Cholesterol Advice: Ask the Expert

Alice H. Lichtenstein, D.Sc., director of the Cardiovascular Nutrition Laboratory at the Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, and an EatingWell advisor, answers your questions about cholesterol.

If a family member has high cholesterol does that mean I'm going to have it as well?

"Not necessarily. Your chances are higher [than others'] but it's not a guarantee. It's important to inform your health care provider that you have a family member who has high cholesterol or has had a heart attack at a relatively young age (under 65, if female; under 55, if male). Your doctor may advise having your cholesterol screened more regularly." Note: According to the American Heart Association, everyone age 20 and older should have their cholesterol measured every 5 years. You may need to have it checked more often if you have risk factors for heart disease. Such factors include diabetes, smoking, high blood pressure or a family history.

If my cholesterol is high does that mean I have heart disease?

“Not necessarily, but your chances of having heart disease are considerably higher than if your cholesterol levels were in a normal range. One important thing is to find out whether your cholesterol level is high due to your LDL (bad) or your HDL (good) cholesterol levels. If your LDL cholesterol levels are high, we recommend modifying your lifestyle first to get them within a normal range. If those changes don’t work well enough, then pharmacological treatment may be necessary. Dietary changes alone are not always enough for everyone.”

There are so many products labeled "heart healthy" in the supermarket. Are they all good for you?

“Just because something is labeled ‘heart healthy’ doesn’t mean you should eat it. These products should only be substitutes for foods you would have eaten anyway. If, say, you were going to buy crackers and one brand is labeled ‘heart healthy,’ you might consider buying those, if there seemed to be a good reason—for example, they were made with whole grains. But don’t buy a product just because it is labeled ‘heart healthy.’ The most critical thing is maintaining a healthy body weight.”

What's the big misconception about lowering blood cholesterol levels?

“One is that all you have to do is find a special food or combination of foods and not worry about anything else. Another one is that you can go on a diet for four weeks, sort of like you take antibiotics for five days, and then you can go back to how you were eating before and still retain the benefit. Changing just one or two foods, or following a certain diet for a few weeks, isn’t going to have a long-lasting effect. Sometimes people ask about individual foods, but it’s really about the whole dietary pattern, regular physical activity and maintaining a healthy body weight. If you really want to reduce your risk of cardiovascular disease, you have to buy into the whole picture.”

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