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Cholesterol level maintenance

Cholesterol level maintenance

This article is based on scientific evidence, mainttenance by experts and fact checked by experts. Oct 12, Written By Matthew Thorpe, Karen Lamoreux. Department of Agriculture.

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How To Reduce Cholesterol Levels

Cholesterol level maintenance -

For most people, the first step would be to reduce their saturated fats intake, and to eat more soy foods, nuts, oats or barley. Eating more fibre and vegetables can help manage cholesterol levels, too. And the more exercise, the better; the government says two and a half hours of moderate-intensity exercise per week is the minimum.

Taking 10, steps a day is good for you but unless that gets you out of breath and your heart rate up, you need to do more. That is why it is just as important to understand your family medical history as it is your own numbers.

Some people have normal cholesterol and blood pressure, but have a family history of heart disease and heart attacks or strokes, so they are still prescribed medication, most often statins, which are taken once daily. Everyone should see their GP every year to have their cholesterol and blood pressure checked.

A lot can change in 12 months. Ezetimibe — Ezetimibe brand name: Zetia blocks the body's ability to actively transport cholesterol from food as well as cholesterol that the body produces internally. It lowers LDL cholesterol levels by 20 to 25 percent and has relatively few side effects.

It is usually prescribed in combination with a statin but is also used alone in patients who cannot tolerate a statin. When used in combination with a statin after an acute coronary syndrome eg, heart attack , ezetimibe provides a small additional reduction in the risk of having another cardiovascular event.

PCSK9 inhibitors — PCSK9 monoclonal antibody inhibitors are another class of drugs that lower LDL cholesterol levels sample brand names: Praluent, Repatha table 1 ; they are given by injection under the skin every two to four weeks.

They reduce cardiovascular events such as heart attack or stroke and potentially death. Aside from mild skin reactions at the site of injection, they have few side effects.

Inclisiran brand name Leqvio is a PCSK9 inhibitor that is given by injection once, 90 days later, and then every six months.

However, they are expensive and their use is limited to patients treated with maximal tolerated statins who have persistent elevations of LDL cholesterol. Bile acid sequestrants — The bile acid sequestrants include colesevelam brand name: Welchol , colestipol brand name: Colestid , and cholestyramine sample brand names: Prevalite, Questran table 1.

These medications bind to bile acids in the intestine, reducing the amount of cholesterol the body absorbs from foods.

They are used only occasionally. They lower LDL cholesterol only modestly 10 to 15 percent. Side effects can be bothersome and may include nausea, bloating, cramping, and liver damage.

Taking psyllium a fiber supplement, such as Metamucil can sometimes reduce the dose required and the side effects. Bile acid sequestrants can interact with some medications, including as digoxin brand name: Lanoxin and warfarin brand name: Jantoven , and with the absorption of fat-soluble vitamins including vitamins A, D, K, and E.

Taking these medications at different times of day can solve these problems in some cases. Bempedoic acid — Bempedoic acid brand name: Nexletol is the newest lipid-lowering agent, and it is approved for lowering LDL cholesterol.

It works by inhibiting cholesterol synthesis at a step before the HMG-CoA reductase or the enzyme inhibited by statin therapy.

Bempedoic acid alone or in combination with a statin or ezetimibe brand name: Nexlizet lowers LDL cholesterol as well as other atherogenic proteins. Bempedoic acid can reduce the risk of cardiovascular events such as heart attacks.

Side effects include an increase in the incidence of gout, gallstones, kidney damage, and small increases in liver enzymes. Early studies reported Achilles tendon rupture as a rare side effect; however, this effect was not seen in a recent large trial.

Omega-3 — Oily fish, such as mackerel, herring, bluefish, sardines, salmon, and anchovies, contain two important fatty acids called docosahexaenoic acid DHA and eicosapentaenoic acid EPA.

Eating a diet that includes one to two servings of oily fish per week can lower triglyceride levels and reduce the risk of death from coronary heart disease. Fish oil supplements, supplements with low-dose mixed fish oils usually approximately 1 gram per day of combined DHA and EPA , had been thought to provide cardiac benefit, but large trials have found no significant benefit.

As such, they are no longer recommended. A second study of a high-dose agent that had both EPA and DHA failed to provide benefit, suggesting that the EPA only preparation at the 4 g dose is important. However, the trials found that omega-3 fatty acid medications increase the risk of atrial fibrillation.

Therefore, a discussion with your cardiologist on the net benefit or harm from taking fish oil supplements including icosapent ethyl is needed before starting this treatment.

