Last month, the National Heart, Lung and Blood Institute issued major new clinical practice guidelines on the prevention and management of high cholesterol in adults. The guidelines are the first major update in nearly a decade.

Here is a summary of the guidelines -- also known as the Adult Treatment Panel III -- and implications for us as consumers.

The key new guidelines are:

More aggressive cholesterol-lowering treatment and better identification of those at high risk for a heart attack.

Use of a lipoprotein profile as the first test for high cholesterol; a new level at which low HDL (high-density lipoprotein) becomes a major heart disease risk factor.

A new set of "Therapeutic Lifestyle Changes," with more power to improve cholesterol levels.

A sharper focus on a cluster of heart disease risk factors known as "the metabolic syndrome."

Increased attention to the treatment of high triglycerides.

The new guidelines are expected to substantially expand the number of Americans being treated for high cholesterol, including raising the number on dietary treatment from about 52 million to about 65 million and increasing the number of people receiving prescribed cholesterol-lowering drugs from about 13 million to about 36 million.

The guidelines recommend a new Therapeutic Lifestyle Changes treatment plan for high cholesterol that reflects changes in Americans' eating habits. The TLC plan includes daily intakes of less than 7 percent of calories from saturated fat and less than 200 milligrams daily of dietary cholesterol. And the guidelines allow up to

35 percent of daily calories from total fat, as long as most is from unsaturated fat (oils, for example), which does not raise cholesterol levels.

The dietary modifications that are called for in these guidelines, such as limiting saturated fats and increasing intakes of soluble fiber and plant stanol esters, can be met with planning and with the help of a dietetics professional. Plant stanols and sterols are included in certain margarines and salad dressings; foods high in soluble fiber include cereal grains, beans, peas, legumes and many fruits and vegetables.

The guidelines specifically emphasize the importance of nutrition therapy in facilitating the behavior changes that people will need to make to follow the recommended diet and lifestyle changes.

The guidelines recommend evaluating patients to see if a diet- and lifestyle-based approach to clinical treatment will be effective prior to -- or with -- cholesterol-lowering drugs.

If you have high cholesterol, you might consider discussing these new guidelines with your doctor and see if some of the recommendations would benefit you.

Nancy Feldman is a registered dietitian and nutrition adviser for the University of California Cooperative Extension in Stanislaus County. Phone: 525-6800. Write: 3800 Cornucopia Way, Suite A, Modesto 95358. E-mail: nifeldman@ucdavis.edu .

From Modbee.com