Nibbling crisp, colorful salads, the 20 or so women sitting around the long conference table at St. Luke's Miners Memorial Hospital, Coaldale, listened as nurse practitioner Jeanette Richards got right to the heart of the biggest threat to women's health: cardiovascular disease and how to avoid it.

She spoke about nutrition, stress, age, hormones, diet and weight, smoking and exercise.

But most importantly, Richards spoke of empowering women to take charge of their own health.

"I want you all to be energetic, passionate and intelligent about your health," she told the women.

Richards, MSN, CRNP, is a nurse practitioner with St. Luke's Physician Group Tamaqua Family Practice, and is board certified from the American Nurses Credentialing Center. She spoke with the group recently about how the heart works, how it can become diseased, and what can be done to prevent that from happening. Richards also talked about supplements, medications, and healthy levels of cholesterol, blood sugar and triglycerides.

The information is crucial ammunition in women's battle against heart disease, she said.

The war is definitely on: While one in 30 American women die of breast cancer, almost one in three will die of cardiovascular disease, according to the American Heart Association. The enemy is stealthy: Almost 64 percent of women who die suddenly of coronary heart disease have no previous symptoms.

"I think it's crucially important that we, as women, take care of ourselves," Richards said.

She pointed out risk factors obesity, diabetes, age, high blood pressure, high cholesterol and high triglycerides, and family history. Some of those risk factors, such as age and family history, are beyond our control. But others, including cholesterol, triglycerides, blood pressure, weight and physical activity, can usually be changed by diet, exercise, medication and supplements.

Cholesterol comes in three types: the good, the bad, and the ugly.

The good cholesterol, the kind that seems to lower your risk of heart attack or stroke, is called HDL. Richards dubbed HDL "happy" cholesterol as a way of helping the women remember that HDL is the good kind. HDL levels should be greater than 50 mg/dL.

The bad type of cholesterol, the kind that causes cholesterol buildup and blockage in your arteries, is called LDL. LDL levels should be less than 100 mg/dL.

Triglycerides are the ugly type of fat in your blood called lipids. High levels of triglycerides can contribute to cardiovascular diseases. Triglyceride levels should be less than 150 mg/dL.

Cholesterol levels can be controlled in most people by avoiding fats, especially saturated and trans-fats, eating more fiber and getting physically active for at least 30 minutes on most days. Medications, including statin drugs such as Lipitor, also help reduce cholesterol.

A diet low in salt and fat and a lifestyle high in activity and weight loss if you are heavy, can reduce blood pressure to healthier levels, although medications may also be prescribed.

Richards also urged women to get enough of the "sunshine vitamin," Vitamin D at least 200 IU for people aged 19-50; 400 IU for those aged 51-70 and 600 IU for those 71 and older.

Vitamin D, good for overall health, is found in fatty fish, such as salmon, tuna and mackerel and beef liver. Many people take fish oil capsules, which Richards advises keeping in the freezer to avoid "fishy burps."

Vitamin D is also available in capsule form.

Wrapping up her message of healthy diets, exercise and compliance with prescribed medications, Richards reminded the women that their health is largely in their own hands.

"Your doctor is not in charge of your health," she said. "You are."