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Oil spills often happen because of accidents, when people make mistakes or equipment breaks down. Other causes include natural disasters or deliberate acts. Oil spills have major environmental and economic effects.

Oil spills can also affect human health. These effects can depend on what kind of oil was spilled and where (on land, in a river, or in the ocean). Other factors include what kind of exposure and how much exposure there was. People who clean up the spill are more at risk. Problems could include skin and eye irritation, neurologic and breathing problems, and stress. Not much is known about the long-term effects of oil spills.

Cholesterol is a waxy, fat-like substance that that's found in all the cells in your body. Your body needs some cholesterol to work properly. But if you have too much of it in your blood, it can stick to the walls of your arteries and narrow or even block them. This puts you at risk for coronary artery disease and other heart diseases.

Cholesterol is made by your liver. It travels through the blood on proteins called lipoproteins. One type of lipoprotein, LDL, is sometimes called the "bad" cholesterol. A high LDL level leads to a buildup of cholesterol in your arteries. Another type, HDL, is sometimes called the "good" cholesterol. It carries cholesterol from other parts of your body back to your liver. Then your liver removes the cholesterol from your body.

The main treatments for high cholesterol are heart-healthy lifestyle changes and medicines. The lifestyle changes include healthy eating, weight management, and regular physical activity.

Heart-healthy lifestyle changes include a diet to lower your cholesterol. The DASH eating plan is one example. Another is the Therapeutic Lifestyle Changes (TLC) diet, which recommends that you:

Choose healthier fats.You should limit both total fat and saturated fat. No more than 25 to 35% of your daily calories should come from dietary fats, and less than 7% of your daily calories should come from saturated fat. Depending upon how many calories you eat per day, here are the maximum amounts of saturated fats that you should eat:

Saturated fat is a bad fat because it raises your LDL (bad cholesterol) level more than anything else in your diet. It is found in some meats, dairy products, chocolate, baked goods, and deep-fried and processed foods.

Instead of saturated fats, switch to foods with healthier fats, such as lean meat, nuts, and unsaturated oils like canola, olive, and safflower oils.

Limit foods with cholesterol. If you are trying to lower your cholesterol, you should have less than 200 mg a day of cholesterol. Cholesterol is in foods from animals, such as liver and other organ meats, egg yolks, shrimp, and whole milk dairy products.

Eat plenty of soluble fiber. Soluble fiber helps prevent your digestive tract from absorbing cholesterol. You should try to get 10 to 25 grams of it per day. Foods that are high in soluble fiber include:

• Whole-grain cereals such as oatmeal and oat bran
• Fruits such as apples, bananas, oranges, pears, and prunes
• Legumes such as kidney beans, lentils, chickpeas, black-eyed peas, and lima beans

Eat lots of fruits and vegetables. They are important sources of vitamins, fiber, and other nutrients.

Increase plant stanols and sterols in your diet.These are substances that also help prevent your digestive tract from absorbing cholesterol. You should try to get 2 grams of them per day. They can be found in whole grains, nuts, legumes, and oils, such as olive oil and avocado oil. They are also added to some foods, such as certain types of orange juice, margarine, and bread.

Eat foods that are high in omega-3 fatty acids. These special fats can lower LDL and triglyceride levels. They can also help control blood pressure and may lower your risk of heart rhythm problems. If you have heart disease, they may lower your risk of heart attack. Omega-3 fatty acids can be found in:

• Fish such as salmon, tuna (canned or fresh), and mackerel. Most people should try to eat these fish two times a week. But if you are pregnant or breastfeeding, you should avoid fish that could be high in mercury, such as mackerel.
• Plant sources such as walnuts, flaxseed, chia seeds, and canola and soybean oils. But they have smaller amounts of omega-3 acids than the fish sources.
• Fortified foods, such as certain brands of eggs, yogurt, juices, milk, soy beverages, and infant formulas.

