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Continued from last week.

This is the last of three columns discussing cholesterol as a health risk for cardiovascular disease. The first two columns discussed dietary changes to lower cholesterol. This week, I will discuss the other changes besides diet that can affect cholesterol levels.Watch your weight. If you weigh too much, your body stores more fat and cholesterol. To lose weight effectively, decrease the amount of fat and sugar in your diet and increase the grains, fruits and vegetables you eat. Of course, these eating guidelines are similar to the guidelines I discussed before to lower cholesterol. Isn't it nice that eating properly works directly to lower cholesterol, and also indirectly to lower cholesterol by lowering your weight?

The second major factor for weight loss - exercise - is also a factor in controlling cholesterol directly. A regular exercise program can help raise your HDL (the good cholesterol) as it helps you control your weight. Choose activities such as walking, jogging or swimming that involve the large muscle groups of the body in rhythmic, continuous movement and do those activities at least three times a week for a least a half hour. You should work hard enough to feel warm and sweaty, but not so hard that you can't carry on a conversation. Most people work too hard during the initial stages of an exercise program, so go slowly enough to enjoy the activity.

Reducing other heart risks. As mentioned in the initial column, high cholesterol is only one of many risk factors for heart disease. In fact, some of the risk factors such as a family history of heart disease, being male or getting older cannot be controlled at all. However, you can control other factors such as smoking, since smoking is known to lower your HDL and increase the risk of heart attack, stroke and cancer. High blood pressure can also be controlled through diet, weight loss and/or medication. Even diabetes and stress can be controlled to lower your risk.

It is important to visit your family doctor periodically to be sure that your cholesterol level - and your other risks for heart disease - are under control. Currently, researchers say that total cholesterol levels of less than 200 mg/dl are normal. Between 200 and 239 are considered borderline high, and anything over 240 is probably too high for heart safety. If your cholesterol level at the present time is desirable, you should probably have it checked every five years.

If borderline high or high, your doctor may ask you to have frequent tests until it is in the normal range. Once your cholesterol level has been lowered to a desirable level, you should have it rechecked every year. If your cholesterol level does not go down after several (three to six) months of diet, exercise and weight loss, your doctor may ask you to take cholesterol-lowering medication. Even if you take medication, your doctor will ask you to continue with your healthier lifestyle, which helps the medication work better. (Thanks to the Krames Communications publication, "You Can Control Your Cholesterol" for its timely information.)

Garth Fisher is director of the Human Performance Research Center at Brigham Young University.