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Medically reviewed by Jeffrey S. Lander, MD
Although it often gets a bad rap, cholesterol is actually essential to health. Your body needs cholesterol to carry out important functions such as building cells and creating hormones such as estrogen and testosterone. The key is to make sure your cholesterol stays within a certain range.
Maintaining normal cholesterol levels can help protect you from heart disease and maintain overall health.
There are certain factors that affect cholesterol and several lifestyle changes that you can implement to maintain normal cholesterol levels.
What is cholesterol?
Cholesterol is a type of fat, or fat-like substance, that your body produces naturally. The liver makes all the cholesterol your body needs to perform essential functions like building cells and producing vitamin D and hormones.
Most people also consume dietary cholesterol through foods such as meat, dairy products, and eggs.
The body transports cholesterol through molecules called lipoproteins, which are made up of fats and proteins. This allows cholesterol – which does not mix with water – to circulate in the blood and be transported to cells.
When your blood is drawn to test your cholesterol levels, health care providers are actually measuring the number of lipoproteins in your blood to estimate the amount of cholesterol in your blood.
There are many lipoproteins that are determined by the amount of protein and fat they contain. Cholesterol is classified into types based on these lipoproteins.
HDL cholesterol
High-density lipoprotein (HDL) has the highest ratio of protein to cholesterol.
HDL is thought of as “good” or healthy cholesterol because this type of lipoprotein collects excess cholesterol and carries it back to the liver. There, the body can either remove the cholesterol or recycle it to use the cholesterol again.
HDL also helps reduce the size of arterial plaque, or the buildup of fat in the arteries, making it beneficial for preventing heart disease.
LDL cholesterol
Low-density lipoprotein (LDL) has a lower ratio of protein to cholesterol. These lipoproteins carry about 67% of the cholesterol in the blood.
LDL is known as the “bad” cholesterol because too much LDL circulating in the blood can contribute to plaque buildup in the arteries, which increases the risk of heart disease.
What is normal cholesterol?
The blood test used to check cholesterol levels is known as a lipid panel. The lipid panel will measure HDL, LDL, and total cholesterol. Total cholesterol is the amount of all types of cholesterol in the blood, such as HDL and LDL.
Test results may also include a measure of non-HDL, which is both LDL and various other fats that can contribute to the formation of plaque in the arteries and increase the risk of heart disease. This includes very low-density lipoprotein (VLDL), which is 90% fat.
Another component of the lipid panel is triglycerides. Your body uses triglycerides for energy, but having high levels can increase your risk of heart disease and stroke.
Cholesterol is measured in milligrams of cholesterol per deciliter of blood. In the graphs, the measurement is shown as mg/dL.
To keep your heart and the rest of your body healthy, it’s important to keep your cholesterol and triglyceride levels within certain ranges.
Normal cholesterol levels for men and women
The following are cholesterol and triglyceride recommendations for adults ages 20 and older.
|
total cholesterol |
LDL |
Change HDL |
HDL |
Triglyceride |
|
|
recommended range |
125-200 mg/dl |
Less than 100 mg/dL |
Less than 130 mg/dL |
Men: 40 mg/dL or more For women: 50 mg/dL or more |
Less than 150 mg/dL |
|
high bounds |
200 to 239 mg/dL |
130 to 159 mg/dL |
Unavailable |
Unavailable |
150 to 199 mg/dL |
|
high |
240 mg/dL or higher |
160 mg/dL or higher |
130 mg/dL or higher |
Unavailable |
200 mg/dL or higher |
It is good to have higher levels of HDL cholesterol because HDL helps reduce arterial plaque buildup. Many experts currently recommend keeping HDL levels above 60 mg/dL, which is considered “excellent” and can help keep your heart healthy.
If your HDL is below the recommended range, it may increase your risk of heart disease, especially if your LDL and triglyceride levels are high.
Normal cholesterol levels for children
Here are the cholesterol and triglyceride levels for children and teens ages 19 and under.
|
total cholesterol |
LDL |
Change HDL |
HDL |
Triglyceride |
|
|
recommended range |
Less than 170 mg/dL |
Less than 110 mg/dL |
Less than 120 mg/dL |
45 mg/dl or higher |
Ages 0 to 9 years: Less than 75 mg/dL Ages 10 to 19: Less than 90 mg/dL |
|
high bounds |
170 to 199 mg/dL |
110 to 129 mg/dL |
120 to 144 mg/dL |
Unavailable |
Ages 0-9 years: 75-99 mg/dL Ages 10-19: 90-129 mg/dL |
|
high |
200 mg/dL or higher |
130 mg/dL or higher |
145 mg/dL or higher |
Unavailable |
Ages 0 to 9: 100 mg/dL or higher Ages 10 to 19: 130 mg/dL or higher |
What affects cholesterol levels?
Certain factors affect your cholesterol levels. Some factors, such as age and gender, may be beyond your control. But you can change other factors, such as diet and activity, to improve your levels.
