Janet Bond Brill - Cholesterol down: ten simple steps to lower your cholesterol in four weeks, without prescription drugs

By Jennifer H. Mieres, M.D., F.A.C.C., F.A.H.A.

Despite tremendous advances in the management and treatment of cardiovascular disease, it remains the leading killer of American men and women. This is at least in part due to the fact that Americans continue to make unhealthy lifestyle choices, particularly when it comes to diet and exercise.

Clinical research over the last two decades has provided overwhelming evidence that lifestyle and dietary factors influence risk of coronary heart disease (CHD)both favorably and unfavorably. Specifically, the Lifestyle Heart Trial published in JAMA in 1998 was the first scientific study to demonstrate the powerful, positive impact of lifestyle changes such as diet, exercise, stress reduction, and smoking cessation on coronary heart disease. Consequently, making the right changes in your diet and lifestyle can significantly lower your risk of heart disease.

Being obese, consuming too much saturated fat, and having high cholesterol are three leading factors that contribute to the progression of atherosclerosis, which is the process of fatty cholesterol-filled plaque accumulating in the lining of the arteries. In particular, elevated levels of cholesterol have been directly linked to plaque buildup in the arteries that supply nutrients to the heart and brain, making high cholesterol a potent risk factor for all cardiovascular diseases, including heart attack and stroke. The data from the landmark Framingham Study and the Multiple Risk Factor Intervention Trial Research Group established beyond a shadow of a doubt that LDL cholesterol is the real culprit when it comes to plaque buildup in the arteries. By taking aggressive measures to lower your LDL level, you can reduce your risk for heart disease and strokemaybe even save your life.

In 2002 the National Cholesterol Education Program, an initiative of the federal government, published the Adult Treatment Panel III (ATP III), which clearly states that significantly reducing LDL cholesterol can halt the progression of atherosclerosis, or plaque buildup in the arteries, to prevent deaths from heart disease and stroke. The guidelines given by ATP III provide scientific rationale and appropriate treatment recommendations for clinical cholesterol management, including both dietary changes and statin therapy, depending on a patient's category of risk.

The 1994 landmark Scandinavian Simvastatin Survival Study (4S), a trial of cholesterol lowering in 4,444 patients with coronary heart disease, clearly demonstrated the positive impact of simvastatin (a lipid-lowering statin drug) on reducing deaths from heart disease. According to this study, a mean reduction of cholesterol by 25 percent with the use of a statin was associated with as much as a 46 percent reduction in deaths and heart attacks from coronary heart disease. There is no question that the introduction of lipid-lowering medications, specifically the statins, has significantly increased our treatment strategies for hypercholesterolemia (elevated levels of the soft, waxy fat cholesterol in the blood) and has clearly resulted in fewer deaths from all cardiovascular diseases. However, many people remain fearful of the side effects, averse to the idea of taking prescription medications, or unable to get their LDL cholesterol to the recommended level on drugs alone. For these people, Dr. Brill's Cholesterol Down Plan provides an effective alternative treatment to cholesterol-lowering prescription drugs. In some cases where changes in diet and lifestyle may not be sufficient in lowering LDL cholesterol to recommended levels, lipid-lowering therapy (e.g., statins) may be prescribed as adjunct treatment.

By leading a heart-healthy lifestyle in terms of diet and exercise, one can lower the risk of heart disease by as much as 82 percent. The American Heart Association's recent secondary prevention guidelines published in May 2006 state that intensively managing risk factorssuch as high cholesterolenhances survival, reduces recurrent events and the need for cardiovascular interventional procedures, and improves the quality of life for those with coronary heart disease. As per the American Heart Association, choosing fiber-rich carbohydrate sources may foster additional cholesterol lowering and other nutritional benefits beyond those derived from fat modification alone.

The American Heart Association's Cholesterol Low Down Program (www.americanheart.org) highlights the following key features to reduce cholesterol levels.

1. Follow a diet low in saturated fat and cholesterol.