The number one killer in the world is cholesterol. Heart disease and stroke, both caused by uncontrolled cholesterol, are the number one and number two causes of death in the world. In the U.S. stroke drops to the 5th leading cause of death, but heart disease remains the leading cause of death here for both men and women.

For all of you who’ve been led by the pink ribbon to believe that cancer, and more specifically breast cancer is the leading killer of women, you’ve been duped. The U.S. has about 40,000 deaths among women each year from breast cancer, but 290,000 deaths among women from heart disease. So, when you urge your wife, mother, or sister to have her annual mammogram, first urge her to have her cholesterol checked.

There are risk factors for heart disease other than cholesterol, but uncontrolled cholesterol is epidemic as is its partner, obesity. Other risk factors include uncontrolled high blood pressure, diabetes, smoking, alcohol abuse, uncontrolled stress, and sedentary lifestyle. As some well-known commercials tell us, cholesterol can also be influenced by genetics too (and age), but the vast majority of risks for heart disease is the foods we put in our bodies that lead to high cholesterol.

Out environment is flooded with restaurants; most of us eat out at least once a day, and some of us eat out far more than we eat at home. In the vast majority of restaurants, there is not a single healthy food option available – trust me, I’ve checked. And if you think that ordering a salad is the answer, boy are you kidding yourself. Just go online and see what the nutritional value of your favorite salad really is. One that I used to order all of the time comes in at 1,100 calories, 84 grams of fat, and 2300 mg of salt. It’s as much of a heart attack special as a giant fast-food burger. The same goes for most prepared or convenience foods found in your grocery store too. Make the nutrition label your best friend; that’s why our government now requires food products to be labeled.

If you’re struggling with weight and/or cholesterol, do yourself a favor and just don’t eat out. Instead make something at home where you can control what you are eating. And rethink taking someone out to dinner as a gift for a holiday or a birthday; you will just be contributing to their risks of a heart attack instead of doing something nice. Take them to a museum or park instead where you both can chat as you walk. To look up nutritional profiles for restaurant choices, go to Calorieking.com/foods/calories-in-fast-food-chains-restaurants_c-Y2lkPTIx.html

The National Institutes of Health has an excellent booklet titled “Lowering Your Cholesterol With TLC” that is available online at Nhlbi.nih.gov/files/docs/public/heart/chol_tlc.pdf It’s a comprehensive guide to lowering cholesterol offering information about both diet and lifestyle and explaining the different factors that make up your cholesterol profile and what influences those numbers to go higher or lower.

By-the-way, when you have your cholesterol checked by your doctor, make sure that you fast a full 12 hours before you have your blood drawn. That means, you only take in water during that time. Your results will be more accurate and will provide the information that you and your doctor will need to have a meaningful conversation. Your results will include your total cholesterol, your triglycerides, your LDL or low density lipids, and your HDL or high-density lipids. Each component has a target range that is recommended based on your sex, age, weight, etc. To remember the difference between LDL and HDL think “your high-density lipids should be high, and your low-density lipids should be low”.

You can tame the cholesterol killer, but you have to be vigilant and determined. Remember, you are fighting for your life.

Debbie Anne is a Public Health Nurse with Frederick County Health Department in Frederick, Maryland and has particular expertise in the field of HIV/AIDS. She has served in the field for thirteen years and in 2014 was awarded a Governor’s Citation for her work with Marylanders living with HIV/AIDS.