Nicotinic acid niacin — Nicotinic acid is a vitamin that is available in immediate-release, sustained-release, and extended-release formulations table 1.

Nicotinic acid is rarely used for a high cholesterol. In most situations, ezetimibe or a PCSK9 inhibitor is tried before nicotinic acid. Historically, this agent used to be used to raise HDL cholesterol levels, but that is no longer recommended.

It is sometimes used for patients with high lipoprotein a levels and LDL cholesterol that is refractory to more effective and better-tolerated medications statins, ezetimibe and PCSK9 inhibitors. Nicotinic acid is associated with many side effects, including flushing when the face or body turns red and becomes warm , itching, nausea, numbness and tingling, and worsening of gout.

This medication can also cause liver damage; people who use it require regular blood tests to monitor their liver function. Red yeast rice — Red yeast rice is a fermented rice product that can lower serum cholesterol.

Red yeast rice contains naturally occurring substances called monacolins that act to reduce cholesterol by a mechanism similar to that of statins. Although red yeast rice is effective for lowering total and LDL cholesterol, there is not evidence that it decreases rates of cardiovascular events or that it is safe to take long-term.

Moreover, red yeast rice supplements are not standardized in the United States. Different commercial preparations vary widely in the amount of the active ingredient, and some commercial preparations have been shown to contain potentially toxic substances or lovastatin, a statin medication.

Soy protein — Soy protein contains isoflavones, which mimic the action of estrogen. A diet high in soy protein can slightly lower levels of total cholesterol, LDL cholesterol, and triglycerides and raise levels of high-density lipoprotein HDL cholesterol. However, normal protein should not be replaced with soy protein or isoflavone supplements in an effort to lower cholesterol levels.

Soy foods and food products eg, tofu, soy butter, edamame, some soy burgers are likely to have beneficial effects on lipids and cardiovascular health because they are low in saturated fats and high in unsaturated fats. Garlic — Garlic has not been proven to be effective in lowering cholesterol.

Plant stanols and sterols — Plant stanols and sterols may act by blocking the absorption of cholesterol in the intestine. They are naturally found in some fruits, vegetables, vegetable oils, nuts, seeds, and legumes.

They are also available in commercially prepared products such as margarine Promise Active and Benecol , orange juice Minute Maid Premium Heart Wise , and rice milk Rice Dream Heart Wise as well as dietary supplements Benecol SoftGels and Cholest-Off.

Despite lowering cholesterol levels, there are no studies demonstrating a reduced risk of coronary heart disease in people who consume supplemental plant stanols and sterols. These products need to be studied more before they can be recommended.

Although medications can rapidly lower your levels within a week , it often takes 6 to 12 months before the effects of lifestyle modifications are noticeable.

Once you have an effective treatment plan and you begin to see results, it is important to stay committed to the plan. Stopping treatment usually allows lipid levels to rise again and increases your risk for heart attack, stroke, or other cardiovascular problems.

Even while taking medications, maintaining a healthy lifestyle is crucial to obtain the most benefit from these therapies. Most people who stop treatment do so because of perceived side effects.

However, there are a wide variety of medications available today, which should make it possible for most people to find an option that works for them. Talk with your health care provider if a specific medication is not working for you; he or she can recommend alternatives that are compatible with your lifestyle and preferences.

Your healthcare provider is the best source of information for questions and concerns related to your medical problem. This article will be updated as needed on our web site www. Related topics for patients, as well as selected articles written for healthcare professionals, are also available.

Some of the most relevant are listed below. Patient level information — UpToDate offers two types of patient education materials. The Basics — The Basics patient education pieces answer the four or five key questions a patient might have about a given condition. Alcohol adds extra calories, which can lead to weight gain.

Being overweight can raise your LDL level and lower your HDL level. Too much alcohol can also increase your risk of heart diseases because it can raise your blood pressure and triglyceride level.

One drink is a glass of wine, beer, or a small amount of hard liquor, and the recommendation is that:. Nutrition labels can help you figure out how much fat, saturated fat, cholesterol, fiber, and sodium is in the foods that you buy.

The information on this site should not be used as a substitute for professional medical care or advice. Contact a health care provider if you have questions about your health. How to Lower Cholesterol with Diet Also called: Low Cholesterol Diet, Therapeutic Lifestyle Changes Diet, TLC Diet.

What is cholesterol? What are the treatments for high cholesterol? How can I lower cholesterol with diet? Another is the Therapeutic Lifestyle Changes diet, which recommends that you Choose healthier fats.

