I second (and third!) what is being said about diet not necessarily doing the trick. I have borderline high cholesterol and for the past 3 months have been eating a very low fat, low cholesterol diet. Tons of veggies, lean white meats and fish instead of red meat, etc. Last week I went for my physical and was excited to see my numbers go down. Well, such wasn't the case. My overall # went up, LDL went up a little, HDL went down. I was disappointed. I suspect that my issue has to do with genetics and now I'm waiting for a followup with my doc about this.
It is great that you are committed to making diet and fitness changes to try and improve your lipid profile in the hopes that you can avoid medication. It is important to know your entire profile and work to improve each aspect and not simply to focus on the total cholesterol number alone.
It has been shown that a low fat/low cholesterol diet may not be the best way to lower cholesterol. There are other effective ways to use diet to lower cholesterol.
There is also now a much better understanding of cholesterol and that there are different types of cholesterol, including more than one type of LDL. More important than the overall cholesterol level is the ratio between HDL/LDL and triglycerides. Low fat diets do not help to improve the overall lipid profile.
When I followed the low fat diet my overall cholesterol was high, high LDL especially. When I stopped eating starches my LDL decreased and my overall lipid profile improved.
Unfortunately, eating a low fat/low cholesterol diet may not lower your cholesterol levels any. If your high levels are genetic, you will most likely need medication. My body makes its own cholesterol so the strict low fat/ low cholesterol diet only lowered my levels from 324 to 299. I now take Lipitor. (At first he had me on 20 mg a day and I got leg cramps. We lowered the dosage to 10 mg and I've had no problems since.) My levels went down to around 190-210 at that point. After starting sparking and exercising, my last levels were 166. I am now taking my meds only every other day.
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I admire that you want to lower your cholesterol through lifestyle changes instead of meds however, according to your tracker, you have already lost 37 pounds (way to go, by the way!) . . . has that loss had a positive effect on your cholesterol? If not, your doctor might have recommended meds because it SHOULD have and since it didn't, your high cholesterol might be mostly due to genetic factors instead of lifestyle choices. I'd talk to the doctor again at the very least to get a referral to a registered dietitian but also to discuss the issue of the meds. If your doctor has a reason to think it might not be possible for you to improve your numbers with exercise and diet, he/she should tell you so you can make an informed decision.
The doctor didn't give you any guidelines? Well, there are different schools of thought on this. There is strict low fat/high carb diets, there are low carb diets, there is 'clean' eating, etc.
What type of eating style do you have now? If you consume a lot of sugars, cutting those back will help reduce triglycerides. Eating healthy fats will help increase HDL (the good kind). This is a blog by a cardiologist, he has a lot of interesting information about cholesterol, statins, etc. I gather from reading his posts that he prefers diet over drugs for his patients.
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