If you don't have prexisting CVD, your numbers should be: total cholesterol: 45 mg/dL LDL cholesterol (the "bad" cholesterol): 35 mg/dL LDL cholesterol: < 100 mg/dL Current Guidelines: New Focus on Statins The ADA now recommends that all people with diabetes take the cholesterol lowering drugsstatinsin addition to lifestyle (2020). Our experts continually monitor the health and wellness space, and we update our articles when new information becomes available. Hypercholesterolemia is one of the major contributors to atherosclerosis and coronary heart disease in our society. You can make swaps such as using olive oil or avocado oil instead of butter. Your total cholesterol and HDL (good) cholesterol are among numerous factors your doctor can use to predict your lifetime or 10-year risk for a heart attack or Patients are classified in one of three categories of risk: (1) CHD and CHD equivalents, (2) two or more risk factors (further delineated by an FRS of 10 to 20 percent versus 10 percent or less), or (3) zero or one risk factor. Several drugs have specific effects on lipoprotein metabolism. (2020). The goal for non-HDL cholesterol is 30 mg/dl higher than the LDL target (< 130 mg/dl for diabetic subjects). (2013). However, evidence for a beneficial effect arising from the addition of niacin therapy to statin treatment was suggested by the HDL Atherosclerosis Treatment Study.22 In this trial, the effect of combination therapy with simvastatin and niacin compared with placebo on angiographic end points was evaluated in 160 (16% with diabetes) individuals with prior CHD and low HDL cholesterol levels. How much physical activity do adults need? In addition to modifying current strategies of risk assessment, the new guidelines stress the importance of an aggressive therapeutic approach in the management of hypercholesterolemia. There was no significant difference in the gender distribution of the study population. (n.d.). Cholesterol levels tend to rise as people get older, particularly after menopause. This article will use the terms men, women, or both to refer to sex assigned at birth. Work with your doctor to establish a personal A1C goal for you. Saturated and trans-unsaturated fatty acids should be avoided. Type 2 Diabetes and Cholesterol Goals. To establish that the product manufacturers addressed safety and efficacy standards, we: We do the research so you can find trusted products for your health and wellness. Although replacing saturated fats with a high-carbohydrate diet results in lower LDL levels, it has the adverse effect of raising triglycerides and lowering HDL. The ATP III guidelines have been expanded to recognize the importance of HDL levels by raising the threshold of low HDL cholesterol from less than 35 mg per dL (0.90 mmol per L) to less than 40 mg per dL (1.05 mmol per L). Men are generally at a higher risk than women for higher cholesterol. The recommended ranges for your cholesterol will vary based on age and gender. American Diabetes Association: Standards of medical care in diabetes (Position Statement). All values are in mg/dL (milligrams per deciliter) and are based on fasting measurements. (2018). We avoid using tertiary references. American Academy of Family Physicians. However, a womans risk goes up after she enters menopause. Sex and gender exist on spectrums. Reddy Kilim S, Chandala SR. A comparative study of lipid profile and oestradiol in pre- and post-menopausal women. For children within a normal weight range, weight loss is usually unnecessary. U.S. Department of Agriculture. Subgroup analyses of intervention trials using statins suggest that the relative cardiovascular benefit of statins is similar among diabetic and nondiabetic participants. Poor glycemic control has repeatedly been shown to be associated with an elevated risk of cardiovascular events. There is no quick fix for reducing cholesterol, but there are plenty of ways to reduce your cholesterol naturally. Integrated guidelines for cardiovascular health and risk reduction in children and adolescents: Summary report. The best way to start an exercise regimen is to find something you enjoy doing. Lipids Health Dis. Centers for Disease Control and Prevention. An improvement of cardiovascular risk factors by omega-3 polyunsaturated fatty acids. Read on to find out more about healthy cholesterol levels, and if a cholesterol level of 250 ml/dL is considered, Heart disease is a top cause of death in the U.S. RICHARD S. SAFEER, M.D., AND PRABHA S. UGALAT, M.P.H. PyoralaK,Pedersen TR, Kjekshus J, Faergeman O, Olsson AG, Thorgeirsson G: Cholesterol lowering with simvastatin improves prognosis of diabetic patients with coronary heart disease: a subgroup analysis of the Scandinavian Simvastatin Survival Study (4S). Benefits of modest weight loss in improving cardiovascular risk factors in overweight and obese individuals with type 2 diabetes. Why do healthy cholesterol levels vary by age? The ATP III recognizes the increasing number of studies correlating elevated triglyceride levels with increased coronary artery disease risk. For adults, 125-200 mg/dL total cholesterol is a normal range. This can be overwhelming for some kids and parents alike, especially if your child is more selective in their food choices. Emergency symptoms such as a stroke or heart attack may be the only indicator of damage from high cholesterol. Total cholesterol. Statin treatments and dosages In children with familial hypercholesterolemia: Meta-analysis. In addition, cyclophilins A, B, and C were significantly correlated with cardiovascular risk factors, but only cyclophilin B was associated with type 2 diabetes. Eating a high fiber diet, reducing saturated fat, losing weight, exercising, and quitting smoking are just some of the things within your control. The concept of CHD equivalent is introducedconditions requiring the same vigilance used in patients with coronary heart disease. A sedentary lifestyle has been associated with high cholesterol. Theyre also fairly straightforward and can be done at any age and within most abilities. J Clin Med Res. Since the release of the second set of guidelines in 1993, the significance of HDL cholesterol in the evolution of coronary artery disease has become more evident. The ATP III and the ADA indicate that in high-risk patients with HDL cholesterol levels < 40 mg/dl (< 50 mg/dl in women, according to the ADA), HDL cholesterol raising should be considered,although neither guideline defines a target level. For children (19 and younger), total cholesterol should be less than 170 mg/dL, LDL less than 110 mg/dL, and HDL greater than 45 mg/dL. Foods rich in saturated and trans-fat include high-fat meats, cured meats like bacon and sausage, skins of meat, fried foods, full-fat dairy, butter, cream, baked goods, and fast food. The relative benefit of atorvastatin was similar in individuals whose baseline LDL cholesterol was< 120 mg/dl and those with LDL cholesterol > 120 mg/dl. Get your children involved in the cooking process, too. Recent studies have shown that the identification and treatment of dyslipidemia in patients 65 years and older can decrease the risk of first and recurrent coronary events. While they lower LDL levels, they have no significant effect on HDL or triglyceride levels.14 Phytosterols can be found in many products, including margarine spreads. The ATP III suggests the addition of plant stanols (hydrogenated phytosterols) to the patient's diet when initial attempts to alter the diet have not resulted in reaching the LDL goal. Overall, 30-40% of patients with diabetes have triglyceride levels > 200 mg/dl, and 10% have triglycerides > 400 mg/dl.5 However, in the U.K. High cholesterol. In order to achieve a 30-40%LDL cholesterol lowering, at least a moderate dosage of statin (rosuvastatin 5-10 mg per day, atorvastatin 10-20 mg per day, simvastatin 20-40 mg per day,or pravastatin, lovastatin, or fluvastatin 40-80 mg per day) should be used. Preschoolers are encouraged to move throughout the day, while adults should aim for a minimum of moderate-to-intense aerobic activity 150 minutes per week and muscle training twice weekly. For most healthy adults (19 and older), your total cholesterol should be less than 200 mg/dL, your LDL less than 100 mg/dL, and your HDL greater than 40 mg/dL. In. Two major modalities for lowering the LDL level advocated by the ATP III are therapeutic lifestyle changes (TLC) and drug therapy. Children and adults will differ in the recommended number of fruits and vegetables that should be consumed daily. Although the study did not have enough power to identify differences in clinical end points, there were fewer cardiovascular events in the fenofibrate compared with the placebo group (18 vs. 23%). Barbie Cervoni MS, RD, CDCES, CDN, is a registered dietitian andcertified diabetes care and education specialist. This is particularly true when it comes to high cholesterol. The American Heart Association recommends that all adults have their cholesterol checked every 4 to 6 years, starting at age 20, which is when cholesterol levels can start to rise. In general, the higher the level, the higher your risk. Patients with diabetes were more likely to be women and to have less education. Dietary therapy remains the first line of treatment, with drug therapy reserved for use in patients at high risk for CHD or patients who do not respond to nonpharmacologic therapy. Cholesterol is an important substance in your body. Its very important to set your own target cholesterol