The ten commandments of cholesterol.

While there has been a proliferation of news and information about cholesterol in recent times, there still tends to be a great deal of confusion among the general public on the subject--especially pertaining to understanding the differences between HDL and LDL levels--or "good" and "bad" cholesterol.

A consortium of several of the nation's leading cardiologists, nutritionists and fitness experts have come together, pledging to educate patients and the general public about the scientific and medical facts pertaining to cholesterol. These clinicians' common goal is to bust some of the myths, clear up the confusion and present a list of standard, easy-to-follow, healthy practices that virtually everyone should consider.

"There's been a surprisingly large amount of misinformation going around regarding cholesterol," said cardiologist Sergio Sanchez-Zambrano, M.D. of Cleburne, Texas. "A crucial role we play as physicians is to educate our patients in particular and the population in general about cholesterol health. Once individuals have been educated about their diet, exercise and the discontinuation of risk factors such as smoking, then it is their responsibility to maintain such programs."

"I find it alarming how many of my clients, when I first consult with them, are unaware of their own LDL and HDL levels, and how those two numbers are significant," said Sports Nutritionist Nancy Clark, M.S., R.D. of Healthworks Fitness Center in Chestnut Hill, Massachusetts. "I believe it is absolutely urgent that we take a stand to educate the public. Simple lifestyle changes that anyone can make can ultimately save lives."

Those simple lifestyle changes are included in the "Ten Commandments of Cholesterol" that Sanchez-Zambrano, Clark, and their likeminded colleagues have compiled. The complete list is below.

The Commandments

By practicing the following basic health tips, you can help to balance the cholesterol levels in your blood and live a longer, healthier life.

1. Know the difference between the 'good' and the 'bad'

Cholesterol and other fats are carried in your blood stream in the form of special particles called lipoproteins. The two most commonly known lipoproteins are low-density lipoproteins (LDL) and high-density lipoproteins (HDL). "It's important to differentiate between these two forms of cholesterol," Cleburne, Texas-based cardiologist Sergio Sanchez-Zambrano, M.D. explains, "because one is harmful to your health and the other is actually good for you.

"LDL is the type of cholesterol commonly called the 'bad' cholesterol," Sanchez-Zambrano clarified, "and is a type of fat in the blood that contains the most cholesterol. It contributes to the formation of plaque buildup in the arteries, known as atherosclerosis.

Meanwhile, HDL is known as the 'good' cholesterol, and is a type of fat in the blood that actually helps to remove other cholesterol from the blood, preventing the fatty buildup and formation of plaque."

2. Trim the fat

Much of the cholesterol in your blood is created from all of the fats you eat. The first thing you should do is reduce the total amount of fat in your diet. Some ways of cutting the fat are:

* Switch to lower fat dairy products (such as skim, 1% or 2% milk).

* Use less butter, margarine, lard and cooking oils.

* Trim fat from meat before you cook it.

* Broil, bake, steam poach or boil meat, fish and poultry.

* Many salad dressings are high in fat. Use as little as possible.

* Use oils such as olive and sunflower, instead of saturated fats such as butter, lard or tropical oils.

By cutting back on fatty foods, you'll also lose body weight--and studies have shown that weight loss is another method of reducing cholesterol levels in the body.

3. Know that not all fats are created equal

A common myth surrounding high cholesterol levels is that only overweight and obese individuals suffer from the condition. "In this current age of low-carb, and sometimes high fat dieting," reports Los Angeles based registered dietician Alana Duffy, R.D. "It's important to note that while weight loss can help in reducing cholesterol, it is far from being the only determiner."

Duffy suggests that being smart about the types of fat you eat can make a world of difference. "Avoid saturated fats (the sorts of fats found in dairy products, red meat and tropical oils)," she says. "Try to choose polyunsaturated fats (such as safflower, sunflower and corn oil, nuts and some fish) and monounsaturated fats (canola, olive and peanut oil). Trans fats are now known to be just as bad as if not worse than saturated fat in terms of elevating cholesterol levels. Look for '0 trans fats' on labels. By 2006 all labels will have trans fat content documented. A basic rule of thumb is that man-made and animal made fats (trans and saturated) are bad fats. Most plant fats are good fats."

