Overview

Not all cholesterol is bad. HDL is called "good cholesterol," because it helps keep "bad" LDL cholesterol from building up in your arteries. High levels of HDL (1.5 or above) are linked with a lower risk of heart attack and stroke.

High cholesterol is treated with lifestyle changes and medicine. You and your doctor may decide to first try treating your high cholesterol without medicine. Changing some of your habits may be all you need to do to improve your cholesterol levels. Your doctor might suggest that you take medicine too.

How can you make changes?

You might have to make a few changes to follow a heart-healthy diet. The truth is that making lifestyle changes takes some work. And making lifestyle changes that become part of your normal routine is harder still. The key is to make small changes and make them a habit. And when you've turned one small change into a lifelong habit, start again with another small change.

Below you'll find some tips for making small changes that can help you get started on healthy changes.

1. Eat healthy foods.

Here are a few tips to get you started on making small changes at home:

• Eat one more serving of fruits or vegetables every day. Add an apple or some carrots at lunch, or double your helping of vegetables at dinner.
• Avoid deep-fried foods. Swap the fried chicken for baked chicken. Or skip the french fries and have a salad instead.
• Think of meat as a side dish, not the centre of the meal. You can still eat meat. Just be smart about it. Eat leaner meat and less of it.
• Try a vegetarian meal each week. You'll be surprised at how delicious and filling a meal without meat can be.
• Switch to skim milk. If you're drinking whole milk, try the step-down approach. Change to 2% milk for a month, then to 1% for another month, and then move to skim. Use it in your coffee too.
• Eat healthy fats such as monounsaturated fat and polyunsaturated fat. Monounsaturated fats are found in vegetable oils such as canola and olive oil. Polyunsaturated fats are found in fish and in vegetable oils such as safflower and corn oil.

At the grocery store:

• Buy less red meat and more white-meat chicken or turkey. Don't forget to remove the skin before you cook or eat it.
• Buy more fresh fish and shellfish. When you cook it, try baking, poaching, or grilling. Don't batter or fry it.
• Use soft or liquid margarine instead of butter or hard margarine. Check the label to make sure liquid (not hydrogenated) vegetable oil is the first ingredient.

Eating out:

• Don't order deep-fried foods. Ask your server how the items on the menu are cooked. Avoid the chips and salsa, and skip the bread and butter too.
• Pay attention to serving size. Don't eat everything on your plate just because it's there. Restaurant portions very often contain too much food. Eat a reasonable amount, and take the rest home.
• Watch out for high-fat salad dressings and toppings at the salad bar. If your salad comes prepared, ask for the dressing on the side.
• Order meats that are roasted, baked, blackened, broiled, or boiled. Trim off the fat. Ask for gravy or sauce on the side, or don't get it at all. Avoid fried, grilled, sauteed, stewed, braised, or breaded meats.

2. Stay active

You don't have to run out and join a gym to get active. Start small, and try to make exercise a part of your daily routine.

For some people, some forms of physical activity might be unsafe or should only be started after talking with a doctor. If you have any concerns, talk to your doctor before starting any exercise or fitness program.

Here are a few tips if you're just starting out:

• To start, just walk more. Take the stairs instead of the elevator. Park farther away at the grocery store. Walk your dog for longer than usual.
• Then find times in your day when you can fit in a half hour of exercise. And find something that you enjoy doing. Make it fun and easy for yourself to do it, and you will be more likely to keep doing it.
• Work your way up to getting moderate to vigorous activity for at least 2½ hours a week. It's fine to be active in blocks of 10 minutes or more throughout your day and week.

Remember that getting more active is not a one-time thing. Activity is something to build into your daily life, for the rest of your life.

Here are a few tips for taking the next step.

• Go longer. If 20 minutes of activity a day feels good for a while, try for 30. Or 40. You can do this all at one time, or you can break it up into chunks. For example, get 15 minutes of activity in the morning before work, 10 more during your lunch hour, and 15 after work. Or break it into four 10-minute sessions.
• Go harder. Spending more time exercising is one way to increase activity. But it's not the only way. If you walk now, try walking faster, or walking on hills or stairs. Maybe even carry a couple of light weights while you walk. The extra energy you use for harder activity will increase your muscle mass and make you stronger.
• Try something new. Dust off that bicycle and go for a ride. Or try swimming. Going for a swim gives your body a great workout without any impact on your bones, joints, or feet. Add dancing to your routine, paddle a boat, or give yoga a try. Talk to your doctor about activities that might be right for you.

3. Lose weight if you need to

If you need to lose a few kilograms to reach a healthy weight, don't think you have to try a radical fad diet.

The best way to lose weight is to eat better and move more. Eating smaller portions of healthier food will make you feel better. And along with exercise or even light activity, eating better can help you lose extra kilograms if you have them.

Look back at the tips for healthy eating and staying active. Make these changes into a habit, and you'll be on your way to a healthy weight.

4. If you smoke, quit

Quitting smoking can help you raise your HDL. It's one of the best things you can do for your health. But it isn't easy. Here are a few tips for when you're ready to quit:

• Get ready. Set a date to quit. Pick a time when you won't have a lot of stress in your life. Before that date, get rid of ashtrays and lighters. And don't let people smoke in your home.
• Change your routine. For example, if you smoke after eating, take a walk instead.
• Use medicine. It can help with cravings and stress. Your doctor can prescribe medicine that can help you quit smoking.
• Try nicotine replacement products. You can buy nicotine gum, lozenges, or patches without a prescription. Using nicotine replacement products or medicine or both can double your chances of quitting smoking for good.