How to improve your cholesterol

You might feel fine, but high cholesterol numbers are a reason to take pause. That’s because many cardiac events, such as a heart attack or stroke, don’t have advance warning, says Arash Bereliani, M.D., a board-certified cardiologist based in Los Angeles. “Just because you exercise, you feel good, and you eat healthily doesn’t mean you necessarily have a normal heart.”

The good news: Preventive care now can help protect your heart down the line. One key element of cardiac preventive care is managing your cholesterol. Here’s how to keep your cholesterol in check so you can keep your heart healthy for life.

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1. Know your numbers

Make sure you have a full cholesterol panel done at your doctor’s appointments — and know what your numbers mean. In general, total cholesterol under 200 mg/dL is good, but it’s also important to know your high-density lipoprotein (HDL) number and low-density lipoprotein (LDL) number. Higher levels of LDL cholesterol raise your risk of heart disease and stroke. Meanwhile, high levels of HDL can actually lower your risk profile because HDL helps bring cholesterol to your liver, where it is then flushed from your body.

2. Know your family history

“Genetics play a big role in determining your cholesterol levels,” says Dr. Bereliani. Do a family audit, going back to your grandparents, aunts, and uncles to check whether anyone might have had heart disease. Pay attention to family members who might have had heart attacks under the age of 50. That could be a sign that there is a genetic component to heart disease in your family. Familial cholesterolemia is a genetic condition that causes high cholesterol, which can be managed with medication.

3. Limit processed foods

If your cholesterol numbers are within the normal range, keep them that way by limiting processed foods. Processed foods often have high amounts of trans fats, which can raise cholesterol levels.

4. Combine medication with lifestyle changes

If your cholesterol is high, your doctor may prescribe medications to lower it. While medications such as statins do a good job of lowering cholesterol by blocking an enzyme within the liver that produces cholesterol, they work best in conjunction with a diet that’s low in saturated fats as well as regular exercise. If you are prescribed medication, talk with your doctor about diet and activity recommendations.

5. Quit smoking

Smoking can lower HDL (good cholesterol), raise triglycerides (a type of fat in your blood), and increase plaque buildup in your heart, all of which contribute to heart disease. If you do smoke (tobacco or marijuana), quitting can potentially help balance your cholesterol and lower your chance of heart disease.

6. Eat a heart healthy diet

The American Heart Association recommends healthy sources of protein (mostly plants, lean cuts of meat, minimal processed foods), fruits and veggies, low-fat or nonfat dairy, and minimal added sodium, sugars, and saturated fat. Working with a dietitian can help you create a realistic meal plan full of foods you love that can also keep your cholesterol levels in check.

7. Move your body

You don’t need to engage in marathon-level training to maintain healthy cholesterol levels. Aim for about 150 minutes a week of moderate physical activity, or 75 minutes of vigorous physical activity. This can be done in various ways throughout the week — so you could do a few cardio sessions on a treadmill or bike, added to a few long walks with friends or your dog.

8. Keep monitoring your cholesterol

“There’s not a day that goes by when I don’t see a healthy-looking man or woman in my office for an unrelated problem, and I realize that they are a time bomb,” says Dr. Bereliani. Because you can’t “feel” whether your cholesterol is high or low, monitoring cholesterol levels at regular doctor appointments, as well as maintaining a healthy lifestyle, is important for improving your cholesterol and keeping your heart healthy.