensive treatment, effective medical therapies are available.


The National Cholesterol Education Program (NCEP) has established these general guidelines for total blood cholesterol levels in adults age 20 and over. Remember that these are simply guidelines; your doctor may make adjustments for factors such as your age, sex hereditary background and lifestyle.


The NCEP recommends that all adults age 20 and over should be screened for high blood cholesterol. Your cholesterol level can be measured with a simple blood test using a sample of blood taken from your vein.


The ideal time to have your blood cholesterol level measured is when you are fasting. If you do not know your cholesterol number, ask about being tested for high blood cholesterol. If the test shows that your cholesterol level is elevated, we will help you get started on an a appropriate program to help lower it.


Establish a goal and work to reach it. High blood cholesterol is a serious disease. It's important that you establish a goal for reducing your cholesterol to a desirable range. Initiate a program of healthy eating and exercise. Monitor your progress with us to determine whether you have attained your goal and whether additional therapeutic measures should be considered to help you reach a desirable cholesterol range.


Though high blood cholesterol can play an important role in the development of coronary heart disease, several other risk factors can also contribute to this problem. When you combine two or more of these factors, the risk begins to escalate dramatically. For example, if your cholesterol level is over 240 and you also have high blood pressure, your risk of heart disease may increase six-fold. If, in addition, you smoke, your risk could increase more than 20 times.


Here's a list of the other known risk factors for coronary heart disease (in addition to high blood cholesterol) as identified by the National Cholesterol Education Program.

  • Known disease or blockage of the arteries of the brain or elsewhere in the body
  • High blood pressure
  • Cigarette smoking
  • Family history of coronary heart disease (definite heart attack or sudden death before the age of 55 in a parent, brother or sister).
  • Diabetes
  • Severe obesity (more than 30% over your desirable weight).
  • Being a male: the rates of coronary heart disease are 3-4 times higher in men than in women during the middle decades of life and approximately twice as high in the elderly. Therefore, a man who has only one risk factor in addition to high blood cholesterol is considered to have a high risk status, while a woman is not considered at high risk unless she has two factors besides high cholesterol.
  • Low HDL cholesterol level: HDL less than 35 mg/dl (confirmed by repeat measurement).



To eat less total fat:

  • Sausage and most processed luncheon meats are high in fat and saturated fat. Choose fish, poultry (without skin) and lean cuts of meat, and eat moderate portions.
  • Bake, roast or broil foods instead of frying
  • Use only small amounts of fats and oils in cooking
  • Cream, sour cream, ice cream, butter and many cheeses are high in fat and saturated fat. Choose low fat dairy products like skim or low-fat milk, yogurt, cheese, sherbet or ice milk instead.

To eat less saturated fat:

  • Reducing your total fat may also help reduce saturated fat
  • Use vegetable oils with a high proportion of unsaturated fats: corn, safflower, sunflower, and soybean oil, rather than highly saturated fats like butter, coconut or palm oil.
  • Corn oil margarines provide an alternative to more saturated fats like butter
  • Egg substitutes provide an alternative to whole eggs.
  • Read the ingredients section of the labels on all prepared foods to choose the items low in saturated fat.
  • Animal products such as meats, poultry and dairy products are the main source of cholesterol. Eat these in moderation.
  • Avoid very high cholesterol foods like organ meats (liver, kidney) and egg yolks.
  • Eating unsaturated fats can actually help reduce the amount of cholesterol in your blood.

To eat more complex carbohydrates:

Vegetable, fruits, cereals, grains, dried peas, beans and pasta all contain complex carbohydrates, little or no saturated fats and no other cholesterol. Choose them more often, and use them in place of high-fat or sugary foods.



Foods to choose: Foods that are low in cholesterol and saturated fat can help lower the amount of cholesterol in your blood.


Food Cholesterol (mg) Saturated Fat (gm)
Skinless chicken (3.5. oz boneless)
75 1.1
Skinless turkey (3.5 oz boneless) 69 0.4
Fish (haddock, 3.5 oz filet) 74 0.2
Water packed tuna (3.5 oz) 0 0.1
Egg substitutes 0 0
Whole grains (whole wheat bread, 1 slice) 0 0.4
Potatoes (1 med. sized, baked, plain) 0 0
Pasta (1 cup spaghetti, cooked) 0 0.1
Vegetables (1/2 cup carrots) 0 0
Fruits (1 apple) 0 0
Popcorn (1 cup, popped, plain) 0 0

Foods to use: Eat moderate portions of foods that, like these, contain moderate amounts of cholesterol and saturated fats.


Food Cholesterol (mg) Saturated Fat (gm)
Lean, fat trimmed red meat (3.5 oz porterhouse steak, w/o bone)
80 4.3
Peanut butter (1 tablespoon) 0 1.5
Low-fat or skim milk (8 oz) 4 0.3
Mozzarella cheese (part skim, 1 oz) 16 2.9
Pancakes (made w/eggs) (3, 4" diameter) 48 1.5

Muffin, corn (2" diameter)
23 1.5
Nuts ( 1 oz peanuts) 0 1.9
Olive, corn, peanut and safflower oils (1 tablespoon) 0 1.7
Corn oil spread (1 tablespoon) 0 2

Frozen yogurt (3.5 oz)




Foods to limit: Limit your intake of foods that contain high levels of cholesterol and saturated fat, like these.


Food Cholesterol (mg) Saturated Fat (gm)
Egg yolk (1)
272 1.7
Fatty meats/luncheon meats (bologna, 3-4 slices)
58 12.1
Whole milk (8 oz)
33 5.1
Butter (1 tablespoon)
31 7.6
Natural/processed cheese (1 oz American cheese)
18 4.4
Ice cream, vanilla (1 cup)
58 8.9
Fried foods (3.5 oz. chicken)
87 4.6
Coconut, palm and palm kernel oils (1 tablespoon)
0 11.8
Candy bar (1 oz plain milk chocolate)
6 5.4
Heavy desserts (1/6 of a 9" cream pie)
8 15
Donuts (1 plain) 20 2.8

Revised 2/08


ŠTed A. Tobey, M.D., Inc. ~ All Rights Reserved