4. Fiber up

"Recent studies show that fiber helps lower cholesterol levels," reports Duffy. "Good sources of dietary fiber include legumes, whole grain cereals and breads, fruits and vegetables. It is now recommended that everyone consume at least five servings of fruits or vegetables daily. Natural supplements containing fiber are also worth exploring--they're typically side-effect free and will give your body the boost it needs in the fight against cholesterol."

5. Get physical

You don't have to be as active as Serena Williams to lower your cholesterol. In fact, just adding a small amount of additional physical activity to your regular routine can make a difference. "Being physically active for 30 to 60 minutes most days of the week, can help lower cholesterol levels," says Duffy. "It can also help boost the 'good' cholesterol--HDL or high density lipoprotein--that protects against heart disease and strokes. Studies have shown that even just twenty minutes of mild exercise three times a week can help raise your HDL count."

6. Explore healthy or natural alternatives

Work with your doctor to see if there are natural and/or healthy products you can utilize to supplement your diet to be certain your body is getting enough in its arsenal to combat cholesterol. Recent clinical data shows that supplementing a healthy diet with policosanol lowers "bad cholesterol" (LDL) levels by as much as 28.1%. Similarly, an FDA study conducted in 2000 demonstrated that phytosterols can also lower "bad" cholesterol by lowering lipid absorption of plasma. Also available on the market is Qwell, an over-the-counter liquid supplement that contains both policosanol and phytosterols as well as soluble fiber--more easily absorbable by the body due to the supplement's liquid consistency.

7. Make better choices at the supermarket

Like a basketball coach, Sports Nutritionist Nancy Clark, M.S., R.D. of Healthworks Fitness Center in Chestnut Hill, Massachusetts likes to tell her patients to "work the perimeter." "Spend more time in the aisles located along the wails of the supermarket," suggests Clark. "That's where you'll find most of the products included in the four basic food groups, such as fruits, vegetables and low fat dairy."

Generally speaking, experts agree that everyone should make wise decisions for a balanced diet that contains plenty of fiber. And don't limit yourself to practicing a well-balanced diet at home. When ordering at restaurants, let what you know about cholesterol help you make your ordering decisions.

8. Scrutinize the small print

Watch out for product labeling! "Low saturated fat" does not necessarily mean low-fat. Like. wise, Low Cholesterol or Cholesterol-Free does not mean the product is low in fat. A diet high in fat leads to cholesterol problems as well.

9. Don't smoke

By now we all know that smoking brings with it the risk of lung cancer and emphysema, among other health disorders and diseases. Add to the list of smoking side effects a heightened cholesterol count. Studies show that most people who quit smoking enjoy the benefit of a drop in cholesterol within a few months of quitting.

"Along with people who suffer from diabetes, hypertension and obesity, smokers make up a segment of the population that is most at risk for developing acute coronary events," says cardiologist Sergio Sanchez-Zambrano, M.D. of Cleburne, Texas. "Couple that with high cholesterol and it becomes crucial to make a lifestyle change."

10. Be in touch with your levels

Whether it's annual checkups with your physician or home cholesterol test kits, it's important to monitor or screen your cholesterol levels at least once a year--and certainly more frequently if you are suffering from high cholesterol.

The American Heart Association reports that high blood cholesterol is a significant risk factor for heart disease. Lowering blood cholesterol through increased physical activity, weight loss, smoking cessation, and proper diet lowers that risk. However, blood cholesterol is very specific to each individual and, for that reason, a full lipid profile is an important part of your medical history and valuable information for your physician to have.

In general, a total cholesterol level below 200 mg/dL is considered desirable.

An LDL level of less than 100 milligrams/per deciliter (mg/dL) is optimal, and an HDL of greater than 40 mg/dL helps lessen your risk for heart disease.

To learn more about controlling cholesterol, the clinicians involved in compiling the "Ten Commandments of Cholesterol" suggest an online visit to the American Heart Association's website at www.AmericanHeart.org. Also informative are the pages on cholesterol at the National Institute of Health's site at www nhlbi.nih.gov.