levels with your doctor. But new medications can help lower cholesterol and improve heart health. CowieCC, Harris ML: Physical and metabolic characteristics of persons with diabetes. Making small changes can yield a big impact. This provides a more reliable indicator of heart health than looking at the total cholesterol or LDL figures. Modest weight loss of about 5%10% of body weight has been shown to improve lipids. How to Lower LDL Cholesterol With Lifestyle Changes, The Connection Between PCOS and Heart Disease, 4 Surprising Foods That Are Safe to Eat With High Cholesterol, 10 Causes of High Triglycerides in Diabetes. Our website services, content, and products are for informational purposes only. WebThe seventh report of the Joint National Committee on prevention, detection, evaluation, and treatment of high blood pressure (BP) recommends a systolic BP goal of <140 mm Hg in patients with hypertension and a more aggressive goal of <130 mm Hg in patients with diabetes mellitus or renal disease. The only study that has evaluated the effect of niacin monotherapy on cardiovascular events is the Coronary Drug Project,20published in 1975. What is considered high cholesterol? The ALLHAT officers and coordinators for the ALLHAT Collaborative Research Group: Major outcomes in moderately hypercholesterolemic, hypertensive patients randomized to pravastatin vs usual care: the Antihypertensive and Lipid-Lowering Treatment to prevet Heart Attack Trial (ALLHAT-LLT). Getting your cholesterol checked. PalumboPJ:Metformin: effects on cardiovascular risk factors in patients with non-insulin-dependent diabetes mellitus. Both the ADA and the ESC suggest people with type 2 diabetes should aim for a low-density lipoprotein-cholesterol (LDL-C) level of less than 100 mg/dL. Table 1. Both the NCEP and the ADA give achievement of the LDL cholesterol target first priority. Sample meal plan for high cholesterolBreakfast: 2 slices whole-wheat toast topped with 1/2 a mashed avocado, sprinkled with salt and pepperLunch: Tuna salad wrap: 3 oz. Snack: 2 graham crackers with 1 tablespoon peanut butterDinner: Grain bowl: 1.5 cups cooked quinoa, 1/2 cup chickpeas, 1.5 cups roasted broccoli, carrots, and red onion blend, olive oil and lemon juice to tasteMore items It helps make cells and performs other functions involving vitamins and hormones. High cholesterol facts. [Evidence level C, consensus/expert opinion]. When you have your cholesterol checked, your blood test should include your: A cholesterol test is recommended every 1 to 2 years for: Its recommended that younger adults get a cholesterol test every 5 years. Ratio of total cholesterol-to-HDL is taken by dividing the total cholesterol figure by the HDL figure. If lifestyle changes cannot keep your cholesterol levels at a healthy level, your healthcare professional may recommend medication. HDL is considered good cholesterol because it helps protect you from heart disease. Research shows that eating more yogurt can help lower your cholesterol, but be mindful of what type you're eating. Medical options for people with familial hypercholesterolemia. The presence of renal disease is a relative contraindication. American Heart Association. Some risk factors are within your control, while others are not: Children and adults benefit from getting regular exercise, maintaining a healthy weight, and eating a well-balanced diet that is rich in fiber. 2018;10(4):281-289. doi:10.14740/jocmr3362w. WebMajor Risk Factors (Exclusive of LDL Cholesterol) That Modify LDL Goals Note: in ATP III, diabetes is regarded as a CHD risk equivalent. How much physical activity do children need. (2018). This will vary based on factors like other medications you may be taking, your age, sex, and general health. Healthy cholesterol levels change with age because as we get older, cholesterol levels rise naturally. Therefore, lipid targets for individuals with diabetes are the same as those for individuals with established CHD.7The primary target is an LDL cholesterol < 100 mg/dl. In addition, cyclophilins A, B, and C were significantly correlated with cardiovascular risk factors, but only cyclophilin B was associated with type 2 diabetes. The AFCAPS/TexCAPS study correlated a 6 percent increase in HDL cholesterol levels with a reduction of first acute major coronary events in men and women with baseline average LDL cholesterol levels and below-average HDL cholesterol levels. 