Exercise and adopt a healthy diet. This age-old advice still holds true for those of us who need to improve our cholesterol profiles. In this Health Alert, Johns Hopkins nutritionists provide practical advice to help you achieve your cholesterol goals – even if you also take statin medication.

You hear it all the time: Watch your cholesterol. Elevated cholesterol levels, along with high blood pressure, smoking, and excess weight, increase your risk of coronary heart disease. But what exactly does watching your cholesterol entail?

It means lowering low-density lipoprotein (LDL) cholesterol, the type that narrows arteries, while striving to boost high-density lipoprotein (HDL) cholesterol ("good" cholesterol), which helps remove LDL cholesterol deposited in artery walls.

Total cholesterol levels should be less than 200 mg/dL, with LDL cholesterol as low as 70 mg/dL if you have coronary heart disease and as high as 160 mg/dL if you have no risk factors for coronary heart disease. Ideally, HDL cholesterol should be above 60 mg/dL or at least above 40 mg/dL in men and 50 mg/dL in women.

But to take the next step by making lifestyle changes to get your cholesterol levels in the right range, you need a game plan. That applies whether or not you've been prescribed a cholesterol-lowering medication.

Small Changes, Big Impact -- Try making gradual heart-healthy changes in your current diet. You're more likely to stick with your new eating plan if you start slowly:

• Add a vegetable serving to your lunch or dinner.
• Substitute a piece of fruit for cookies, cake, or ice cream as your dessert or snack.
• Drink low-fat or skim milk at lunch instead of soda.
• Cut back on meat portions by a half or a third at each meal. (Shoot to eat 3 oz, the size of a deck of cards.) Select only lean cuts; trim away fat; broil, roast, or boil (don't fry!); and remove skin from poultry.
• Eat one or two meatless meals a week.
• Choose whole-grain foods. (Look for the word "whole" instead of "unbleached" or "enriched" as part of the first ingredient listed in a product.)

In addition to dietary changes, experts recommend burning 1,500 calories a week with exercise to impact levels of cholesterol and especially triglycerides, which breaks down to about 20–30 minutes of daily moderate-intensity activity like walking, swimming, or cycling.

While lifestyle is important, oftentimes using a medication, like a statin, is the most effective way to reduce LDL cholesterol. Still, dietary changes can help ward off the need for drugs or help your medication work more effectively.