Even though it often gets a bad rap, cholesterol is actually essential for health. Your body needs cholesterol for important functions like building cells and creating hormones like estrogen and testosterone.1 The key is making 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 you can implement to maintain normal cholesterol levels.
What Is Cholesterol?
Cholesterol is a type of lipid, or a fat-like substance, your body naturally produces. Your 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 like meat, dairy, and eggs.
The body transports cholesterol through particles called lipoproteins which are made of fat and protein. This allows cholesterol—which doesn’t mix with water—to be carried in the blood and delivered to cells.
When you have your blood drawn to test your cholesterol levels, the healthcare providers are actually measuring the number of lipoproteins in your blood to then make an estimate of the amount of cholesterol.
There are several lipoproteins that are defined by the amount of protein and fat they contain. Cholesterol is categorized into types based on these lipoproteins.
HDL Cholesterol
High-density lipoprotein (HDL) contains the highest proportion of protein to cholesterol.
HDL is thought of as “good” or healthy cholesterol because this type of lipoprotein collects excess cholesterol and returns it to the liver. There, the body can remove the cholesterol or recycle it to use the cholesterol again.
HDL also helps reduce the size of arterial plaque, or fat buildup in the arteries, making it beneficial for heart disease prevention.
LDL Cholesterol
Low-density lipoprotein (LDL) has a lower proportion of protein to cholesterol. These lipoproteins carry around 67% of the cholesterol in your blood.
LDL is commonly known as “bad” cholesterol because having too much LDL circulating in your blood can contribute to plaque buildup in your arteries, increasing your risk for heart disease.
What Is Normal Cholesterol?
The blood test used to check your cholesterol levels is known as a lipid panel. A lipid panel will measure your HDL, LDL, and total cholesterol. Total cholesterol is how much of all types of cholesterol, such as HDL and LDL, is in your blood.
The test results might also include a measurement of non-HDL, which is both LDL and various other lipids that can contribute to plaque formation in your arteries and raise your risk for 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 raise your risk of heart disease and stroke.
Cholesterol is measured in milligrams of cholesterol per deciliter of blood. In charts, the measurement presents 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
Here are the cholesterol and triglyceride recommendations for adults aged 20 and over.596
Total Cholesterol | LDL | Non-HDL | HDL | Triglycerides | |
Recommended Range | 125-200 mg/dL | Less than 100 mg/dL | Less than 130 mg/dL | Men: 40 mg/dl or higher Women: 50 mg/dL or higher | Less than 150 mg/dL |
Borderline High | 200 to 239 mg/dL | 130 to 159 mg/dL | N/A | N/A | 150 to 199 mg/dL |
High | 240 mg/dL or higher | 160 mg/dL or higher | 130 mg/dL or higher | N/A | 200 mg/dL or higher |
It’s good to have higher levels of HDL cholesterol because HDL helps reduce arterial plaque buildup. Many experts currently recommend keeping your 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 for heart disease, especially if your LDL and triglyceride levels are elevated.
Normal Cholesterol Levels for Children
Here are the cholesterol and triglyceride levels for children and adolescents aged 19 and under.
Total Cholesterol | LDL | Non–HDL | HDL | Triglycerides | |
Recommended Range | Less than 170 mg/dL | Less than 110 mg/dL | Less than 120 mg/dL | 45 mg/DL or higher | Ages 0-9: Less than 75 mg/dL Ages 10-19: Less than 90 mg/dL |
Borderline High | 170 to 199 mg/dL | 110 to 129 mg/dL | 120 to 144 mg/dL | N/A | Ages 0-9: 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 | N/A | Ages 0-9: 100 mg/dL or higher Ages 10-19: 130 mg/dL or higher |
What Affects Cholesterol Levels?
There are certain factors that impact your cholesterol levels. Some factors, like age and gender, may be out of your control. But you can change other factors, like diet and activity, to improve your levels.
Factors that affect your cholesterol levels include:
- Age and sex: Many people’s cholesterol levels increase as they get older. After menopause, women’s LDL levels get higher, which can increase heart disease risk.
- Genetics: Those with a family history of high cholesterol are more likely to have high cholesterol levels. One in every 250 people has something called familial hypercholesterolemia, a genetic condition that causes high levels of LDL cholesterol.