2018 AHA/ACC/AACVPR/AAPA/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA guideline on the management of blood cholesterol. But having too much of the bad type of cholesterol low-density lipoprotein (LDL) puts you at risk for having a heart attack or stroke. [Evidence level A, RCTs/meta-analyses]. Figures 1 and 2 outline FRS assessment for men and women, respectively.4, In the ATP II guidelines, risk categories were developed to separate patients with CHD (or its equivalent, such as abdominal aortic aneurysm, intermittent claudication, symptomatic carotid artery disease, etc.) WebPrimary aim of therapy is to reach LDL goal Intensify weight management Increase physical activity If triglycerides are >200 mg/dL after LDL goal is reached, set secondary goal for High glucose levels can WebWith type 2 diabetes, your body doesnt regulate or use glucose ( sugar) the way it should. Benefits of modest weight loss in improving cardiovascular risk factors in overweight and obese individuals with type 2 diabetes. Metabolic syndrome, or insulin resistance syndrome, is defined as a cluster of abnormalities that include obesity, hypertension, dyslipidemia, and type 2 diabetes; it is associated with insulin resistance and compensatory hyperinsulinemia.18 It is estimated that this syndrome affects 70 to 80 million Americans.19. The decision to start medication will also depend on your medical history, age, weight, and if you have any other risk factors for heart disease, including high blood pressure and diabetes. The higher your HDL level, the better. doi:10.1371/journal.pone.0112715, Wing RR, Lang W, Wadden TA, et al. (2020). Children should have their cholesterol checked at least once between the ages of 9 and 11 and again between 17 and 20 years The American Heart Association (AHA) recommends that adults reduce saturated fat to less than 6% of total calorie intake. That can lead to too-high levels of glucose in your blood. Coronary heart disease (CHD) is the leading cause of morbidity and mortality in the United States, accounting for approximately 500,000 deaths per year and an associated annual morbidity cost of more than $200 billion.1 In the past three decades, numerous clinical and epidemiologic studies have shown repeatedly that an elevated blood cholesterol level is one of the major modifiable risk factors associated with the development of CHD.2 In particular, these studies have demonstrated that low-density lipoprotein (LDL) cholesterol is the primary lipoprotein mediating atherosclerosis. ATP III continues to stress the importance of nonpharmacologic treatment but recognizes its limitations by reducing the trial of these modalities from six months to 12 weeks before considering the use of medications to assist in achieving recommended LDL goals. WebA normal A1C level is below 5.7%, a level of 5.7% to 6.4% indicates prediabetes, and a level of 6.5% or more indicates diabetes. Current guidelines recommend that all children have their cholesterol checked between ages 9 and 11 years, and then again between ages 17 and 21 years. Positive relationship between serum low-density lipoprotein cholesterol levels and visceral fat in a Chinese nondiabetic population, Benefits of modest weight loss in improving cardiovascular risk factors in overweight and obese individuals with type 2 diabetes. Most would argue that individuals with type 2 diabetes and another risk factor are at high risk of cardiovascular events. You can learn more about how we ensure our content is accurate and current by reading our. By Barbie Cervoni MS, RD, CDCES, CDN Take this short assessment quiz to determine if youre at risk for a heart attack. Copyright 2023 American Academy of Family Physicians. Three fourths of patients with diabetes die from heart diseaserelated illnesses compared with one half of the general population. WebFor good total cholesterol, the goal is less than 200 mg/dL (milligrams per deciliter). WebTotal cholesterol Heart disease, diabetes, or risk score more than 20%* I. The good news is that it is never too late to start eating well. This is why it's important to get your cholesterol levels checked. KashyapML,McGovern ME, Berra K, Guyton JR, Kwiterovich PO, Harper WL, Toth PD, Favrot LK, Kerzner B, Nash SD, Bays HE, Simmons PD. Cholesterol levels in children and adolescents. WebGale Academic OneFile includes Adherence to statin therapy and LDL cholesterol goal at by Elizabeth S. Parris, David B. Lawrence,. High Risk 2 or more risk factors and risk score 10-20% II. Cholesterol levels tend to rise with age, so the recommended ranges for your cholesterol will depend on your age. Adults who have a history of high cholesterol, heart disease, diabetes, or obesity need more frequent readings, as do all adults as they age. Cholesterol levels: What you need to know. The American Heart Association (AHA) states that diabetes often lowers HDL (good) cholesterol levels and raises triglycerides and LDL (bad) cholesterol levels. Both of these increase the risk for heart disease and stroke. An LDL cholesterol level under 100 milligrams/deciliter (mg/dL) is considered ideal. 