lifestyle.

Do you drink? Do you smoke? Are you overweight lacking in exercise? If your answer is yes to all of the above then you are en route to disaster.

High cholesterol and elevated blood pressure can lead to coronary heart disease.

According to Nutritionist Betsy Baillie of Nutrition Services the Bermuda lifestyle may be hazardous to your health. Heart disease is the leading cause of death.

In 1987, 222 people in Bermuda died as a result of heart disease, 47 percent of all deaths. This figure has remained fairly constant for many years, unlike in other countries which have had a reduction in deaths from heart disease.

Coronary heart disease is a result of atherosclerosis, or hardening of the arteries. Normally, the walls of an artery are thin and soft and stretch like elastic.

In atherosclerosis too much cholesterol is deposited along the artery walls.

These "plaques'' can build up and eventually block the arteries and cause a heart attack or stroke.

There is no cure for coronary heart disease, but the risk of developing it can be reduced through a healthy life style.

"There are ten risk factors associated with heart disease. A risk factor for heart disease is defined as a habit or trait which occurs more commonly among persons with heart disease than in persons without it,'' Ms Baillie states.

She added it was important to count the risk factors: smoking; elevated blood pressure; elevated blood cholesterol; diabetes; overweight; little exercise; stress; being male; over 45 years of age; and family history of heart disease.

How many risk factors put you at risk for developing heart disease? The last three factors -- your sex, your age, and what you inherit, you cannot change.

However, you can take steps to alter your lifestyle to minimise these other seven risk factors.

To be at risk for coronary heart disease is not the same as having coronary heart disease. You should see your doctor for a full risk assessment.

"Diet is associated with elevated blood pressure, elevated blood cholesterol, adult onset diabetes and overweight. If you have any one of these risk factors you need to modify your diet and get more physical exercise.

"Reduce your risk of developing heart disease by adopting a healthy life style,'' Ms Baillie said.

She added that "no cholesterol'' on a food product label is no guarantee that a food promotes heart health.

"Most people know that dietary cholesterol can contribute to coronary heart disease; unfortunately, some people think that dietary cholesterol is the only factor influencing blood cholesterol levels.

"They do not realise that it is the total composition of the diet, including the type and amount of fat eaten, which can cause blood cholesterol levels to rise.

"To confuse us, manufacturers focus exclusively on a food's lack of cholesterol, so we overlook other significant factors, such as the type and amount of fat in the food product.'' Ms Baillie also said: "We tend to associate `cholesterol free' with `fat free'; however, both animal and vegetable fats have a similar fat content.

"Health authorities recommend that males eat 300 mg or less of cholesterol per day and females less than 250 mg. The average diet contains between 400 to 600 mg per day. Our body also manufacturers 500 to 1,000 mg per day.'' There is no cholesterol in vegetable and cereal foods. Vegetable products such as oil, margarine, shortening and peanut butter contain no cholesterol but are high in fat; consequently, they can contribute to a high fat diet that can elevate blood cholesterol levels, regardless of the fact they are cholesterol-free.

Ms Baillie also said the cholesterol in food is not divided into good and bad cholesterol as it is in blood cholesterol analysis.

"If you want to reduce your intake of cholesterol, consume no more than three servings of high cholesterol foods per week - egg yolks and organ meats.

"Be a discerning consumer. Look beyond the `no cholesterol' on the label - remember it does not mean a food is low in fat or that it promotes heart health.'' She added that a fat-reduced diet does not mean being unable to eat the foods you love.

"It means making gradual changes to control and modify your present diet to make it a healthier one.'' You can accomplish this by consuming high fat foods less often, like skim milk instead of whole milk, smaller portions and foods cooked by low-fat methods.

Specifically you should use lean meat, fish and poultry. Avoid well-marbled meats. Trim all visible fat off meat and remove skin from poultry.

Eat more poultry and fish instead of red meats and eat controlled portions of meat, two to three ounces is one serving.

Also choose cooking methods that require little or no fat or oil -- grill, bake, broil, barbecue, or steam instead of fry. You could also have meatless meals each week, using cooked dried beans and lentils in casseroles, salads, soups, or stews.

Ms Baillie also suggested using the turkey products instead of high fat luncheon meats, bologna and salami.

"Use polyunsaturated oils and margarines made from liquid safflower, sunflower, soy or corn oil instead of butter, and limit the amount of butter, polyunsaturated margarines, oils, mayonnaise and salad dressings that you add to you foods.

"Cook foods in wines, vinegars, fruits and vegetable juices, broths, herbs and spices instead of rich sauces.

"And instead of high fat desserts such as pies, pastries, and puddings eat fruit ices, salads, fresh fruit or angel food cake.

"Choose low-fat snacks such as homemade popcorn (no added butter), pretzels or bread sticks instead of high fat potato chips, cheesies, nuts and seeds.'' Ms Baillie added that fruits and vegetables, breads and cereals are usually low in fat and high in complex carbohydrates.