Now that you know about blood cholesterol, get set to lower it. All healthy Americans, regardless of their blood cholesterol level, should eat in a heart-healthy way. This is true beginning with toddlers (about age 2) on up to their parents, grandparents, and even great-grandparents. The whole family should also be physically active. And if you have a high blood cholesterol level -- whether due to what you eat, heredity, or both -- it is even more important to eat healthfully and to be physically active. Adopting these behaviors also can help control high blood pressure as well as diabetes.

You'll find more help on heart-healthy eating and physical activity a little later in this resource. First, here are some general rules to lower blood cholesterol:

1. Choose foods that are low in saturated fat.

All foods that contain fat are made up of a mixture of saturated and unsaturated fats. Saturated fat raises your blood cholesterol level more than anything else that you eat. It is found in the greatest amounts in foods from animals, such as fatty cuts of meat, poultry with the skin, whole-milk dairy products, lard, and in some vegetable oils like coconut, palm kernel, and palm oils. The best way to reduce your blood cholesterol level is to choose foods low in saturated fat. One way to do this is by choosing foods such as fruit, vegetables, and whole grain foods naturally low in fat and high in starch and fiber.

Since many foods high in total fat are also high in saturated fat, eating foods low in total fat will help you eat less saturated fat. When you do eat fat, you should substitute unsaturated fat for saturated fat. Unsaturated fat is usually liquid at room temperature and can be either monounsaturated or polyunsaturated. Examples of foods high in monounsaturated fat are olive and canola oils, those high in polyunsaturated fat include safflower, sunflower, corn, and soybean oils. Any type of fat is a rich source of calories, so eating foods low in fat will also help you eat fewer calories. Eating fewer calories can help you lose weight -- and, if you are overweight, losing weight is an important part of lowering your blood cholesterol.

Foods high in starch and fiber are excellent substitutes for foods high in saturated fat. These foods -- breads, cereals, pasta, grains, fruits, and vegetables -- are low in saturated fat and cholesterol. They are also usually lower in calories than foods that are high in fat. Foods high in starch and fiber are also good sources of vitamins and minerals.

Diets low in saturated fat and cholesterol, and high in fruits, vegetables, and grain products -- like oat and barley bran and dry peas and beans -- may help to lower blood cholesterol.

Dietary cholesterol also can raise your blood cholesterol level, although usually not as much as saturated fat. So, it is important to choose foods low in dietary cholesterol. Dietary cholesterol is found only in foods that come from animals. Many of these foods also are high in saturated fat. Foods from plant sources do not have cholesterol but can contain saturated fat.

Moving it -- being physically active -- helps your blood cholesterol levels; it can raise HDL and may lower LDL. Being more active can also help you lose weight, lower your blood pressure, improve the fitness of your heart and blood vessels, and reduce stress.

People who are overweight tend to have higher blood cholesterol levels than people of desirable weight. And overweight people with an "apple" shape -- bigger (pot) belly -- tend to have a higher risk for heart disease than those with a "pear" shape -- bigger hips and thighs.

Whatever your body shape, when you cut the fat in your diet, you cut down on the richest source of calories. An eating pattern high in starch and fiber instead of fat is a good way to lose weight: many starchy foods have little fat and are lower in calories than high fat foods. If you are overweight, losing even a little weight can help to lower LDL-cholesterol and raise HDL-cholesterol. You don't need to reach your desired weight to see a change in your blood cholesterol levels.

Think about the foods you eat each week. Look at each food category -- are the foods you eat listed under Group 1 or Group 2? Once you know the group, follow the line over to the circles under "Weekly Consumption." Check the circle that best describes the number of servings of those foods you usually eat in one week. Then check the circle for the portion size you usually eat. Do the same thing for each of the food groups. Check your score on the bottom of page 11. It will show you whether you are following the Step I or Step II diet, or whether you need to make some further changes. If you need help with MEDFICTS, bring it with you the next time you visit your doctor.

Access MEDFICTS
Note: MEDFICTS is a large HTML file consisting of 6 large graphics; it may take several minutes to load.

If you have high blood cholesterol, you will have to pay attention to what you eat by following either the Step I diet or Step II diet, as advised by your doctor.

• The National Center for Nutrition and Dietetics' Consumer Nutrition Hotline at 1-800-366-1655,
• Your local hospital and/or public health department, or
• Your doctor.

The recommendations for saturated fat and total fat are based on a percentage of the calories you eat; the actual amount you should eat daily will vary depending on how many calories you eat. See the chart below to get an idea of the number of grams of saturated fat and total fat you should be eating.

For more detailed sodium information on specific foods, refer to the table listing the "Sodium Content of Heart-Healthy Foods" and to the tables on food and food groups.