High blood cholesterol itself does not cause symptoms, so many people are unaware that their cholesterol is high and putting them at risk for heart disease.

High blood cholesterol is a major risk factor for heart disease. Nearly 1 in 2 Americans have high or borderline-high cholesterol levels, according to the American Heart Association.

High blood cholesterol itself does not cause symptoms, so many people are unaware that their cholesterol is high and putting them at risk for heart disease.

What is cholesterol? Cholesterol is a waxy, fat-like substance found in our blood and in all cells of our body. Cholesterol is needed to make necessary hormones, use vitamin D and make the bile acids that help with digestion.

Why is my cholesterol number important? Over time, cholesterol can build up and cause hardening of the arteries. This can block blood flow, causing lack of oxygen to the heart. The higher the blood cholesterol level, the greater the risk for developing heart disease or having a heart attack.

Where do we get cholesterol? Our liver makes all the cholesterol we need. But we also get cholesterol from food. Cholesterol is found only in animal products, including meat, dairy, eggs and shellfish. It is still unclear how the cholesterol that we eat affects our blood cholesterol levels. The American College of Cardiology concluded in 2013 that there was not enough evidence to make a recommendation regarding dietary cholesterol for treatment of high levels of LDL cholesterol. Further research is needed to understand the effects of dietary cholesterol on heart disease.

What do my cholesterol numbers mean? Everyone over the age of 20 should have their cholesterol checked at least every five years. This test is most accurate when done after you have been fasting for 12 hours or so. A lipid panel will consist of a total cholesterol, HDL cholesterol, LDL cholesterol and triglycerides. Your total cholesterol should be less than 200. HDL cholesterol helps keep cholesterol from building up in your blood. The higher this number is, the lower your risk for heart disease. A level less than 40 is considered a risk factor for developing heart disease. LDL cholesterol, on the other hand, is the main source of cholesterol buildup and blockage of the arteries. You want this number to be low — less than 100 is optimal. Triglycerides are not cholesterol but another form of fat found in the blood that can raise heart disease risk. Levels less than 150 are desired.

What affects my cholesterol level? Some risk factors for high cholesterol can’t be controlled. For example, high cholesterol sometimes runs in families, so you may have an inherited tendency towards high cholesterol. Also, cholesterol levels tend to increase with age, especially in post-menopausal women. But other risk factors are tied to factors you can control, such as your diet and activity level.

How can I lower my cholesterol? Increasing your activity can help lower your cholesterol. Losing weight will help lower your LDL cholesterol and triglycerides and improve your HDL cholesterol levels. Aim for a waist measurement of less than 40 inches for men and less than 35 inches for women. There are several types of drugs available for lowering cholesterol, including statins, bile acid sequestrants, nicotinic acids, fibric acids and cholesterol absorption inhibitors. Your doctor can help decide which type of drug is best for you.

But even if you begin drug treatment to lower your cholesterol, it is important to make some lifestyle changes as well. Following are the top diet recommendations for lowering cholesterol.

Eat less saturated fat. Many foods that are high in saturated fat are also high in cholesterol. Although the effect of cholesterol in our diet is unclear, we do know that a diet high in saturated fat has a direct negative impact on our cardiovascular health. The main sources of saturated fat include fatty meats, full-fat dairy and processed foods.

Include plenty of soluble fiber in your diet. This type of fiber helps move cholesterol out of your body. Good options include beans, oatmeal, fruits and vegetables.

Add more omega 3 fats, which are anti-inflammatory. Try to eat fish twice a week, and include some plant sources of omega 3, such as flaxseed and nuts.

Use healthy fats. Lard, butter and coconut oil all contain harmful saturated fats so use them sparingly. Choose liquid oils such as olive oil or canola oil for the majority of your fat.

Limit alcohol consumption and intake of simple sugars, such as candy, sugar-sweetened beverages and desserts, especially if your triglycerides are too high.

Exercise at least 30 minutes daily to help with weight control and improve HDL cholesterol.

Take time to get your cholesterol levels checked if it’s been longer than five years. Making even small changes to your diet and lifestyle can have a big impact on your health later on.