Limit salt. You should try to limit the amount of sodium (salt) that you eat to no more than 2,300 milligrams (about 1 teaspoon of salt) a day. That includes all the sodium you eat, whether it's added in cooking, used at the table, or already present in food products. Limiting salt won't lower your cholesterol, but it can lower your risk of heart diseases by helping to lower your blood pressure. You can reduce your sodium by instead choosing low-salt and "no added salt" foods and seasonings at the table or while cooking.

Limit alcohol. Alcohol adds extra calories, which can lead to weight gain. Being overweight can raise your LDL level and lower your HDL level. Too much alcohol can also increase your risk of heart diseases because it can raise your blood pressure and triglyceride level. It's best not to drink, but if you do:

• Have no more than 2 drinks per day if you are a man
• Have no more than 1 drink per day if you are a woman

Nutrition labels can help you figure out how much fat, saturated fat, cholesterol, fiber, and sodium is in the foods that you buy. This can help you eat healthier and lower your cholesterol.

NIH: National Heart, Lung, and Blood Institute

Fat is a type of nutrient. You need some fat in your diet but not too much. Fats give you energy and help your body absorb vitamins. Dietary fat also plays a major role in your cholesterol levels.

But not all fats are the same. You should try to avoid:

• Saturated fats such as butter, solid shortening, and lard
• Trans fats. These are found in vegetable shortenings, some margarines, crackers, cookies, snack foods, and other foods made with or fried in partially hydrogenated oils (PHOs). By 2018, most U.S. companies will not be allowed to add PHOs to food.

Try to replace them with oils such as canola, olive, safflower, sesame, or sunflower. Of course, eating too much fat will put on the pounds. Fat has twice as many calories as proteins or carbohydrates.

NIH: National Heart, Lung, and Blood Institute

An herb is a plant or plant part used for its scent, flavor, or therapeutic properties. Herbal medicines are one type of dietary supplement. They are sold as tablets, capsules, powders, teas, extracts, and fresh or dried plants. People use herbal medicines to try to maintain or improve their health.

Many people believe that products labeled "natural" are always safe and good for them. This is not necessarily true. Herbal medicines do not have to go through the testing that drugs do. Some herbs, such as comfrey and ephedra, can cause serious harm. Some herbs can interact with prescription or over-the-counter medicines.

If you are thinking about using an herbal medicine, first get information on it from reliable sources. Make sure to tell your health care provider about any herbal medicines you are taking.

NIH: National Center for Complementary and Integrative Health

DASH stands for Dietary Approaches to Stop Hypertension. It is an eating plan that is based on research studies sponsored by the National Heart, Lung, and Blood Institute (NHLBI). These studies showed that DASH lowers high blood pressure and improves levels of cholesterol. This reduces your risk of getting heart disease.

The DASH eating plan:

• Emphasizes vegetables, fruits, and whole-grains
• Includes fat-free or low-fat dairy products, fish, poultry, beans, nuts, and vegetable oils
• Limits foods that are high in saturated fat. These foods include fatty meats, full-fat dairy products, and tropical oils such as coconut, palm kernel, and palm oils.
• Limits sugar-sweetened beverages and sweets

Along with DASH, other lifestyle changes can help lower your blood pressure. They include staying at a healthy weight, exercising, and not smoking.

NIH: National Heart, Lung, and Blood Institute

Cholesterol is a waxy, fat-like substance that's found in all the cells in your body. Your liver makes cholesterol, and it is also in some foods, such as meat and dairy products. Your body needs some cholesterol to work properly. But having too much cholesterol in your blood raises your risk of coronary artery disease.

HDL and LDL are two types of lipoproteins.They are a combination of fat (lipid) and protein. The lipids need to be attached to the proteins so they can move through the blood. HDL and LDL have different purposes:

• HDL stands for high-density lipoproteins. It is sometimes called the "good" cholesterol because it carries cholesterol from other parts of your body back to your liver. Your liver then removes the cholesterol from your body.
• LDL stands for low-density lipoproteins. It is sometimes called the "bad" cholesterol because a high LDL level leads to a buildup of cholesterol in your arteries.

