September is National Cholesterol Education Month with a goal of informing the public of the most common and misunderstood condition. All ages are susceptible to having high cholesterol, which is a major risk factor for heart disease, the #1 cause of death in the United States. So, it is vital to understand what cholesterol is and the steps you can take to prevent or lower high cholesterol levels.

Cholesterol is typically discussed in a negative light, but it is a necessary molecule for our bodies to function (specifically HDL cholesterol). Cholesterol is a fatty, waxy substance used to maintain the structure of cell membranes and in turn affects what molecules (i.e. nutrients, toxins) are allowed in or out of the cell. Some other important functions include regulating the salt/water balance, creating bile to aid digestion of fatty foods, and it is also a building block for many hormones in the steroid family. Steroid hormones help to regulate blood sugar levels, boost your immune system, and help you to cope with stress.

However, too much cholesterol (specifically LDL cholesterol) can lead to the formation of plaque, which can build up in arteries blocking blood flow and potentially break off into a clot. This can compromise your brain or heart and lead to a stroke or heart attack.

About 25% of your cholesterol levels come from the foods that you eat. The other 75% comes from your liver and other cells in your body. So, it is safe to say that genetics play a large role in what your cholesterol levels look like. However, this does not give you the ability to fully blame your genetics, although we all wish we could!

Currently, about 120 million Americans ages 20+ have cholesterol levels above the recommended healthy level of less than 170 mg/dL. This number is referred to as “total cholesterol” and takes into account your LDL cholesterol, HDL cholesterol, and triglyceride levels. Relating back to that 25%, it is important to understand which foods contain these molecules so you can alter your diet accordingly.

The first step is to determine and/or monitor your cholesterol levels. Medicare covers cholesterol screenings at 100% every 5 years. However, if you have a Medicare Supplement Plan, it will cover the full cost of the test if you need it more often. Depending on your levels, a doctor may prescribe medications that are likely covered under your Part D (prescription drug plan).

Exercise! Incorporating exercise of at least 30 minutes five times a week is also shown to reduce your risk of other conditions such as cardiovascular disease as it strengthens your heart. Implementing activities to increase your physical activity are an easy way to start. Simply taking the stairs or taking brisk morning walks around your neighborhood can make a big difference. Playing with your grandkids counts too!

Quit smoking or don’t pick up the habit. With almost 20% of all coronary heart disease deaths linked to smoking and multiple studies showing that current smokers have less good cholesterol, quitting the cigs are high on the list of priorities. Did you know that Medicare covers up to 8 visits in a 12-month period specifically for smoking and tobacco-use cessation counseling? Plus, if you quit smoking for more than 12 months you can qualify for lower premiums!

Maintain a healthy weight. Your weight is a key factor in your risk for a multitude of conditions. While losing weight is helpful in lowering your cholesterol levels, being thin does not decrease your risk for high cholesterol. So, make sure you also incorporate the other mentioned points!

The most important point is to eat heart-healthy foods! This includes low-fat, high-fiber, high-protein, and whole grain products. Make sure to reduce your intake of saturate and trans fats.

Whole Grains, Oats, and Barley…Oh my! Change out your sandwich bread or try some oatmeal for breakfast. Be careful not to add too much sugar to your oatmeal though or you will get an oatmeal cookie! Unfortunately, the sugar does more damage. Instead, try some fresh fruit for that sugary taste and fiber like apples, grapes, strawberries, or citrus fruits. Note to stay away from dried fruits as the fiber has already been broken down. Plus, the lack of water in the dried fruit means most of the sugars stay in your body instead of being flushed out.

With so many types and so many ways to cook them, you can never do wrong with beans. Beans are especially rich in fiber, which also make you feel fuller for longer! Eggplant and okra are also fantastic sources of soluble fiber.

Almonds, walnuts, peanuts, and other nuts are great as simple snack or as an addition to a salad. Just make sure to be grabbing the low-salt or no-salt packages!

Whey protein can easily be added into smoothies, cookies, pancakes, and even your morning coffee.

Fatty fish have high levels of omega-3 fatty acids, which help to reduce your triglyceride levels among other benefits for your body. The best fish to try are salmon, trout, tuna, herring, and mackerel! Stay away from breaded fish though. Instead, try using a walnut crust (walnuts also contain some omega-3!).

Avocados! Maybe it’s the millennial in me, but avocado toast (with whole grain bread) is one of my favorite breakfasts. A few slices of avocado added to your favorite sandwich or salad are another great way to lower LDL (bad) cholesterol levels.

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