Depending upon how many calories you eat per day, here are the maximum amounts of fats that you should eat: Calories per Day Total Fat Saturated Fat 1, grams 10 grams 2, grams 13 grams 2, grams 17 grams Saturated fat is a bad fat because it raises your LDL bad cholesterol level more than anything else in your diet.

These foods include: Whole-grain cereals such as oatmeal and oat bran Fruits such as apples, bananas, oranges, pears, and prunes Legumes such as kidney beans, lentils, chick peas, black-eyed peas, and lima beans Eat lots of fruits and vegetables.

One drink is a glass of wine, beer, or a small amount of hard liquor, and the recommendation is that: Men should have no more than two drinks containing alcohol a day Women should have no more than one drink containing alcohol a day Nutrition labels can help you figure out how much fat, saturated fat, cholesterol, fiber, and sodium is in the foods that you buy.

NIH: National Heart, Lung, and Blood Institute. Learn More. Butter, margarine, and cooking oils Medical Encyclopedia Also in Spanish DASH Diet: MedlinePlus Health Topic National Library of Medicine Also in Spanish Dietary fats explained Medical Encyclopedia Also in Spanish Facts about monounsaturated fats Medical Encyclopedia Also in Spanish Facts about polyunsaturated fats Medical Encyclopedia Also in Spanish Facts about saturated fats Medical Encyclopedia Also in Spanish Facts about trans fats Medical Encyclopedia Also in Spanish High-fiber foods Medical Encyclopedia Also in Spanish How to read food labels Medical Encyclopedia Also in Spanish Mediterranean diet Medical Encyclopedia Also in Spanish Omega-3 fats - Good for your heart Medical Encyclopedia Also in Spanish Simple, heart-smart substitutions Medical Encyclopedia Also in Spanish.

Clinical Trials. gov: Low Cholesterol Diet National Institutes of Health. Article: Mediterranean Dietary Treatment in Hyperlipidemic Children: Should It Be an Option? Article: Beneficial Impact of Pork Dry-Cured Ham Consumption on Blood Pressure and Article: The Prebiotic Effects of Oats on Blood Lipids, Gut Microbiota, and

Cholesterol drops over Cholewterol, not maintenancce after a few days of healthier living. There Antispasmodic Remedies for Neck and Shoulder Tension no set period in which lwvel is guaranteed to drop. The body Cholesterol level maintenance some cholesterol to function normally. However, too much cholesterol — especially low density lipoprotein LDL cholesterol — increases the risk of cardiovascular disease, including heart attacks and strokes. People concerned about their cholesterol may wonder how to reduce cholesterol in 30 days. However, cholesterol reduction takes time, and most research looks at cholesterol changes over many months.

Cholesterol level maintenance -

They are found in foods such as butter, coconut and palm oil, saturated or partially hydrogenated vegetable fats such as shortening and margarine, animal fats in meats, and fats in whole milk dairy products.

Limit the amount of saturated fat in your diet. Avoid trans-fat completely. Most fats in fish, vegetables, grains, and tree nuts are unsaturated.

Try to eat unsaturated fat in place of saturated fat. For example, use olive oil or canola oil when cooking instead of butter. Use healthier cooking methods. Baking, broiling, and roasting are the healthiest ways to prepare meat, poultry, and other foods.

Trim any outside fat or skin before cooking. Lean cuts can be pan-broiled or stir-fried. Use either a nonstick pan or nonstick cooking spray instead of adding fats such as butter or margarine.

When eating out, ask how food is prepared. You can request that your food be baked, broiled, or roasted, rather than fried. Look for other sources of protein.

Meats are a good source of protein. But they contain a lot of cholesterol and saturated fats. Fish, beans, tree nuts, peas, and lentils also offer protein, but without the cholesterol and fats. They also contain fiber and other nutrients.

Consider eating one meatless meal each week. Try substituting beans for meat in a favorite recipe, such as lasagna or chili. Snack on a handful of almonds or pecans. Soy is also an excellent source of protein. Good examples of soy include soymilk, edamame green soybeans , tofu, and soy protein shakes.

Get more fiber in your diet. Add good sources of fiber to your meals. Examples include:. In addition to fiber, whole grains supply B vitamins and important nutrients not found in foods made with white flour.

Eat more fish. Fish is an excellent source of omega-3 fatty acids. Wild-caught oily fish are the best sources of omega-3s. These include salmon, tuna, mackerel, and sardines. But all fish contain some amount of this beneficial fatty acid.