A blood test can measure your cholesterol levels, including HDL. When and how often you should get this test depends on your age, risk factors, and family history. The general recommendations are:

For people who are age 19 or younger::

• The first test should be between ages 9 to 11
• Children should have the test again every 5 years
• Some children may have this test starting at age 2 if there is a family history of high blood cholesterol, heart attack, or stroke

For people who are age 20 or older::

• Younger adults should have the test every 5 years
• Men ages 45 to 65 and women ages 55 to 65 should have it every 1 to 2 years

With HDL cholesterol, higher numbers are better, because a high HDL level can lower your risk for coronary artery disease and stroke. How high your HDL should be depends on your age and sex:

If your HDL level is too low, lifestyle changes may help. These changes may also help prevent other diseases, and make you feel better overall:

• Eat a healthy diet. To raise your HDL level, you need to eat good fats instead of bad fats. This means limiting saturated fats, which include full-fat milk and cheese, high-fat meats like sausage and bacon, and foods made with butter, lard, and shortening. You should also avoid trans fats, which may be in some margarines, fried foods, and processed foods like baked goods. Instead, eat unsaturated fats, which are found in avocado, vegetable oils like olive oil, and nuts. Limit carbohydrates, especially sugar. Also try to eat more foods naturally high in fiber, such as oatmeal and beans.
• Stay at a healthy weight. You can boost your HDL level by losing weight, especially if you have lots of fat around your waist.
• Exercise. Getting regular exercise can raise your HDL level, as well as lower your LDL. You should try to do 30 minutes of moderate to vigorous aerobic exercise on most, if not all, days.
• Avoid cigarettes.Smoking and exposure to secondhand smoke can lower your HDL level. If you are a smoker, ask your health care provider for help in finding the best way for you to quit. You should also try to avoid secondhand smoke.
• Limit alcohol. Moderate alcohol may lower your HDL level, although more studies are needed to confirm that. What we do know is that too much alcohol can make you gain weight, and that lowers your HDL level.

Some cholesterol medicines, including certain statins, can raise your HDL level, in addition to lowering your LDL level. Health care providers don't usually prescribe medicines only to raise HDL. But if you have a low HDL and high LDL level, you might need medicine.

Taking certain medicines can lower HDL levels in some people. They include:

• Beta blockers, a type of blood pressure medicine
• Anabolic steroids, including testosterone, a male hormone
• Progestins, which are female hormones that are in some birth control pills and hormone replacement therapy
• Benzodiazepines, sedatives that are often used for anxiety and insomnia

If you are taking one of these and you have a very low HDL level, ask your provider if you should continue to take them.

Diabetes can also lower your HDL level, so that gives you another reason to manage your diabetes.

Most women experience breast changes at some time. Your age, hormone levels, and medicines you take may cause lumps, bumps, and discharges (fluids that are not breast milk).

If you have a breast lump, pain, discharge or skin irritation, see your health care provider. Minor and serious breast problems have similar symptoms. Although many women fear cancer, most breast problems are not cancer.

Some common breast changes are:

• Fibrocystic breast changes - lumpiness, thickening and swelling, often just before a woman's period
• Cysts - fluid-filled lumps
• Fibroadenomas - solid, round, rubbery lumps that move easily when pushed, occurring most in younger women
• Intraductal papillomas - growths similar to warts near the nipple
• Blocked milk ducts
• Milk production when a woman is not breastfeeding

NIH: National Cancer Institute

You have many choices to make about your cancer treatment. One choice you might consider is using complementary and alternative medicine (CAM). CAM is the term for medical products and therapies that are not part of standard medical care.

CAM for cancer treatment involves caring for your mind, body, and spirit. Some methods focus on your breathing or body movements to help you relax. Other CAM therapies may use special foods, supplements, or diets. Examples of CAM therapies include acupuncture, chiropractic, and herbal medicines.