Factors that affect blood cholesterol levels include:
-
age and gender: Many people’s cholesterol levels increase as they get older. After menopause, women’s LDL levels rise, which can increase the risk of heart disease.
-
Genetics: Those with a family history of high cholesterol are more likely to have high cholesterol levels. About 1 in 250 people have familial hypercholesterolemia, an inherited condition that causes high levels of low-density lipoprotein cholesterol.
-
My diet: A diet high in highly processed, fatty, and low-nutrient foods, high-fiber foods can increase LDL cholesterol levels and decrease HDL cholesterol.
-
body fat levels: High levels of body fat increase your risk of high LDL cholesterol and low HDL cholesterol.
-
activity levels: A sedentary lifestyle is associated with lower HDL and higher LDL cholesterol. Becoming more active can improve cholesterol levels and reduce the risk of heart disease.
-
Smoking and excessive drinking: Smoking is significantly associated with higher LDL cholesterol and lower HDL cholesterol. Heavy drinking can negatively affect cholesterol levels and heart health.
How to maintain normal cholesterol levels
If you have high cholesterol levels, there are several ways to improve levels and reduce your risk of heart disease.
Eat a nutrient-rich diet
Since cholesterol can come from eating food, diet plays a huge role in managing cholesterol. If your LDL or total cholesterol is high or your HDL is low, making some dietary changes can help improve your levels.
The typical diet in the United States is high in highly processed foods, added sugars, and saturated fats. All of these can raise levels of bad LDL cholesterol and triglycerides, while lowering HDL cholesterol.
Transitioning to a diet rich in whole, nutrient-dense foods such as vegetables, beans, fruits, nuts, fish and seeds can help reduce LDL cholesterol and increase HDL cholesterol levels. For example, the Mediterranean diet features many of these foods and has been shown to improve cardiovascular health.
Maintain an optimal level of body fat
High levels of body fat are significantly associated with increased LDL cholesterol.
For those with high levels of body fat, research has shown that losing 5-10% of body weight can significantly reduce total cholesterol, LDL cholesterol, and triglycerides.
Quit Smoking
Cigarette smoking can lower levels of HDL cholesterol, and puts you at risk for a number of health conditions, including heart disease and cancer.
If you need help quitting smoking, there are online resources to help you quit. Your healthcare provider can also provide advice on how to stop smoking.
Increased physical activity
Having a sedentary lifestyle, meaning you spend most of your time sitting or lying down and not exercising at all, is associated with higher levels of total cholesterol and levels of LDL cholesterol.
Adding more physical activity to your daily life can help improve your cholesterol levels. Exercise has been shown to lower LDL cholesterol and increase HDL cholesterol.
The American Heart Association recommends getting at least 150 minutes of moderate-intensity activity or 75 minutes of vigorous aerobic exercise — or a combination of both — each week.
Moderate activity might include brisk walking or gardening while vigorous activity might include running or swimming.
Take the medication as prescribed
Even when eating a healthy diet and exercising regularly, some people may need medication to maintain normal cholesterol levels.
For example, people with a strong family history of high cholesterol, such as those with familial hypercholesterolemia, may not be able to manage cholesterol and protect against heart disease through lifestyle changes alone.
If you are unable to maintain normal cholesterol levels through lifestyle changes alone, your healthcare provider may recommend a cholesterol-lowering medication, such as a statin, to improve your cholesterol levels.
How often should cholesterol be tested?
It is important to have your cholesterol levels tested regularly so that you and your healthcare provider can keep track of your levels.
Healthy adults should have their cholesterol levels checked every four to six years. People with heart disease, diabetes, or a family history of high cholesterol should check their levels more often.
Men should begin regular cholesterol screening at age 35 if they do not have risk factors for heart disease such as obesity, smoking, high blood pressure, or high cholesterol. If they have any of these risk factors, men should start screening between ages 25 and 30.
Women should start having regular cholesterol checks at age 45 if they don’t have risk factors for heart disease and at age 30 to 35 if they do.
A health care provider should check a child’s cholesterol once between the ages of nine and 11 and again between the ages of 17 and 21.
If you have at least one risk factor for heart disease, your healthcare provider will recommend the most appropriate course of cholesterol screening based on your overall health and risk of heart disease.
Quick review
The liver naturally produces cholesterol. You also consume cholesterol through foods such as meat, dairy products, and eggs. Cholesterol is needed for critical processes such as making hormones and building cells.
While cholesterol is essential to health, having normal cholesterol levels is key. For an adult, a normal total cholesterol level is 125-200 mg/dL. For children, a normal total cholesterol level is less than 170 mg/dL. These levels are measured by a blood test called a lipid panel. The test measures not only cholesterol as a whole, but also levels of certain types of cholesterol, such as LDL and HDL. High levels of total and LDL cholesterol and low levels of HDL can increase your risk of heart disease and other health problems.
Maintaining a nutrient-dense diet, getting the recommended amount of exercise, and quitting smoking can help you reach and maintain normal cholesterol levels.
If you are not sure if your cholesterol is in the healthy range, make an appointment with your healthcare provider so they can check your levels.
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