Ranking diet and exercise to manage high cholesterol

Dr. Robert Kelly (photo) is associate director and curriculum coordinator for the Fairview Hospital /Cleveland Clinic Family Medicine Residency Program.

He lists aspects of diet and exercise that are most and less effective in controlling cholesterol.

Most beneficial

• Reduce intake of saturated and trans fats.
• Increase intake of polyunsaturated and monounsaturated fats.
• Fortify foods with plant stanols or sterols.
• Add tree nuts to the diet, while maintaining total caloric intake.
• Consume 1 or 2 alcoholic drinks per day.
• Adopt a Mediterranean, low-carbohydrate, or low-fat diet.

Smaller benefit but still effective

• Reduce the intake of dietary cholesterol.
• Increase intake of soluble fiber and soy protein.
• Eat fatty marine fish or take marine-derived omega-3 fatty acid supplements.
• Red yeast rice supplements have effects similar to those of statin medications and are better tolerated in some patients.
• Regular aerobic exercise has beneficial effects on lipid levels, particularly if performed for at least 120 minutes per week.

Small effect

• Brief physician counseling.

The bottom line.

Efforts should concentrate on patients who are motivated and ready to make lifestyle changes.

5/15/10 12:00 JR