CAM claims can sound promising, but often, researchers don't know how safe some are or how well they work. Studies are ongoing to find out the safety and usefulness of many of these methods.

If you're thinking about using CAM along with your standard care, it's called integrative medicine. Some methods, such as acupuncture, might help with nausea, pain, and other side effects of cancer treatment.

A few reasons that people with cancer may use CAM include to:

• Help cope with the side effects of cancer treatments
• Ease worries about cancer treatment and related stress
• Feel that they are doing something more to help their care

CAM treatments don't work for everyone. Some products might interact with your other medicines. Talk to your health care provider about all the different types of treatment you use. Your provider can help you make sure that everything you're using for your cancer care works well together.

NIH: National Cancer Institute

Carbohydrates, or carbs, are sugar molecules. Along with proteins and fats, carbohydrates are one of three main nutrients found in foods and drinks.

Your body breaks down carbohydrates into glucose. Glucose, or blood sugar, is the main source of energy for your body's cells, tissues, and organs. Glucose can be used immediately or stored in the liver and muscles for later use.

There are three main types of carbohydrates:

• Sugars. They are also called simple carbohydrates because they are in the most basic form. They can be added to foods, such as the sugar in candy, desserts, processed foods, and regular soda. They also include the kinds of sugar that are found naturally in fruits, vegetables, and milk.
• Starches. They are complex carbohydrates, which are made of lots of simple sugars strung together. Your body needs to break starches down into sugars to use them for energy. Starches include bread, cereal, and pasta. They also include certain vegetables, like potatoes, peas, and corn.
• Fiber. It is also a complex carbohydrate. Your body cannot break down most fibers, so eating foods with fiber can help you feel full and make you less likely to overeat. Diets high in fiber have other health benefits. They may help prevent stomach or intestinal problems, such as constipation. They may also help lower cholesterol and blood sugar. Fiber is found in many foods that come from plants, including fruits, vegetables, nuts, seeds, beans, and whole grains.

Common foods with carbohydrates include:

• Grains, such as bread, noodles, pasta, crackers, cereals, and rice
• Fruits, such as apples, bananas, berries, mangoes, melons, and oranges
• Dairy products, such as milk and yogurt
• Legumes, including dried beans, lentils, and peas
• Snack foods and sweets, such as cakes, cookies, candy, and other desserts
• Juices, regular sodas, fruit drinks, sports drinks, and energy drinks that contain sugar
• Starchy vegetables, such as potatoes, corn, and peas

Some foods don't have a lot of carbohydrates, such as meat, fish, poultry, some types of cheese, nuts, and oils.

You do need to eat some carbohydrates to give your body energy. But it's important to eat the right kinds of carbohydrates for your health:

• When eating grains, choose mostly whole grains and not refined grains:
  • Whole grains are foods like whole-wheat bread, brown rice, whole cornmeal, and oatmeal. They offer lots of nutrients that your body needs, like vitamins, minerals, and fiber. To figure out whether a product has a lot of whole grain, check the ingredients list on the package and see if a whole grain is one of the first few items listed.
  • Refined grains are foods that have had some parts of the grains removed. This also removes some of the nutrients that are good for your health.
• Eat foods with lots of fiber. The Nutrition Facts labels on the back of food packages tells you how much fiber a product has.
• Try to avoid foods that have a lot of added sugar. These foods can have many calories but not much nutrition. Eating too much added sugar raises your blood sugar and can make you gain weight. You can tell if a food or drink has added sugars by looking at the Nutrition Facts label on the back of the food package. It tells you how much total sugar and added sugar is in that food or drink.

There is no one-size-fits-all amount of carbohydrates that people should eat. This amount can vary, depending on factors such as your age, sex, health, and whether or not you are trying to lose or gain weight. On average, people should get 45 to 65% of their calories from carbohydrates every day. On the Nutrition Facts labels, the Daily Value for total carbohydrates is 275 g per day. This is based on a 2,000-calorie daily diet. Your Daily Value may be higher or lower depending on your calorie needs and health.

