When it comes to picking up blood work results from an annual physical, most people are pretty nervous. Are the years of too many potato chips, rich sauces and cake about to catch up with them? Or will they be one of the genetically gifted few, who can eat what they like, yet sail through their physical with perfect results?

At physical time, nothing seems to cast a shadow of more doom and gloom than a high cholesterol level ? specifically a high cholesterol level. Eating and drinking is such a big part of our culture that dietary restrictions can be very depressing. Not only do you then have to avoid steaks and cake at barbeques and christenings, but you are constantly reminded of your cardiac risk. Unlike a pill that you take in the morning (and can forget about for the rest of the day) watching your diet can be both worrying and tedious.

This is the reason why you hear so many couples arguing about cholesterol ? people tend to avoid the worry and the tedium by throwing caution to the wind and embracing denial. It's amazing the excuses that people come up with ? for example, how many of you have overheard this:

"John darling, you're impossible! Don't order shrimp! Your cholesterol's 280!"

"Oh give me a break, I'm not that bad! Martin's was over 300!"

Hmmm, see the problem there? And another common scenario:

"Jayne, NO! No more ice cream! It's bad for your cholesterol?.."

"Oh, really? Those diet rules are nonsense. Anne's aunt's sister ate whatever she fancied, smoked 20 a day and lived to 96!"

And she has us fooled. But the problems with these kind of excuses are simple. Just because someone else has a higher cholesterol level than you, doesn't mean that you can use them as a barometer for your own health.

As so many factors are involved in heart disease, you may well have a higher cardiac risk, even if your cholesterol is lower. In addition, citing incredible examples of unhealthy living and old age doesn't cut it either. The individual in question is usually someone else's sister's boyfriend's mum's aunt's cousin?. and often a figment of their imagination!

In reality, these cases are few and far between ? how many people do you know that have had such miraculous luck with their health? Exactly!

However, even with all this in mind, is cholesterol in food really as bad as it's made out to be? The fact is that we all do need some cholesterol in the body as it's crucial for healthy hormone production and for good mental health.

The fact that high blood cholesterol is a risk factor for heart disease is not under debate here, but what is under debate is the idea that a diet containing cholesterol rich foods directly contributes to high blood cholesterol.

In fact, recent research has actually failed to demonstrate a link for example between the number of eggs a person eats and their cholesterol level. But the most interesting fact is this ? the Inuit Eskimos have one of the highest cholesterol diets in the world, yet they have one of the lowest incidences of heart disease. How is that possible?

Well the case of the Inuit has essentially highlighted the difference between good cholesterol and bad cholesterol. A "good" lipoprotein called HDL takes cholesterol out of the arteries and back to the liver where it can be recycled.

In contrast, a "bad" lipoprotein called LDL carries cholesterol to the artery walls where it may be deposited, causing atherosclerosis ? the build of fatty deposits on the artery walls that can lead to high blood pressure and heart attack. So it turns out that rather than focusing on avoiding cholesterol rich foods per se, we may be better off being more specific, aiming to reduce our LDL and increase our HDL cholesterol instead.

So how do you do this? The steps below demonstrate how to lower LDL and boost HDL. Yes, there are dietary restrictions, but this is positive guidance that focuses more on what you should be doing, rather than what you shouldn't!

Incorporating these steps into your life will help you to prevent high LDL cholesterol, or help you to take control if you already have high levels ? and the very fact that you are in charge, will help relieve some of the anxiety that you may feel.

In addition, next month I'll be giving you a series of really great recipes, all demonstrating that food can be heart-healthy and taste delicious too. Keep checking this column every Friday to find out more ? and remember, no more excuses!

Nature has a very clever trick up her sleeve when it comes to fibre! Fibre actually reduces LDL (bad) cholesterol. It binds with bile salts and causes them to be excreted from the digestive tract.

Bile salts are vital for digestion and are made using LDL cholesterol, so the body then makes more by diverting LDL cholesterol away from the artery walls and into the digestive system. Wholegrains, fruit and vegetables are all rich in fibre. Oats and apples are particularly good at helping to remove excess cholesterol from the body, so try oatmeal for breakfast with grated apple and cinnamon on top! Quick note re oats ? try and use whole oats rather than the "quick cook" refined oats, as whole oats have more fibre.

Vitamin C helps fibre to bind to bile salts in the digestive tract. It has also been shown to inhibit excessive cholesterol production. Yellow and red peppers, blueberries, strawberries, broccoli, oranges and papaya are all rich in vitamin C. You may also choose to supplement vitamin C ? try building up to 1000mg daily, but if you have any health conditions or are on any medications (especially blood thinners), do check with your doctor first.

Oily fish, such as mackerel, salmon, tuna and sardines have a very high Omega 3 "good fat" content. Omega 3 has been shown to increase good HDL cholesterol and lower bad LDL cholesterol. Aim to eat oily fish at least 3 times a week (baked or grilled, NOT fried) or consider supplementing Omega 3. However, please consult your GP before supplementing your diet with Omega 3 oils as some medical conditions (e.g. epilepsy) and drugs (e.g. blood thinners such as Warfarin) are contradicted with Omega 3.

Saturated, trans and hydrogenated fats should be avoided at all costs as these directly raise LDL cholesterol. Replace margarines and butter with a no-cholesterol spread such as Earth Balance vegan margarine (Down to Earth.) Replace other cooking oils with olive oil and never heat an oil so much that it smokes in the pan. Other common sources of bad fats include mayo, chips and fries. Try replacing these with hummus, vegetable crudit?s and baked potatoes. Bake or grill food instead of frying. Finally, as animal proteins are higher in saturated fats than vegetable proteins, experiment with some vegetarian dishes!

To be safe, go easy on foods that are naturally high in cholesterol ? including shrimp, meat, eggs, dairy products, unroasted nuts and avocado. However, if ? and only if! ? you are following the other steps religiously, it's ok to have these foods .

Usefully, this step complements steps 1 and 2. LDL cholesterol deposited on artery walls is bad enough, but oxidized cholesterol is even worse as it is more difficult for the body to remove. Cigarette smoke, fried foods and pollution all oxidize cholesterol. So if you do smoke, it is vital that you give up. However antioxidants found in fruits and vegetables do help to protect cholesterol from oxidation. One serving is equivalent to one apple, one kiwi, 2 tablespoons of vegetables or a side salad.

Whilst statins block the enzymes that make cholesterol, they also prevent the manufacture of CoQ10. This antioxidant is vital for maintaining a healthy heart so if you are taking statins, consider supplementing CoQ10. The American Heart Association has also recently reported that Noni Juice has been shown to lower LDL cholesterol. In addition, research shows that Sytrinol (available at Rock On) can lower LDL and improve HDL levels. However, always consult your GP prior to taking any supplement in conjunction with medication.

Exercise actively helps to lower LDL and raise HDL cholesterol. In addition, as smoking oxidizes cholesterol in the arteries, it's crucial to give up. Finally, stress exacerbates all health conditions, so it's important to keep it under control.

The advice given in this article is not intended to replace medical advice, but to complement it. Always consult your GP if you have any health concerns. Catherine Burns is a fully qualified Clinical Nutritionist. She can be contacted at 291 4725 or clinicalnutritiongmail.com