Aim for 2 6-oz. servings every week. Add supplements to your diet. Some examples include:. Learn how to read a nutrition facts label. All packaged and processed foods should contain a nutrition facts label.

This label shows the nutritional content of the food. It will outline the fat, fiber, protein, and other nutrients in the food. Ask your doctor to help you learn to read these labels. Often, there are no symptoms telling you that you could have high cholesterol.

If you have high cholesterol, your body may store the extra cholesterol in your arteries. This build-up is called plaque. Over time plaque can become hard and make your arteries narrow.

Large deposits of plaque can completely block an artery. The plaque can also break open. If you are a Mayo Clinic patient, this could include protected health information.

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Appointments at Mayo Clinic Mayo Clinic offers appointments in Arizona, Florida and Minnesota and at Mayo Clinic Health System locations. Request Appointment. Top 5 lifestyle changes to improve your cholesterol. Products and services. Top 5 lifestyle changes to improve your cholesterol Lifestyle changes can help improve your cholesterol — and boost the cholesterol-lowering power of medications.

By Mayo Clinic Staff. Thank you for subscribing! Sorry something went wrong with your subscription Please, try again in a couple of minutes Retry. Show references Your guide to lowering your cholesterol with TLC.

National Heart, Lung, and Blood Institute. pdf Accessed May 22, Kumar P, et al. Lipid and metabolic disorders. In: Kumar and Clark's Clinical Medicine. Philadelphia, Pa. Accessed May 22, Tangney CC, et al.

Lipid lowering with diet or dietary supplements. Catapano AL, et al. Department of Health and Human Services and U. Department of Agriculture. Final determination regarding partially hydrogenated oils removing trans fat. Food and Drug Administration. Accessed June 28, Cooking to lower cholesterol.

American Heart Association. Fekete AA, et al. Whey protein lowers blood pressure and improves endothelial function and lipid biomarkers in adults with prehypertension and mild hypertensions: Results from the chronic Whey2Go randomized controlled trial.

American Journal of Clinical Nutrition. Douglas PS. Exercise and fitness in the prevention of atherosclerotic cardiovascular disease. Accessed May 30, Hyperlipidemia adult. Rochester, Minn. Braun LT, et al.

Effects of exercise on lipoproteins and hemostatic factors. Smoke-free living: Benefits and milestones. It is sometimes used for patients with high lipoprotein a levels and LDL cholesterol that is refractory to more effective and better-tolerated medications statins, ezetimibe and PCSK9 inhibitors.

Nicotinic acid is associated with many side effects, including flushing when the face or body turns red and becomes warm , itching, nausea, numbness and tingling, and worsening of gout.

This medication can also cause liver damage; people who use it require regular blood tests to monitor their liver function. Red yeast rice — Red yeast rice is a fermented rice product that can lower serum cholesterol.

Red yeast rice contains naturally occurring substances called monacolins that act to reduce cholesterol by a mechanism similar to that of statins.

Although red yeast rice is effective for lowering total and LDL cholesterol, there is not evidence that it decreases rates of cardiovascular events or that it is safe to take long-term.

Moreover, red yeast rice supplements are not standardized in the United States. Different commercial preparations vary widely in the amount of the active ingredient, and some commercial preparations have been shown to contain potentially toxic substances or lovastatin, a statin medication.

Soy protein — Soy protein contains isoflavones, which mimic the action of estrogen. A diet high in soy protein can slightly lower levels of total cholesterol, LDL cholesterol, and triglycerides and raise levels of high-density lipoprotein HDL cholesterol.

However, normal protein should not be replaced with soy protein or isoflavone supplements in an effort to lower cholesterol levels. Soy foods and food products eg, tofu, soy butter, edamame, some soy burgers are likely to have beneficial effects on lipids and cardiovascular health because they are low in saturated fats and high in unsaturated fats.

Garlic — Garlic has not been proven to be effective in lowering cholesterol. Plant stanols and sterols — Plant stanols and sterols may act by blocking the absorption of cholesterol in the intestine.

They are naturally found in some fruits, vegetables, vegetable oils, nuts, seeds, and legumes. They are also available in commercially prepared products such as margarine Promise Active and Benecol , orange juice Minute Maid Premium Heart Wise , and rice milk Rice Dream Heart Wise as well as dietary supplements Benecol SoftGels and Cholest-Off.

Despite lowering cholesterol levels, there are no studies demonstrating a reduced risk of coronary heart disease in people who consume supplemental plant stanols and sterols.

