1. Section Editor(s): Mosocco, Doris J. RN, BSN, CHCE, COSC

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Maintaining a healthy cholesterol level is one of the most powerful steps you can take to guard yourself against heart attack and stroke. Your body needs some cholesterol. This soft, waxy substance is used by the body to build cell walls everywhere, including inside your brain, nerves, muscles, skin, liver, intestines, and heart. Cholesterol is also used to produce hormones and to make the bile acids that help to aid in the digestion of food. We get into trouble when there is too much bad cholesterol, low-density lipoproteins (LDL), and not enough of the good stuff, high-density lipoproteins (HDL), in the body. Age, gender, and genes can affect your cholesterol levels, but you have the power to control the raising or lowering of cholesterol. How, you might ask? The National Heart, Lung, and Blood Institute (NHLBI) of the NIH has a new guide to help you lower your cholesterol.


The booklet is titled Your Guide to Lowering Your Cholesterol with Therapeutic Lifestyle Changes (TLC). The 80-page, easy-to-read booklet is based on the National Cholesterol Education Program guidelines on cholesterol management. The guidelines emphasize the importance of TLC. Intensive use of heart-healthy eating, physical activity, and weight control is included in the program. The booklet has four main sections and explains why cholesterol matters and includes tips on communicating with your doctor. (NHLBI, n.d. [a])


"Lifestyle is crucial for lowering cholesterol, but it's not enough to tell people it's important, you have to help them do it. This guide offers a set of tools to help people get started and to embrace a heart-healthier way of living," said NHLBI's James Cleeman, MD, coordinator of the National Cholesterol Education Program. "TLC is more than a diet. It's really a change in your way of living to help you stay heart healthy," said Dr. Cleeman (NHLBI, n.d. [b]).


If you weigh more than you should, slimming down may produce a significant drop in your cholesterol level. Research suggests that being overweight disrupts the normal metabolism of dietary fat. So even though you may be eating less fat, you may not see a difference in your cholesterol profile until you lose those extra pounds. To assist in losing those extra pounds, the guide includes calorie-cutting strategies, ideas for substituting lower-calorie foods for high-calorie favorites, and a handy chart of portion sizes based on NHLBI's Portion Distortion Interactive Quiz ( There are also sample menus for TLC at different calorie levels.


The booklet is available on the NIH Web site at The price for one copy of the booklet is $4.00. It is also available free of charge in PDF format at the same address.


The NIH also has other guides, including Your Guide to Lowering Your Blood Pressure with DASH; Your Guide to a Healthy Heart; Your Guide to Physical Activity and Your Heart; Your Guide to Living Well With Heart Disease; and Your Guide to Healthy Sleep. These are all available at a minimal cost or free in PDF format.


Additional Resources Available:


What Is High Blood Cholesterol? Available at:


High Blood Cholesterol, What You Need to Know. Available at:


Live Healthier/Live Longer. Available at:




National Heart, Lung, and Blood Institute. (n.d. [a]). Your guide to lowering cholesterol with therapeutic lifestyle changes (TLC). Retrieved August 23, 2006 from


National Heart, Lung, and Blood Institute. (n.d. [b]). A little TLC goes a long way toward reducing high cholesterol. Retrieved August 23, 2006 from U.S. Department of Health & Human Services/National Institutes of Health/NIH News.