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Keeping cholesterol levels in check can be a delicate balancing act. THE BODY MAKES CHOLESTEROL, a waxy, fat-like substance found in cells, in order to produce hormones and help digestion, but it also influences heart and vascular health. High levels of low-density lipoproteins, also known as LDL or bad cholesterol, can lead to atherosclerosis—narrowed arteries, which cause the heart to work harder to deliver oxygen throughout the body. High-density lipoproteins, also called HDL or good cholesterol, help the body balance LDL levels by tracking and removing it, sending it to the liver to be reprocessed. This reduces the risk for heart disease. LDL cholesterol levels can be affected by genetics, smoking habits, gender and age. LDL levels begin to rise after age 20 in men and women, but increase more significantly in women after menopause. Additional risk factors, including excess body weight and unhealthy food choices, play a significant role. "The people most at risk for high LDL cholesterol are those who are obese and those who frequently eat high-fat foods," says John Heitner, M.D., director of noninvasive cardiac imaging at New York Methodist Hospital. "When we need to measure cholesterol in a patient, we use a screening blood test called a lipid panel." When a doctor orders a lipid panel, the patient's blood sample is drawn and analyzed by a medical laboratory to measure a number of factors, including: LDL – Levels less than 100 mg/dL (milligrams per deciliter of blood) are acceptable. HDL – Levels of 60 mg/dL or higher can help protect heart health. HDL levels can be increased by exercising, maintaining a healthy weight and quitting smoking. TREATABLE AND BEATABLE When high LDL cholesterol is left untreated, the risk for heart disease, stroke and vascular disease increases. Aside from lifestyle changes (see "Do's and Don'ts"), the most common treatment for high LDL cholesterol is statin therapy. "Statin medications like atorvastatin and rosuvastatin are the mainstay for people with high cholesterol, particularly for those with high heart disease risk," Dr. Heitner says. "Hundreds of thousands of patients have been studied to gauge the effectiveness of statins, and the overall benefit is tremendous." DO's and DON'Ts take prescribed cholesterol medications as directed. DON'T eat foods containing trans fats like stick margarine or shortening. Trans fats are artificial fats found in many processed foods and raise LDL levels. eat foods containing unsaturated fat. These include monounsaturated fats—like those in olive oil and avocados—or polyunsaturated fats—that can be found in sunflower and safflower oil. These helpful fats can boost HDL levels. Limit foods high in saturated fat, like red meat or full-fat dairy products. DON'T smoke cigarettes or use other tobacco products. Even secondhand smoke can lower HDL levels. exercise daily at a moderate intensity for at least 30 minutes to help maintain a normal weight and assist the body in raising HDL levels and lowering LDL levels. Curb Your CHOLESTEROL P H Y S I C I A N RE F E R R A L / / 718 . 49 9. C A RE 7