These products need to be studied more before they can be recommended. Although medications can rapidly lower your levels within a week , it often takes 6 to 12 months before the effects of lifestyle modifications are noticeable. Once you have an effective treatment plan and you begin to see results, it is important to stay committed to the plan.

Stopping treatment usually allows lipid levels to rise again and increases your risk for heart attack, stroke, or other cardiovascular problems.

Even while taking medications, maintaining a healthy lifestyle is crucial to obtain the most benefit from these therapies. Most people who stop treatment do so because of perceived side effects. However, there are a wide variety of medications available today, which should make it possible for most people to find an option that works for them.

Talk with your health care provider if a specific medication is not working for you; he or she can recommend alternatives that are compatible with your lifestyle and preferences.

Your healthcare provider is the best source of information for questions and concerns related to your medical problem. This article will be updated as needed on our web site www. Related topics for patients, as well as selected articles written for healthcare professionals, are also available.

Some of the most relevant are listed below. Patient level information — UpToDate offers two types of patient education materials.

The Basics — The Basics patient education pieces answer the four or five key questions a patient might have about a given condition.

These articles are best for patients who want a general overview and who prefer short, easy-to-read materials. Patient education: High cholesterol The Basics Patient education: High triglycerides The Basics Patient education: Can foods or supplements lower cholesterol?

The Basics. Beyond the Basics — Beyond the Basics patient education pieces are longer, more sophisticated, and more detailed. These articles are best for patients who want in-depth information and are comfortable with some medical jargon.

Patient education: High cholesterol and lipids Beyond the Basics Patient education: Heart attack recovery Beyond the Basics Patient education: Type 2 diabetes: Overview Beyond the Basics Patient education: Exercise Beyond the Basics Patient education: Diet and health Beyond the Basics.

Professional level information — Professional level articles are designed to keep doctors and other health professionals up-to-date on the latest medical findings. These articles are thorough, long, and complex, and they contain multiple references to the research on which they are based.

Professional level articles are best for people who are comfortable with a lot of medical terminology and who want to read the same materials their doctors are reading. Contributor disclosures are reviewed for conflicts of interest by the editorial group. When found, these are addressed by vetting through a multi-level review process, and through requirements for references to be provided to support the content.

Appropriately referenced content is required of all authors and must conform to UpToDate standards of evidence. Conflict of interest policy. Why UpToDate? Product Editorial Subscription Options Subscribe Sign in.

View Topic Loading Font Size Small Normal Large. Patient education: High cholesterol and lipid treatment options Beyond the Basics. Formulary drug information for this topic. No drug references linked in this topic. Find in topic Formulary Print Share. Official reprint from UpToDate ® www.

com © UpToDate, Inc. All Rights Reserved. Authors: Robert S Rosenson, MD Christopher P Cannon, MD Section Editor: Mason W Freeman, MD Deputy Editor: Sara Swenson, MD.

All topics are updated as new evidence becomes available and our peer review process is complete. Literature review current through: Jan This topic last updated: Oct 11, Other special groups People with high triglyceride levels — Triglycerides, like cholesterol, are a type of lipid.

Due to these risks, the FDA no longer recommends its use with statins or cautious use. Nutritional supplements Red yeast rice — Red yeast rice is a fermented rice product that can lower serum cholesterol. The Basics Beyond the Basics — Beyond the Basics patient education pieces are longer, more sophisticated, and more detailed.

Patient education: High cholesterol and lipids Beyond the Basics Patient education: Heart attack recovery Beyond the Basics Patient education: Type 2 diabetes: Overview Beyond the Basics Patient education: Exercise Beyond the Basics Patient education: Diet and health Beyond the Basics Professional level information — Professional level articles are designed to keep doctors and other health professionals up-to-date on the latest medical findings.

Effect of raw garlic vs commercial garlic supplements on plasma lipid concentrations in adults with moderate hypercholesterolemia: a randomized clinical trial.

By living pevel healthy lifestyle, you maintenanec help keep your Cholesterol level maintenance kevel a healthy Choleeterol and maintenanc your risk of heart disease and stroke. Your Cholesterol level maintenance makes all of the cholesterol it Herbal remedies for anxiety and depression, so maitnenance do not need to obtain cholesterol through foods. Eating lots of foods high in saturated fat and trans fat may contribute to high cholesterol and related conditions, such as heart disease. The combination raises your risk of heart disease and stroke. Physical activity can help you maintain a healthy weight and lower your cholesterol and blood pressure levels. Smoking damages your blood vessels, speeds up the hardening of the arteries, and greatly increases your risk for heart disease. Cholesterol level maintenance

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