The American College of Cardiology and the American Heart Association just released new cholesterol guidelines to reduce the cardiovascular risks. The changes are pretty significant.

First, the guidelines have moved away from achieving target cholesterol levels. Instead of focusing on laboratory numbers, doctors are encouraged to focus on whether a therapy lowers the risk of heart disease and stroke. Studies over the past several years have shown that improving your lab number with drugs is not equivalent to lowering your heart risks. The guidelines still state that cholesterol is important, but lowering the cholesterol number just with medications may come with other side effects that offset the benefit of reducing cholesterol.

There's one exception to the numbers rule. People with very high levels of the harmful cholesterol known as LDL still need to worry about targets. The new guidelines set that LDL level at 190 milligrams per deciliter — but the principle is that if people have very high cholesterol levels, then their cardiovascular risk is so high that it is likely that treatment to reduce the levels would offset any risks of the drug treatment.

So, the new guidelines are saying: We should not be chasing the cholesterol levels alone. The "know your number" campaign is no longer consistent with the guidelines, and the days of doctors adding additional medications to get you to some arbitrary cholesterol number should no longer occur.

The second big change in the guidelines is to focus on overall risk of heart disease and stroke. Drug treatment is recommended for people with a high risk — and that more powerful treatments are best for those with the highest risk. There's even an online calculator to figure out your risk, and then determine if you want to take medication. It's available on the American Heart Association website.

Finally, if you choose to use medication, the recommendations suggest statins, the drug class with clear evidence that it can lower risk in many groups of patients. In fact, statins seem to lower risk regardless of your cholesterol levels. So the guidelines now make clear that if you use drug therapy for higher risk, you should use statins.

Here's the new bottom line to the guidelines — don't just chase a number, know your risk. And if you need drug therapy, use statins.

Information courtesy of the American Heart Association.

Q and A

Q: How long can cooked vegetables, as leftovers, be stored in the refrigerator before they should be thrown out?

A: For leftovers of any kind, the issue is really about food safety rather than the retention of nutrients. Bacteria and mold will eventually grow — even in the refrigerator. To avoid the risk of consuming something that might make you sick (a foodborne illness), the general rule is consume most cooked foods within three to five days of refrigeration. If in doubt, throw it out.

Information courtesy of the Tufts Health and Nutrition Letter.

Recipe

This recipe for Chicken Enchilada Casserole, from Cooking Light, fits under the label of a healthy casserole. Try it when you're craving something Southwestern.

Chicken Enchilada Casserole

—Cooking spray

—4 bone-in chicken thighs, skinned

—1/3 cup chopped fresh cilantro, divided

—1 cup frozen corn kernels, thawed

—1/3 cup (3 ounces) 1/3-less-fat cream cheese, softened

—1/2 teaspoon ground red pepper

—1/2 teaspoon ground cumin

—1/4 teaspoon kosher salt

—1/4 teaspoon black pepper

—2 cups chopped onion, divided

—6 garlic cloves, minced and divided

—1 cup fat-free, lower-sodium chicken broth

—2/3 cup salsa verde

—1/4 cup water

—2 tablespoons chopped pickled jalape?o pepper

—9 (6-inch) corn tortillas

—1/4 cup (1 ounce) shredded sharp cheddar cheese

Preheat oven to 425?. Heat a large ovenproof skillet over medium-high heat. Coat pan with cooking spray. Add chicken to pan; saute 4 minutes on each side. Place skillet in oven; bake at 425? for 10 minutes or until done. Remove chicken from pan; let stand 15 minutes. Remove meat from bones; shred. Discard bones. Place chicken in a medium bowl. Add 1 1/2 tablespoons cilantro, corn, and next 5 ingredients (through black pepper) to chicken; toss to combine. Return pan to medium-high heat. Add 1/2 cup onion; saute 5 minutes, stirring occasionally. Add 3 garlic cloves; saute 30 seconds, stirring constantly. Add onion mixture to chicken mixture; stir to combine. Combine remaining 1 1/2 cups onion, remaining 3 garlic cloves, broth, salsa, 1/4 cup water, and jalapeno in a medium saucepan over medium-high heat; bring to a boil. Reduce heat, and simmer 15 minutes, stirring occasionally. Remove from heat; let stand 10 minutes. Carefully pour mixture into a blender; add 2 tablespoons cilantro. Process until smooth. Heat a large skillet over medium-high heat. Add 2 tortillas; cook 1 1/2 minutes on each side. Remove tortillas from pan; repeat procedure with remaining tortillas. Cut tortillas into quarters. Spread 1/2 cup salsa mixture in the bottom of an 8-inch square glass or ceramic baking dish coated with cooking spray. Arrange 12 tortilla quarters over salsa mixture. Spoon half of chicken mixture over tortillas. Repeat layers, ending with tortillas. Pour remaining salsa mixture over tortillas; sprinkle evenly with cheddar cheese. Bake at 425? for 15 minutes or until bubbly and lightly browned. Top with remaining cilantro. Serves four.

Per serving: 371 calories, 23.1 g protein, 45.3 g carbohydrate, 12.4 g fat, 80 mg cholesterol, 5.4 g fiber, 759 mg sodium.

Charlyn Fargo is a registered dietitian from Springfield, Ill. For comments or questions, contact her at [email protected] or follow her on Twitter @NutritionRD. To find out more about Charlyn Fargo and read features by other Creators Syndicate writers and cartoonists, visit the Creators Syndicate website at www.creators.com.