How to Lower Cholesterol Without Statins

High blood cholesterol can affect anyone. It’s a serious condition

that increases the risk for heart disease, the number one killer of Americans—women and men. The higher your blood cholesterol level, the greater your risk.

Fortunately, if you have high blood cholesterol, there are steps you can take to lower it and protect your health. This booklet will show you how to take action by following the “TLC Program” for reducing high blood cholesterol. TLC stands for Therapeutic Lifestyle

Changes, a three-part program that uses diet, physical activity, and

weight management. Sometimes, drug treatment also is needed to

lower blood cholesterol enough. But even then, the TLC Program

should be followed.

The booklet has four main sections: It explains why cholesterol

matters and helps you find your heart disease risk; describes the

TLC Program; talks about a condition called the

metabolic syndrome that can also be treated

with TLC; and offers advice on how to

make heart healthy lifestyle changes.

Within the sections you’ll find tips on

such topics as how to: communicate

better with your doctor and other

health care professionals, read food

labels, make and stick with lifestyle

changes, plan heart healthy menus for the

whole family, and make heart healthy

choices when you eat out.

Anyone can develop high blood

cholesterol—everyone can take steps

to lower it.

Why Cholesterol Matters

2

Cholesterol is a waxy, fat-like substance found in the walls of cells

in all parts of the body, from the nervous system to the liver to the

heart. The body uses cholesterol to make hormones, bile acids,

vitamin D, and other substances.

The body makes all the cholesterol it needs. Cholesterol circulates

in the bloodstream but cannot travel by itself. As with oil and

water, cholesterol (which is fatty) and blood (which is watery) do

not mix. So cholesterol travels in packages called lipoproteins,

which have fat (lipid) inside and protein outside.

Two main kinds of lipoproteins carry cholesterol in the blood:

■ Low density lipoprotein, or LDL, which also is called the “bad”

cholesterol because it carries cholesterol to tissues, including the

arteries. Most of the cholesterol in the blood is the LDL form.

The higher the level of LDL cholesterol in the blood, the

greater your risk for heart disease.

■ High density lipoprotein, or HDL, which also is called the

“good” cholesterol because it takes cholesterol from tissues to

the liver, which removes it from the body. A low level of HDL

cholesterol increases your risk for heart disease.

If there is too much cholesterol in the blood, some of the excess can

become trapped in artery walls. Over time, this builds up and is

called plaque. The plaque can narrow vessels and make them less

flexible, a condition called atherosclerosis or “hardening of the

arteries.”

This process can happen to blood vessels anywhere in the body,

including those of the heart, which are called the coronary arteries.

If the coronary arteries become partly blocked by plaque, then the

blood may not be able to bring enough oxygen and nutrients to the

heart muscle. This can cause chest pain, or angina. Some cholesYour Guide to Lowering Your Cholesterol With Therapeutic Lifestyle Changes

terol-rich plaques are unstable—they have a thin covering and can

burst, releasing cholesterol and fat into the bloodstream. The

release can cause a blood clot to form over the plaque, blocking

blood flow through the artery—and causing a heart attack.

When atherosclerosis affects the coronary arteries, the condition is

called coronary heart disease or coronary artery disease. It is the

main type of heart disease and this booklet will refer to it simply as

heart disease.

Because high blood cholesterol affects the coronary arteries, it is

a major risk factor for heart disease. Risk factors are causes and

conditions that increase your chance of developing a disease.

Other major heart disease risk factors are given in Box 1.