To combat America's No. 1 killer cardiovascular disease three local health organizations have mounted an effort to educate Utahns about cholesterol, a major risk factor.

Sponsored by the Utah Department of Health, the American Heart Association's Utah Division and the Utah Medical Association, the three-tiered program will focus on physician education, patient awareness particularly diet information and finally, screening clinics."It's part of a national and state strategy to lower the cholesterol level of individuals and eventually of the entire population," said Dr. Brett Lazar, director of the health department's Division of Community Health Services.

Lazar and Dr. James M. Pearce, a Salt Lake internist and Heart Association president, are the two physician/educators providing their counterparts with the most current cholesterol data.

"The information that physicians received in medical school or through medical literature has been changing so rapidly that anything they got more than a year ago is outdated," Lazar said. "The epidemiology has particularly changed. A lot of studies have come forward in the past year that make it very evident what a major risk factor high blood cholesterol is for heart disease."

Lazar said that unless physicians have been keeping up with all the current literature, they may be using the wrong level of blood cholesterol as an indication for treatment.

But physicians alone, he stressed, can't curb the problem.

In their travels around the state, Lazar and Pearce are recommending prevention techniques for the general public.

They advise that everyone over age 20 have a cholesterol test. Depending on the result of that test, future checks are determined.

"If the first check is normal and there is no family history of elevated cholesterol, then a person probably doesn't need to have it checked again for five years," Lazar said. "If, on the other hand, a person has an elevated cholesterol, then the doctor would recommend a more frequent schedule of checks, and also suggest that the person look carefully at his diet."

He said that in most cases diet is the first step to lower an elevated cholesterol level, unless the person has an extremely high level that can assumed to be genetically-caused.

Then the physician may decide to prescribe medication as well. "But people started on medication to lower blood cholesterol are committed to a lifetime of drugs, and these drugs are not without side effects," he said.

Whether or not their cholesterol level is elevated, Lazar said all people can do a number of things to reduce the saturated fats and cholesterol in their diets, and therefore protect themselves against cardiovascular disease.

The three health organizations recommend diet modifications to lower blood cholesterol. Here's their "good eating, good nutrition" diet plan:

Fish, chicken, turkey and lean meats.

Skim and low-fat milk, cheese, yogurt, and dairy substitutes.

Eggs.

Fruits and vegetables.

Breads and cereals.

Fats and oils.

CHOOSE:

Fish, poultry without skin, lean cuts of beef, lamb, pork or veal, shellfish.

Skim or 1 percent fat milk (liquid, powered, evaporated buttermilk).

Non-fat (zero percent fat) or low-fat yogurt.

Low-fat cottage cheese (1 percent or 2 percent fat).

Low-fat cheeses, farmer or pot cheeses (all of these should be labeled no more than 2-6 grams fat per ounce.

Sherbert, sorbet.

Egg whites (two whites equal one whole egg in recipes), cholesterol-free egg substitutes.

Fresh, frozen, canned or dried fruits and vegetables.

Homemade baked goods using unsaturated oils sparingly, angel food cake, low-fat crackers, low-fat cookies.

Rice, pasta.

Whole-grain breads and cereals (oatmeal, whole wheat, rye, bran, multi-grain).

Baking cocoa.

Unsaturated vegetable oils: corn, olive, rapesseed (canola oil), safflower, sesame, soybean, sunflower.

Margarine or shortenings made from one of the unsaturated oils listed above.

Diet margarine.

Mayonnaise and salad dressings made with unsaturated oils listed above.

Low-fat dressings.

Seeds and nuts.

DECREASE:

Fatty cuts of beef, lamb, pork, spare ribs, organ meats, regular cold cuts, sausage, hot dogs, bacon, sardines, roe.

Whole milk (4 percent fat), regular, evaporated or condensed; cream, half-and-half, 2 percent milk, imitation milk products, most non-dairy creamers, whipped toppings.

Whole-milk yogurt.

Whole-milk cottage cheese (4 percent fat).

All natural cheeses (blue, roquefort, camembert, cheddar, Swiss).

Low-fat or "light" cream cheese, low-fat or "light" sour cream.

Cream cheeses, sour cream.

Ice cream.

Egg yolks.

Vegetables prepared in butter, cream or other sauces.

Commercial baked goods: pies, cakes, doughnuts, croissants, pastries, muffins, biscuits, high-fat crackers, high-fat cookies.

Egg noodles.

Breads in which eggs are a major ingredient.

Chocolate.

Butter, coconut oil, palm oil, palm kernel oil, lard, bacon fat.

Dressings made with egg yolk.

Coconut.