How to improve your cholesterol profile

You can't change your age or family medical history, both of which can affect your cholesterol levels. However, you can lose weight and boost physical activity, which will help lower your LDL cholesterol and boost HDL. Probably the most important step, though, is changing the way you eat.

Get your copy of A Guide to Men's Health Fifty and Forward

This Special Health Report, A Guide to Men's Health Fifty and Forward, offers steps and strategies to lessen — or prevent — threats to a man's well-being and longevity. It provides a wide-ranging, clear-eyed look at the leading causes of death for men at midlife and beyond. It examines those factors that put them at risk for a variety of health problems and explains the important measures that can be taken to reduce risk and live a longer, healthier life.

Focus on fats. Most of the cholesterol in our bodies does not come directly from cholesterol-containing foods like eggs. Rather, it is made by our bodies from components of food. To improve your cholesterol profile, avoid saturated fats (found in animal products). These fats increase unhealthy LDL levels. Instead, replace some of the saturated fats in your diet with healthier unsaturated fats, which are found in fish, nuts, avocados, and vegetable oils, such as olive oil, canola oil, and safflower oil.

Choose whole grains. Whole-grain breads, pasta, and cereal help prevent dramatic ups and downs in blood sugar and make you feel full longer. Many of these foods contain fiber that lowers LDL levels.

Make healthy substitutions. Eat more fruits and vegetables, especially if you substitute these for processed foods like potato chips. And make healthy dairy substitutions: fat-free milk instead of whole milk, or plain yogurt instead of sugar-laden versions.

Take a cholesterol-lowering drug if you are at high risk for heart disease—even if your cholesterol is normal. Statin drugs first became available in the 1980s and proved far better at lowering total cholesterol and LDL cholesterol than previous drugs. These medications reduce the body's production of LDL cholesterol and help it reabsorb existing LDL. When studies showed that taking statins reduced the chance of getting heart disease, most doc-tors assumed that this was exclusively through their ability to lower cholesterol. However, statins also lower the chance of heart disease even if you have normal levels of total cholesterol or LDL cholesterol. The likely reason: statins dampen inflammation and help prevent arterial plaques from rupturing and causing a heart attack.

The decision to go on a statin depends on your age and overall cardiovascular risk. If your cholesterol is high-normal but your overall risk of a heart attack is low, it may be unnecessary to take a statin. Conversely, if your cholesterol is average but your overall risk is high, taking a statin may be a smart move.

To help people determine their 10-year risk of a heart attack, the American Heart Association and American College of Cardiology created an online calculator; you can find it at www.health.harvard.edu/heartrisk. Using that number, you and your doctor can decide on your best course.

A second class of cholesterol-lowering drugs, the PCSK9 inhibitors, is also available. The two drugs in this class are alirocumab (Praluent) and evolocumab (Repatha). These are approved for people who are already taking the maximum tolerated dose of a statin and either have known heart disease (a previous heart attack or stroke) or a genetic condition called familial hypercholesterolemia that causes very high LDL levels.

For more on how to reduce your health risks from heart health to dementia, buy A Guide to Men's Health Fifty and Forward by Harvard Medical School.

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Protecting memory: strategies for healthy brain aging

Many people begin to notice changes in memory by around age 50. A typical sign of this mild forgetfulness is difficulty recalling a word or name that once came easily to you. As your body ages, so does your brain, and as the structure of the brain ages, so does its ability to process information quickly. Memory can falter as a result of stress, anxiety, fatigue, distractions, or being overloaded. Memory difficulties may also be caused by medications, poor vision or hearing, sleep disturbances, depression, or chronic pain—all things you can take steps to correct.

Cardiovascular fitness is also tied closely to brain health and memory. Any condition that compromises heart health and blood vessel flexibility can also affect memory and other mental skills. Similarly, research has linked diabetes and obesity to poorer brain health.

The good news is that many age-related memory slips are perfectly normal and not necessarily signs of dementia due to brain diseases like Alzheimer's. There are also simple ways to help sharpen your everyday memory.

Protecting memory

Maintaining your overall cardiovascular fitness is a potent way to preserve memory function. Research also suggests that good nutrition, physical activity, a healthy weight, and remaining mentally active in midlife can help to reduce or delay memory impairment later in life.

Here are some fundamental strategies for healthy brain aging:

Eat a plant-based diet. Research shows that a diet that contains abundant fruits, vegetables, legumes, nuts, and whole grains— with limited amounts of animal products—is best for cognitive fitness.

Exercise regularly. Exercise has a variety of potentially positive influences on cognitive skills. Exercise enriches the blood (and therefore the brain) with oxygen. During exercise, the body produces sub-stances that help maintain the physical integrity and function of the brain. Regular exercise also supports restful sleep, which is essential restorative "down time" for the brain.

Get enough sleep. To learn new information, you must be able to pay attention, which you can't do if you're not well rested. It's also harder to hold on to memories and retrieve information you've learned previously if you're poorly rested, because the process in which you solidify recent experiences into durable memories occurs during sleep. It's no coincidence that forgetfulness is a common symptom of insomnia.

Manage stress. Stress can be helpful in reason-able doses to motivate you and focus attention. But intense or prolonged stress takes a toll on your health. Long-term exposure to stress hormones can harm the brain—including the hippocampus, a brain region key to memory. Exercise, meditation, restful sleep, friend-ships and other social connections, and a positive approach to life's challenges can all help you manage stress better and optimize memory.

Use it or lose it. Challenging your brain through-out life builds a buffer against the detrimental effects of aging on the brain. People who have led mentally active lives thanks to their education, work, and leisure activities have more cognitive reserve—essentially "extra brain in the bank"—to prevent or delay a decline in mental abilities. It's particularly useful to challenge your brain by learning new skills, such as taking up a musical instrument you haven't played before or studying a foreign language that's new to you. Learn memory techniques. There are many ways to make the most of your existing memory skills. Techniques like these can help you deal with common situations that invite forgetfulness:

Use notebooks, address books, calendars, and smartphone apps to organize and store information for fast retrieval rather than relying entirely on memory.
Keep items like your wallet and car keys in designated spots so you always know where to find them.
Practice focusing more mindfully when you're taking in new information, such as when you're meeting people, to enhance your recall of facts and impressions later.
Employ memory-enhancing tricks, like making up a funny rhyme to remember a name or place, or repeating new information silently several times to yourself—for example: "Tom's friend Joe, Tom's friend Joe, Tom's friend Joe."

For more on how to reduce your health risks from heart health to dementia, buy A Guide to Men's Health Fifty and Forward by Harvard Medical School.

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