- Diet: Following a diet high in ultra-processed and fatty foods and low in nutritious, fiber-rich foods can increase levels of LDL cholesterol and decrease HDL cholesterol.
- Body fat levels: Having high body fat levels increases your risk of developing high LDL and low HDL cholesterol.
- Activity levels: Leading a low-activity lifestyle is associated with lower HDL and higher LDL cholesterol. Becoming more active can improve cholesterol levels and lower your risk of heart disease.
- Smoking and excessive drinking: Smoking is significantly associated with high LDL cholesterol and low HDL cholesterol. Heavy alcohol use can also negatively impact 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 heart disease risk.
Follow a Nutrient-Rich Diet
Since cholesterol can come from consuming food, diet plays a big role in cholesterol management. If your LDL or total cholesterol is high or your HDL is low, making a few dietary changes can help improve your levels.
The typical U.S. diet is high in ultra-processed foods, added sugars, and saturated fat. These can all raise LDL cholesterol and triglyceride levels, while lowering HDL cholesterol.
Transitioning to a diet rich in whole, nutrient-rich foods like vegetables, beans, fruit, nuts, fish, and seeds can help reduce LDL cholesterol and increase HDL cholesterol levels. For instance, the Mediterranean diet features many of these foods and has been shown to improve cardiovascular health.
Maintain an Optimal Level of Body Fat
Higher body fat levels are significantly associated with increased LDL cholesterol.
For those who have high body fat levels, research has shown losing 5-10% of your body weight can significantly reduce total and LDL cholesterol as well as triglycerides.
Quit Smoking
Smoking cigarettes can lower your HDL cholesterol levels and put you at risk for a number of health conditions, including heart disease and cancer.5
If you need help quitting smoking, there are online resources to help you quit smoking. Your healthcare provider can also offer advice on how to stop smoking.
Increase Physical Activity
Leading a sedentary lifestyle, meaning you spend most of your time sitting or lying down and get little to no exercise, has been associated with higher total and LDL cholesterol levels.
Adding more physical activity to your daily life could help improve your cholesterol levels. Exercising 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 activity—or a combination of both—each week.
Moderate-intensity activity might include brisk walking or gardening while vigorous activity might include running or swimming laps.
Take Medication as Prescribed
Even when following a healthy diet and exercising regularly, some people may require medication to maintain normal cholesterol levels.
For instance, people who have a strong family history of high cholesterol, such as those with familial hypercholesterolemia, may not be able to manage their cholesterol and protect against heart disease with lifestyle changes alone.
If you’re unable to maintain normal cholesterol levels with just lifestyle changes, your healthcare provider may recommend taking a cholesterol-lowering medication, like a statin, to improve your cholesterol levels.
How Often Should Cholesterol Be Tested?
It’s important to test your cholesterol levels regularly so 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 who have heart disease, diabetes, or a family history of high cholesterol should get their levels checked more often.
Men should start having regular cholesterol screening at 35 if they don’t have risk factors for heart disease like obesity, smoking, high blood pressure, or high cholesterol. If they do have any of these risk factors, men should start screening between 25 to 30 years old.
Women should start having regular cholesterol screenings at 45 if they don’t have heart disease risk factors and at 30 to 35 years old if they do have those risk factors.
A healthcare provider should check a child’s cholesterol once between the ages of nine and 11 and once again between the ages of 17 and 21.
If you have at least one heart disease risk factor, your healthcare provider will recommend the most appropriate cholesterol screening cycle based on your overall health and heart disease risk.
A Quick Review
The liver naturally produces cholesterol. You also consume cholesterol through foods like meat, dairy, and eggs. Cholesterol is needed for critical processes such as making hormones and building cells.
While cholesterol is necessary for health, having normal cholesterol levels is key. For adults, a normal total cholesterol level is 125-200mg/dL. For children, a normal total cholesterol level is less than 170mg/dL. These levels are measured through a blood test called a lipid panel. The test measures not only cholesterol as a whole but also levels of specific types of cholesterol, such as LDL and HDL. Having high total and LDL cholesterol levels and low HDL levels can increase your risk of heart disease and other health issues.
Maintaining a nutrient-rich diet, getting the recommended amount of exercise, and quitting smoking can help you reach and maintain normal cholesterol levels.
If you’re unsure whether your cholesterol is within a healthy range, make an appointment with your healthcare provider so they can check your levels.