100-129 mg/dL is close to ideal. It has been clearly shown that the addition of ezetimibe to a statin will lower LDL cholesterol to goal more often than statin monotherapy will.28 Bile acid sequestrants may also help to lower LDL cholesterol but should be used with caution because they have a triglyceride-raising effect in hypertriglyceridemic patients.29. The Food and Drug Administration has approved certain statins starting at age 8, but discussions with your physicians are warranted. Fibrates lower triglyceride levels more efficiently than do statins (Table 2) and might be preferred in individuals with significantly elevated triglycerides (e.g., > 300 mg/dl) and at-goal LDL cholesterol values. 2011;34(7):1481-1486. doi:10.2337/dc10-2415. For those with high cholesterol and other cardiac risk factors, such as diabetes, more frequent testing is recommended. How Much Cholesterol Should I Be Having Each Day to Be Healthy? Maria P. Solano, MD, is an assistant professor of medicine, and Ronald B. Goldberg, MD, is a professor of medicine in the Division of Diabetes,Endocrinology, and Metabolism, Diabetes Research Institute at the Miller School of Medicine of the University of Miami in Florida. Rubenfire M. (2018). The two major cholesterol-carrying lipoproteins are low-density lipoprotein (LDL) and high-density lipoprotein (HDL): Since your total cholesterol level is a combination of your LDL cholesterol and your HDL cholesterol, ideally you want to keep your LDL levels low and your HDL levels high. WebThe A1C goal for most adults with diabetes is between 7% and 8%, but your goal may be different depending on your age, other health conditions, medicines youre taking, and other factors. Recommended total cholesterol levels are under 200 milligrams per deciliter (mg/dL) for most adults and under 170 mg/dL for children. Healthline only shows you brands and products that we stand behind. Debra Rose Wilson, Ph.D., MSN, R.N., IBCLC, AHN-BC, CHT. The risk of recurrent nonfatal MI was reduced by 27% with niacin. Moreover, cyclophilin B is elevated in male patients with hypertension, type 2 diabetes, or high glucose levels. What are the warning signs of high cholesterol? MyPlate: Fruits. For some people, lifestyle changes can be enough to bring cholesterol levels into the healthy ra The defined goals In CARDS, 2,383 individuals (mean age 62 years, mean LDL cholesterol 118 mg/dl) with diabetes but no CVD and at least one risk factor, including hypertension, smoking, retinopathy, and micro- or macroalbuminuria, were randomized to atorvastatin 10 mg per day versus placebo. GoldbergRB,Mellies MJ, Sacks FM, Moye LA, Howard BV, Howard WJ, Davis BR, Cole TG,Pfeffer MA, Braunwald E: Cardiovascular events and their reduction with pravastatin in diabetic and glucose-intolerant myocardial infarction survivors with average cholesterol levels: sub-group analysis in the Cholesterol and Recurrent Events (CARE) trial. However, the available statins across the range of approved dosages have a good safety and tolerability record, with elevation of liver enzymes > 3 times the upper limit of normal reported in< 1.5% and clinically significant myopathy (creatine phosphokinase 10 times the upper limit of normal) in < 0.3% of participants in large clinical trials.26-27. This medication interferes with cholesterol production in your liver. Patients diagnosed with diabetes (N=998,790) between 2015 and 2019 were evaluated for CKD risk on the basis of achieving treatment goals. Treatment with gemfibrozil reduced the risk of CHD death, nonfatal myocardial infarction (MI), or confirmed stroke by 24% in both the diabetic and nondiabetic subsets. The NCEP and the ADA concur in reducing the intake of saturated and trans-saturated fatty acids to lower LDL cholesterol levels.7,23The NCEP ATP III recommends limiting the intake of saturated fat to < 7% of daily calories and limiting the intake of cholesterol to < 200 mg per day. What steps can you take to lower yourcholesterol? Patients diagnosed with diabetes (N=998,790) between 2015 and 2019 were evaluated for CKD risk on the basis of achieving treatment goals. Lifestyle change alone sufficient to lower cholesterol in male patient with moderately elevated cholesterol: A case report. The results of the analyses of the diabetic subgroups in the major statin intervention trials are shown in Table 1.10-17The strongest evidence for the beneficial effect of cholesterol lowering with statins in diabetic individuals with and without evidence of CVD and average cholesterol values comes from the Heart Protection Study(HPS)11 and the Collaborative Atorvastatin Diabetes Study(CARDS),10 the first statin trial conducted only in diabetic subjects. The good news is that lifestyle changes are