Q: I'm a middle aged man in generally good health, but during my recent routine physical, my doctor informed me that my cholesterol levels are above normal. I would prefer to not use medication to control this if I don't have to. Are there ways for me to lower my cholesterol naturally without the use of drugs?

A: First of all, I would like to congratulate you on being proactive with your health. By getting evaluated by your physician and assessing your risk factors, you have already taken the first step in preventing cardiovascular disease-which also includes heart disease and stroke-and is far and away the leading cause of death and disability in American men and women (killing as many people each year as all forms of cancers, lung disease, diabetes and accidents combined).

LDL cholesterol is the most established risk factor for CVD, so your doctor has discussed with you your personal LDL cholesterol goal. This really depends on your risk status: the higher your risk, the lower your goal. According to the American Heart Association, the "optimal" goal for LDL cholesterol-for the prevention of heart disease-is less than 100 mg/dL. An LDL of between 100 and 129 mg/dL is defined as "near or above optimal."

Since you indicate that your cholesterol levels are "above normal," I assume that your physician has told you that your LDL level is too high. So, if your LDL cholesterol is too high, what should you do? Because lifestyle changes (diet and exercise) remain the foundation for cardiovascular disease prevention and cholesterol control, the answer to your excellent question is to focus on both diet and exercise to lower your LDL cholesterol level before you resort to prescription medication.

The good news is that high cholesterol can often be prevented or effectively treated with proper lifestyle management. In fact, recent scientific research has proven that the "complementary" effects of the combination of several simple dietary and lifestyle manipulations can be as effective as statin medications (drugs used to prevent heart disease) in lowering LDL. For example, if you eat a handful of almonds, two servings of plant sterols, and a bowl of oatmeal each day, along with taking a 30 minute walk, you can make a huge dent in your LDL cholesterol level-without the use of medication. This is due to the fact that individually, each one of these factors is proven to lower cholesterol, but when combined, they have an additive LDL-lowering effect. Good luck!

A leading diet, nutrition, fitness author and national TV spokeswoman, Janet Bond Brill, Ph.D., R.D., LDN holds master's degrees in both nutrition and exercise physiology and a doctorate in exercise physiology. She is also registered dietitian and certified by the American College of Sports Medicine, National Strength and Conditioning Association, and Wellcoaches, Inc. An expert in the field of health, wellness and cardiovascular disease prevention, Dr. Brill has been published in noted scientific journals including the International Journal of Sport Nutrition, the International Journal of Obesity and the ACSM Health & Fitness Journal.