These are the measures that have been found to work, based on randomized, controlled clinical trials, the gold standard of clinical research.
* Alcohol: Consuming one or two drinks a day can lower LDLs by 4mg to 10mg. Red wine is considered most effective. For those who cannot drink alcohol, purple grape juice may be a reasonable, albeit less effective, substitute.
* Exercise: Aerobic exercise, like brisk walking, jogging, cycling and lap swimming, can reduce LDLs by 3mg to 16mg and raise the good HDLs. Consistency is important. Aerobic activities should be performed at least five times a week for maximum benefit.
* Weight loss: When achieved through diet and exercise, weight loss can reduce LDL levels by as much as 42mg. When achieved through drug therapy, weight loss has been associated with an LDL drop of 10 to 31mg.
* Yoga and tai chi: These forms of exercise, which are accessible to just about everyone who can walk, even the elderly, have reduced LDLs by 20mg to 26mg when done for 12 to 14 weeks.
THE RIGHT STUFF
About 85 percent of the cholesterol in your blood is made in your body. The remaining 15 percent comes from food. But by reducing dietary sources of saturated fats and cholesterol and increasing consumption of cholesterol-fighting foods and drink, you can usually lower the amount of harmful cholesterol in your blood. My college roommate, for example, recently adopted a mostly vegetarian-and-fish diet, minus cheese but with occasional meat and chicken, and lowered her total cholesterol from 240mg to 160mg.
There are exceptions, of course, and I happen to be one of them. Still, I intend to continue to follow a heart-healthy diet, because that will enhance the effectiveness of the medication I'm taking.
Start by switching to low-fat and nonfat dairy products, like skim milk and, if you can stand it, fat-free cheese. Substitute sorbet, sherbet or fruit ices for ice cream, or choose ice milk or ice cream with half the fat.
For protein, choose fish and shellfish, poultry without the skin and lean meats, all prepared with low-fat recipes. Eat more dried beans and peas (cooked, of course), soy products like tofu, and nuts like walnuts and almonds. Grains should be mostly or entirely whole - 100 percent whole wheat bread and cereals made from whole wheat or oats, brown rice, bulgur and the like. Oats and oatmeal are rich in soluble fiber, which lowers cholesterol.
Pile on the vegetables and fruits. Especially helpful are those high in fiber like Brussels sprouts, cabbage, spinach, carrots, blueberries, oranges and apples.
Cook with canola or olive oil, and use margarine made from plant stanols.
And enjoy a glass of wine with dinner.
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