Heart disease is the number one killer of both men and women in the United States, despite the pervasive mis-belief that breast cancer kills more women. Women are advised to get their mammograms but not always told to get a thorough heart health examination.

A contributing factor to heart disease is elevated cholesterol. Do we really know what our cholesterol numbers are and what they mean? The typical medical doctor will check what's called a lipid profile (total cholesterol, triglycerides, HDL, LDL) but this test does not tell you the whole picture. To truly access our risk for heart attack and stroke we need to know the particle size and density of the particles that carry the cholesterol in our blood.

The Vertical Auto-Profile (VAP ™) test assesses subclasses of lipids that are known or emerging risk factors for cardiovascular disease. The more numerous the particles that carry cholesterol and the smaller and denser they are, the greater the risk for a heart attack or stroke. Over time these particles penetrate our arterial walls where they build up as plaque. Once a plaque ruptures a blood clot can form and depending on where it is in the body it will cause a heart attack or stroke.

Other important measures to have the doctor check are fibrinogen and homocysteine. Homocysteine ​​is an amino acid produced by the body and elevated levels have been linked to atherosclerosis and heart disease. Fibrinogen is a protein produced by the liver and high levels that can lead to heart attack and stroke.

Armed with this information from a VAP test, doctors and nutritionists can help us make changes to our diet and lifestyle, using medicine, exercise and supplements. Most forms of heart disease can be reversed with these measures. Dietary changes may include adding omega 3 fatty acids from fish, high fiber foods and limiting refined carbohydrates and alcohol.

Dietary changes to reduce cholesterol need to include reducing or eliminating saturated fats (red meat, french fries, cheese) but also must address too much sugar in the diet. Most people do not realize that sugars get stored in the body as fat, in the form of triglycerides. Since all carbohydrates convert to sugars in the body we must also watch the amount of carbohydrates we consume. Foods that can help support healthy levels of cholesterol include high fiber foods. Getting sufficient fiber is important as fiber helps prevent the re-absorption of cholesterol. Good sources of fiber include leafy green vegetables, beans, lentils, apples, and oatmeal. Omega 3 fatty acids found in fish or taken in high quality supplement form are also beneficial as they help to keep LDL particles (unhealthy cholesterol) large and buoyant, so they can not penetrate the arterial wall and build-up as plaque.

A lifestyle change that can make a difference in cholesterol levels, especially supporting levels of HDL, known as our healthy cholesterol, is exercise. Cardiovascular exercise such as walking, biking, running and swimming four to five days a week is supportive of healthy cholesterol levels.

Is all of this overwhelming, it does not have to be. Work with a qualified cardiologist and health coach who can support you in making small changes over time that will make a lifesaving difference. Rethink heart health so that a long healthy life is a reality.