Some people go on a low-carb diet to try to lose weight. This usually means eating between 25 g and 150 g of carbs each day. This kind of diet can be safe, but you should talk to your health care provider before starting it. One problem with low-carb diets is that they can limit the amount of fiber you get each day. They can also be hard to stay on for the long term.

Cholesterol is a waxy, fat-like substance that that's found in all the cells in your body. Your body needs some cholesterol to work properly. But if you have too much of it in your blood, it can stick to the walls of your arteries and narrow or even block them. This puts you at risk for coronary artery disease and other heart diseases.

Cholesterol is made by your liver. It travels through the blood on proteins called lipoproteins. One type of lipoprotein, LDL, is sometimes called the "bad" cholesterol. A high LDL level leads to a buildup of cholesterol in your arteries. Another type, HDL, is sometimes called the "good" cholesterol. It carries cholesterol from other parts of your body back to your liver. Then your liver removes the cholesterol from your body.

If you have high cholesterol, lifestyle changes can help you lower your cholesterol levels. But sometimes the lifestyle changes are not enough, and you need to take cholesterol medicines. But you should still continue with the lifestyle changes even though you are taking medicines.

Your health care provider may prescribe cholesterol medicines for you if:

• You have already had a heart attack or stroke, or you have peripheral arterial disease
• Your LDL (bad) cholesterol level is 190 mg/dL or higher
• You are 40-75 years old, you have diabetes, and your LDL cholesterol level is 70 mg/dL or higher
• You are 40-75 years old, you have a high risk of developing heart disease or stroke, and your LDL cholesterol level is 70 mg/dL or higher

There are several types of cholesterol-lowering drugs available, including:

• Statins. They reduce the amount of cholesterol made in the liver. They also increase your liver's ability to remove LDL cholesterol that is already in the blood. Statins are the most common medicines used to treat high cholesterol.
• Bile acid sequestrants. They keep bile acids, which digest fats and oils, from being absorbed into the body. But your body needs bile acids, so your liver will make more of them. It makes them by breaking down LDL cholesterol, so this helps lower your LDL cholesterol. Your provider may prescribe these medicines if you cannot take statins or if statins alone are not lowering your cholesterol enough.
• Cholesterol absorption inhibitors. They block how cholesterol is absorbed into the body. They are also used if you cannot take statins or if statins alone are not lowering your cholesterol enough.
• Nicotinic acid (niacin). It is a type of B vitamin. It reduces the amount of fats made by your liver, so it lowers your LDL cholesterol and triglycerides. Niacin also raises HDL cholesterol. Even though you can buy niacin without a prescription, you should talk to your provider before taking it to lower your cholesterol. High doses of niacin can cause serious side effects.
• PCSK9 inhibitors. These are medicines that you inject under your skin. They block a protein called PCSK9. This helps your liver remove and clear LDL cholesterol from your blood. Your provider may prescribe a PCSK9 inhibitor and a statin if you are at high risk of complications like heart attack or stroke, or if you have familial hypercholesterolemia (FH). FH is an inherited disorder that causes very high levels of cholesterol in the blood.
• Fibrates. They lower triglycerides in several complex ways, including reducing the amount of triglycerides made by the liver. They may also help increase HDL cholesterol and may lower LDL levels a bit. If you take them with statins, it might increase the risk of side effects.
• Combination medicines. They include more than one type of cholesterol-lowering medicine. There are also combination medicines that can treat both high blood pressure and cholesterol.

There are also a few other cholesterol medicines (lomitapide and mipomersen) that are only for people who have FH.

When deciding which medicine you should take and which dose you need, your provider will consider:

• Your cholesterol levels.
• Your risk for heart disease and stroke.
• Your age.
• Any other health problems you have.
• Possible side effects of the medicines. Higher doses are more likely to cause side effects, especially over time.

Medicines can help control your cholesterol, but they don't cure it. You need to keep taking your medicines and get regular cholesterol checks to make sure that your cholesterol levels are in a healthy range.