You are probably aware that managing your cholesterol is an important part of preventing heart disease. But do you actually know how to manage your cholesterol or understand what the cholesterol numbers mean? If your answer is no, don't worry, you're not alone. The highly regarded National Heart, Lung and Blood Institute and its National Cholesterol Education Program (NCEP) have developed guidelines on cholesterol testing and management. Listed below are some important points from these guidelines. For complete details visit the National Heart Lung National Heart Lung and Blood Institute Cholesterol Guidelines.

At what age should I have my cholesterol tested and how often?

All adults aged 20 years or older should be tested at least once every five years.

What tests should I have performed?

The guidelines recommend that your physician order a fasting lipoprotein profile which includes total cholesterol, LDL (bad) cholesterol, HDL (good) cholesterol and triglyceride (fat) test. The best test is one in which you fast for nine to 12 hours before the blood is drawn.

What do the numbers in the test results mean?

When you go to your doctor's appointment to review the results, we recommend you take this chart. It will help you understand your numbers.

Blood Level (mg/dl)	Classification
Total Cholesterol
Less than 200	Desirable
200-239	Borderline High
240 or more	High
LDL (Bad) Cholesterol
Less than 100	Optimal
100-129	Near Optimal/Above Optimal
130 or 159	Borderline High
160 or 189	High
190 or more	Very High
HDL (Good) Cholesterol
Less than 40	Low
40-59	High
60 or more	Optimal
Triglycerides
Less than 150	Acceptable
150 - 199	Borderline High

What can I do to get started helping my heart before I am even tested?

You can work to prevent coronary heart disease by changing your lifestyle. Here are some of the changes the guidelines recommend.

• Reduce your consumption of saturated fat, trans fat, and cholesterol
• Become more physically active
• Control your weight
• Increase your physical activity to at least 30 minutes per day

How should I change my diet to reduce cholesterol and the risk of heart disease?

The guidelines recommend the following changes in your diet to help lower your blood fat numbers:

• Cut saturated fat to less than 7% of your total calories. Trans fatty acids are another fat that raises bad cholesterol so limit those as well. Total fat should be only 25%-35% of your total calories
• Carbohydrates (from grains, especially whole grains, fruits, and vegetables) should make up 50% to 60% of total calories.
• Eat foods rich in fiber.
• Limit protein to about 15% of total calories
• Reduce your cholesterol with heart healthy recipes from our Cooking & Recipes section.

What do the guidelines say about physical activity?

A lot! We need to balance our energy intake with our energy uses to maintain a healthy body weight and prevent weight gains. Increased physical activity is a key ingredient to minimizing risks to the heart. Shoot for being active every day for at least 30 minutes. You do not need to pursue vigorous exercise. You can walk, bike or jog your way to health. Click here for information on starting an exercise program or other fitness ideas. Be sure to consult your physician before starting any exercise program.

Sources JAMA, May 16, 2001-Vol. 285, No. 19 National Heart Lungs and Blood Institute Cholesterol Guidelines