Cholesterol Treatment

Usual cure


The best way to keep cholesterol levels low is to watch what you eat. Reducing dietary risk factors by maintaining ideal body weight, eating a well balanced, low fat diet, and limiting cholesterol intake will help prevent the onset of high cholesterol related problems.

The recommended level for total cholesterol is either less than 200 or less than 190 milligrams per deciliter (mg/dl) and it is considered "desirable" because that level carries the least risk of heart disease. Consult your health care provider to measure and discuss your cholesterol profile.

It is also important to know the 2 types of cholesterol: the levels of High Density Lipoprotein (HDL) also known as the "good cholesterol" and Low Density Lipoprotein (LDL) or "bad cholesterol". A level above 200 mg/dl is open to risk for coronary heart disease increases. However, it is more important is the ratio of total cholesterol to HDL as a preventive factor for cardiovascular and other related health problems.

Consume less than 30% of the total daily calories from fat. Of that 30%, less than one-third should be from *saturated fat (animal fat) and not more than one-third should be from *polyunsaturated fat. At least one-third of the total fat calories should be from *monounsaturated fat. Less than 300 milligrams (mg) of dietary cholesterol per day should be consumed.

*Saturated fats: These are the biggest dietary cause of high LDL levels ("bad cholesterol"). When looking at a food label, pay very close attention to the % of saturated fat and avoid or limit any foods that are high (for example, over 20% saturated fat). Saturated fats are found in animal products such as butter, cheese, whole milk, ice cream, cream, and fatty meats. They are also found in some vegetable oils -- coconut, palm, and palm kernel oils. (Note: most other vegetable oils contain unsaturated fat and are healthy.)

Unsaturated fats: Fats that help to lower blood cholesterol if used in place of saturated fats. However, unsaturated fats have a lot of calories, so you still need to limit them. There are two types: mono-unsaturated and polyunsaturated. Most (but not all!) liquid vegetable oils are unsaturated. (The exceptions include coconut, palm, and palm kernel oils.)

*Mono-unsaturated fats: Fats that help to lower blood cholesterol if used in place of saturated fats. However, mono-unsaturated fats have a lot of calories, so you still need to limit them. Examples include olive and canola oils.

*Polyunsaturated fats: Fats that help to lower blood cholesterol if used in place of saturated fats. However, polyunsaturated fats have a lot of calories, so you still need to limit them. Examples include safflower, sunflower, corn, and soybean oils.

Keeping a low-fat diet provides 190 mg of dietary cholesterol. Recommendations for children's diets are similar to those of adults. It is imperative that children's caloric intake be adequate to support growth and activity level and that the child achieve and maintain a desirable body weight. Children should have a diet that is closer to 30% of calories from fat. Lower-fat diets may be appropriate in some cases but require careful follow-up from a physician and dietitian.

If you have high cholesterol, the goal of therapy is to reduce the risk of atherosclerosis and cardiovascular disease through therapy aimed at lowering the blood lipid levels. Dietary modification is the initial step in treatment for most patients with mild to moderate hyperlipidemia.

For overweight individuals, weight reduction to ideal body weight is recommended. Reduction of total calories, cholesterol, and saturated fat is appropriate for most people. The degree of dietary restriction is proportional to the degree of the hyperlipidemia.

Drug therapy is generally initiated if there is no improvement within 2 months after maximal dietary modification, or if the initial cholesterol level is severely elevated. The type of drug chosen depends upon the type of lipoprotein elevated in the serum. Several types of medications are available. Bile sequestrant resins, cholestyramine, colestipol, and nicotinic acid are drugs that may be prescribed for mild to moderate hyperlipidemia.

The class of drugs prescribed for the most common cause of hyperlipidemia is the HMG-coA reductase inhibitors. These drugs, also known as the statins, are prescribed for patients with elevated LDL levels. Most patients with a history of heart attack or high risk for heart attack who have high cholesterol, should be prescribed one of these medications. The statins have been shown in studies to reduce death from heart attacks in patients with a history of coronary artery disease.

Don't stop taking prescription medication without consulting your doctor. Drug and diet therapy usually need to continue throughout the life of the affected individual. Periodic monitoring of blood levels is necessary to determine the response to treatment. Reduction of high cholesterol levels has shown a decrease in the progression of atherosclerosis.

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