Managing your cholesterol is like a juggling act. You want to keep your LDL low and your HDL high. Throw in triglycerides, a type of fat in the blood, and you’re juggling three balls.

You have to pay attention to lots of numbers to stay healthy – LDL, HDL, triglycerides, apoB, blood pressure (systolic and diastolic), blood glucose, C-reactive protein, weight and more. Cholesterol readings have been around a long time, but they’re still among the most important markers for your health.

Although most people may be advised to lower their cholesterol, it’s the LDL portion of total cholesterol that generally needs to be lower, while the HDL part may need to be higher. Cholesterol, although it’s related to dietary fat, serum lipids (fats in your blood) and bodyfat, isn’t a fat but a waxy substance that’s part of all cells in your body. So you can’t get away from it, but you want a healthy balance of the types related to cardiovascular health.

In terms of cholesterol and the related triglycerides, here are the components:

• TOTAL CHOLESTEROL: This is your bad LDL added to your good HDL, along with another type, VLDL (very low density lipoprotein) cholesterol. Generally a high total cholesterol indicates high LDL, but a lower LDL with a higher HDL (both good readings) could also total high. So you need to know the components for a true indicator.
• LDL or LOW-DENSITY LIPOPROTEIN CHOLESTEROL: This is considered the bad cholesterol because too much in the bloodstream can be deposited on artery walls and build up as blockages or break off as clots. Blockages can eventually choke off blood circulation to critical areas such as the heart and brain, and clots can lead to heart attacks or stroke (among other consequences). Your body makes cholesterol as well getting it from foods with cholesterol, saturated fats and trans fats. While you’re keeping your intake of saturated and trans fats down, you may want to increase your intake of polyunsaturated fats (as in safflower and corn oil) and monounsaturated fats (as in olive oil).
• HDL or HIGH-DENSITY LIPOPROTEIN CHOLESTEROL: This is the good guy, the cholesterol that helps carry the bad cholesterol out of the bloodstream. If it’s low, it’s hard to bring it up, but losing excess fat, exercising regularly and consuming omega-3 fatty acids may help. Omega-3s are found in fatty fish like wild salmon, walnuts and flaxseed. You can also get them in supplement form.

  Alcohol in moderation might also boost low HDL. Moderation means one drink per day for a woman, two for a man. Red wine and dark beer may have added nutrients, but they also have calories, so stick to your limit if you choose to drink alcoholic beverages. Used in excess, alcohol can damage not only your health but also your social and economic well-being. Obviously, don’t consume alcohol if it might worsen existing conditions or you’re taking medications that countraindicate its use.

• TRIGLYCERIDES: This is the typical type of fat found in foods and in your body (in your bloodstream and stored as bodyfat). The name refers to three fatty acids plus glycerol. High triglyceride levels prompt the liver to manufacture more cholesterol, which can lead to higher LDL and total cholesterol levels. Alcohol, which might benefit your HDL levels, could raise triglycerides (so don’t overdo).

  The low-fat fallacy is that eating all those low-fat (but high-carbohydrate) foods was good for us. In fact, the some fats are good for us, even essential. So if you’ve cut the fat but increased your carbohydrates and perhaps your total calories, you could end up fatter with higher triglyceride levels. Instead, eat a moderate-fat diet, with your total fat intake at or below 30% of your calories (about 600 calories on a 2,000-calorie-per-day diet, for example). You may also need to avoid sugar and keep your carbohydrates at 45% to 50% of your total calories.

  Focus on healthy fats from fatty fish, nuts and other plant sources. Keep your saturated fats low, and avoid trans fats as much as possible. Many food manufacturers have already eliminated them, and proclaim the fact on labels.

Cholesterol & Triglycerides at a Glance Always consult your physician regarding your health status and actions you should take. Target numbers may vary depending on individual risk factors.
Component	Target	Function	What you can do (besides taking recommended medications)
Total cholesterol	Below 200 mg/dl is desirable. If you have other risk factors, your goal may be lower.	Basically the sum of LDL and HDL, plus VLDL.	The ratio of total, LDL and HDL is important. A high LDL and a low HDL is bad, while a lower LDL and higher HDL might be fine.
LDLLow-Density Lipoprotein Cholesterol	Generally below 130 mg/dl.Less than 100 is optimal for most. If you are higher risk, goal is below 70.	The bad cholesterol. Too much in the blood and fatty particles build up on artery walls.	Watch your dietary cholesterol and saturated fat intake. Avoid trans fat. Eat more soluble fiber (as in oatmeal, beans and apples).
HDLHigh-Density Lipoprotein Cholesterol	60 mg/dl is desirable.For women, less than 50 is a risk factor. For men, less than 40 is a risk factor.	HDL helps remove LDL from the blood.	Exercise regularly. Lose excess bodyfat.Consume more omega-3 fatty acids, as in wild salmon. Don’t smoke.
Triglycerides	Less than 150 mg/dl is desirable.150-199 is borderline high.	High triglycerides are the other side of the coin to low HDL; the two often go together in blood-test results. Excess calories are converted to triglycerides for storage as bodyfat.	Exercise regularly. Lose excess bodyfat. Watch your carbohydrate and total calorie intake. Eat fatty fish.
ApoB (Apolipoprotein B)	Discuss with your physician. Not part of the standard lipid panel.	This component of LDL indicates the more dangerous form of LDL. Basically, while LDL is bad, ApoB is worse.	This is a relatively new screening. It can tell you if you’re at risk for heart disease (even if your LDL reading is normal) and is also associated with glucose-metabolism problems.

SOME FOODS TO EAT (For healthy cholesterol and triglyceride levels)
Oatmeal, Oat bran, Wild salmon, Beans, Barley, Peas, Soybeans, Tuna, Herring, Trout, Flaxseed, Flaxseed oil, Walnuts, Other nuts and seeds, Apples, Oranges, Strawberries, Carrots, Other vegetables and fruits

SOME FOODS TO MINIMIZE
For cholesterol management, you need to cut down not just on cholesterol but also on saturated fat, which the body can convert into cholesterol. As for triglycerides, watch the calories because an excess from any source – carbohydrates and protein as well as dietary fat – can be converted into triglycerides.
High-fat fast foods (especially those with trans fats), Packaged foods with trans fats (may be labeled “partially hydrogenated”), Butter, Partially hydrogenated margarine, Full-fat milk, Full-fat cheese, High-fat beef, pork, Regular hot dogs, Regular sausage, Egg yolks (but one a day is okay for most), High-fructose sweeteners