reasonably effective in helping you reduce cholesterol levels. Children should have their cholesterol checked at least once between the ages of 9 and 11 and again between 17 and 20 years Cholesterol levels: What is a cholesterol test. Long-term safety and efficacy of a once-daily niacin/lovastatin formulation for patients with dyslipidemia. The strategy underlying the addition of a second or third agent is to optimize improvements in the lipid profile achieved by initial (usually statin) therapy. We avoid using tertiary references. Effects of aerobic exercise on lipids and lipoproteins. The National Institutes of Health recommends the following cholesterol levels based on your age and gender. When Should You Start Getting Your Cholesterol Levels Tested? If that fails to bring LDL levels below 100 mg/dL and there are other cardiovascular risk factors present, the addition of ezetimibe to statin therapy should be considered. In an effort to address this public health issue, the National Institutes of Health established the National Cholesterol Education Program in 1985. (n.d.). RubinsHB, Robins SJ, Collins D, Fye CL, Anderson JW, Elam MB, Faas FH, Linares E, Schaefer EJ,Schectman G, Wilt TJ, Wittes J: Gemfibrozil for the secondary prevention of coronary heart disease in men with low levels of high-density lipoprotein cholesterol. Plant based diets are associated with a lower risk of incident cardiovascular disease, cardiovascular disease mortality, and all-cause mortality in general population of middle aged adults. Patients with diabetes and patients with an FRS of 20 percent or higher are considered CHD equivalents. Benefits of LDL-lowering therapy initially should be monitored at six-week intervals. HDL cholesterol is the third lipid target, and HDL cholesterol-raising strategies may be considered in high-risk individuals with HDL cholesterol levels < 40 mg/dl. Begin by adding one serving of fruits or vegetables daily to children's meals. [Evidence level A, randomized controlled trials (RCTs)/meta-analyses] The Scandinavian Simvastatin Survival Study (4S), the Cholesterol and Recurrent Events (CARE) study, and the Air Force/Texas Coronary Atherosclerosis Prevention Study (AFCAPS/TexCAPS) were further analyzed for the population older than 65 years. The ATP III also recommends limiting the intake of carbohydrates to < 60% in individuals with elevated triglycerides and low HDL cholesterol levels. Click here to learn more. GoldbergRB,Kendall DM, Deeg MA, Buse JB, Zagar AJ, Pinaire JA, Tan MH, Khan MA, Perez AT,Jacober SJ: A comparison of lipid and glycemic effects of pioglitazone and rosiglitazone in type 2 diabetes patients and dyslipidemia. By clicking Accept All Cookies, you agree to the storing of cookies on your device to enhance site navigation, analyze site usage, and assist in our marketing efforts. Because of potential worsening of hyperglycemia with niacin, high doses of niacin (> 2,000 mg) should be used with care,and avoidance of niacin is prudent for individuals with poor glycemic control(i.e., hemoglobin A1c > 8%). However, there are as yet no controlled clinical trials comparing statin monotherapy with combination treatment. As reflected in ATP III, an additional step in the determination of CHD risk involves the calculation of the Framingham risk score (FRS) for persons with two or more risk factors. (2011). Getting your cholesterol checked. The goals of alternative treatment for heart disease are often to control cholesterol levels, lower blood pressure, and improve heart health. The establishment of diabetes as a CHD risk equivalent reflects the prevalence of heart disease as a cause of death in the diabetic population. Fenofibrate appears to have significantly fewer pharmacokinetic interactions with statins compared with gemfibrozil, a consideration to take into account when using fibrate-plus-statin combinations.33Additionally, in combination therapy, high-dose statins should be avoided to reduce the risk of myopathy. If a child has a family history of high cholesterol, heart disease, or is overweight or obese, their pediatrician may recommend getting checked sooner and more often. Once low-density lipoprotein cholesterol is at an accepted level, physicians are advised to address the metabolic syndrome and hypertriglyceridemia. Your cholesterol levels are affected by genetics, dietary choices, and lifestyle factors like: For some people, lifestyle changes can be enough to bring cholesterol levels into the healthy range, according to a 2019 study. 2023 Dotdash Media, Inc. All rights reserved, Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Maintain a healthy weight: Carrying too much weight in the abdomen can increase the risk of heart disease and is associated with increased LDL.