Are you an apple or a pear? The answer to that question could very well tell you if you’re at risk for high cholesterol and heart disease.

Waist circumference has become a benchmark for determining heart health, said Dr. Mary Ann McLaughlin, a cardiologist at Mount Sinai Medical Center in New York City.

People with apple shapes carry more weight around their abdominal regions giving them larger waist circumferences, whereas people who are pear-shaped tend to have small waists and large hips and thighs.

“The pear shape is the protective shape,” McLaughlin explained. “With apple shapes, where people tend to have large waists with skinny legs and hips, the risk of high cholesterol and heart disease is higher. What we’ve found is that the fat tissue that lines the abdomen, the adipose fat, is high in the inflammatory markers that lead to heart and cholesterol problems.”

Cholesterol is a substance found throughout the body that is carried in blood particles called lipoproteins. An excess of cholesterol can lead to a complete blockage of the coronary artery, which will trigger a heart attack. A total cholesterol level of less than 200 is considered healthy.

Waist circumference is a problem for both men and women but the cause is contradictory.

“As women age, their cholesterol profile changes because as estrogen levels go down, the HDL or good cholesterol also goes down and the LDL or the bad cholesterol goes up,” McLaughlin said.

Most often the cause is the decline of female estrogen levels and the increase of testosterone, which accompanies menopause. As men age, the opposite often occurs, estrogen levels go up and testosterone levels go down.

“In men, the low testosterone levels that sometimes occur in 50s and 60s can increase the risk for heart disease, pre-diabetes, and insulin resistance,” McLaughlin said. “During this time, we also see an increase in abdominal fat. So it’s actually the opposite of women where we see a decrease in estrogen causing an increase in adipose fat.”

McLaughlin said curbing belly fat is the key to cutting the risk for both high cholesterol and heart disease.

She offers these tips to do so:

Exercise, especially your midsection. Even if you don’t lose a single pound, you can cut your risk of heart disease by doing sit-ups and crunches, which will slim your stomach and waist line, McLaughlin said.

Reduce carbohydrate intake. Simple carbs, the type found in white flour, pasta, rice and potatoes, have been shown to increase abdominal fat. Reducing these carbs is a good way to lower your risk for heart disease and cholesterol.

Get nutty. Eating 12-24 walnuts or almonds each day has been shown to reduce cholesterol levels, according to McLaughlin.

Sprinkle flax. Flaxseed has cholesterol-lowering properties. McLaughlin recommends sprinkling the powder on cereal or yogurt rather than taking supplements.

Drink up. Wine, grape juice and cranberry juice are all effective cholesterol fighters, McLaughlin said. Although grape and cranberry juices can be imbibed anytime, wine should be limited to one glass per day for women and two for men, McLaughlin said.