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Question: I have borderline high cholesterol. I don't need medications yet, but I'm afraid I will later. Is it enough just to avoid certain foods?
C.B., Long Island, New York

Answer: First of all, you're right to restrict your intake of foods that are high in cholesterol. You also need to limit your consumption of foods high in saturated fats (animal products) and trans fats (stick margarines, some baked goods such as doughnuts and cookies). These foods actually affect blood-cholesterol levels to a greater degree, according to Dr. Roger Blumenthal, director of the Johns Hopkins Ciccarone Center for the Prevention of Heart Disease.

The American Heart Association (AHA) recommends that most adults consume less than 300 milligrams of cholesterol a day. Those at high risk for heart disease should take in less than 200 milligrams.

In addition, consumption of saturated fats and trans fats should not exceed 10 percent of total calories for healthy people and needs to be less than 7 percent for those with heart disease. Making the following dietary choices can help you achieve this.

Budget fat and cholesterol. If you make healthy choices most of the time, you're less likely to exceed your total fat and saturated-fat intake, and you can still enjoy some of your favorite fatty foods on occasion.

Reduce overall fat intake. One way to do so is by cutting back on fats in cooking. Instead, add flavor to your food by using herbs and spices.

Include less meat in your diet. If you eat meat, choose leaner cuts over fatty ones, as well as low-fat dairy products.

Limit eggs to one a day. Each whole egg has about 213 milligrams of cholesterol. For many people, one egg a day is fine. However, you shouldn't eat much else with cholesterol in it that day. (Egg substitutes and egg whites are good alternatives.)

Use AHA-specified margarines. Instead of using butter, which is high in saturated fat and cholesterol, or solid margarine, which contains trans fats, the AHA recommends you use soft, tub-packaged or liquid margarine. Olive oil and canola oil are even better choices.

Reduce your intake of trans fats. To do this, limit foods made from partially hydrogenated vegetable oils, which are often used in cakes, cookies, pies and crackers.

Get plenty of soluble fiber. It has been shown to help decrease bad LDL levels. Eat oat bran (in bread, cereal and oatmeal) and naturally fibrous foods such as fruits, vegetables and legumes.

Question. I keep hearing reports about how healthy the Mediterranean diet is. I know it includes a lot of olive oil. Is that one of the reasons?
A.O., Tarpon Springs, Florida

Answer:That's certainly a big reason. For centuries, the people living in regions around the Mediterranean Sea have, indeed, recognized the nutritional, cosmetic and medicinal benefits of olive oil.

Now recent research has provided additional proof that a Mediterranean diet, which includes olive oil on a nearly daily basis, is healthy because it has shown that consuming olive oil can actually help lower bad LDL cholesterol and raise good HDL cholesterol. Olive oil, a monounsaturated fat, is rich in vitamins A, B1, B2, C, D, E and K, as well as iron.

Among the health benefits associated with olive oil: It can dissolve clots in capillaries, discouraging artery clogging and chronic diseases (including cancer); it has been found to lower the degree of absorption of edible fats; and it is cholesterol-free.

The antioxidants found in the oil--such as vitamins E and K and polyphenols--are widely believed to provide a defense mechanism that delays the aging process.

In addition, olive oil promotes bone mineralization, which is good for older adults who have bone-calcification problems. And if all this isn't enough, olive oil also has beneficial effects on brain and nervous system development (as well as on overall growth of bodily cells), helps in the healing of tissues, and shields the body against infection.

Reginald B. Cherry, M.D., has been practicing diagnostic and preventive medicine for almost 40 years and specializes in the use of nutrition, exercise and natural supplements to lower disease risk. He is the author of several best-selling books.

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