What Is a Healthy Cholesterol Level by Age?

Cholesterol Basics | Levels by Age | Get Your Cholesterol Checked | What Affects Cholesterol Levels | Lower Your Cholesterol | When to See a Provider | Summary

Normal HDL and LDL cholesterol ranges vary by age and assigned sex. HDL cholesterol is the “good” cholesterol you generally want more of, while LDL cholesterol is the “bad” cholesterol you generally want less of.

For most healthy adults 19 years and older, your LDL should be less than 100 milligrams per deciliter (mg/dL), and your HDL should be greater than 40 mg/dL. For teens and children 19 and younger, the LDL should be less than 110 mg/dL, while the HDL should be greater than 45 mg/dL.

What Are Cholesterol Levels?

Cholesterol is a type of fatty compound called a lipid that has many roles in the body. It is the building block for many hormones and vitamin D and also helps carry other lipids to organs and tissues in the body. Cholesterol is found in the foods you eat, but it is also made by the liver.

Cholesterol circulating in the blood is carried by special particles called lipoproteins. The two major cholesterol-carrying lipoproteins include:

• Low-density lipoprotein (LDL): This is often referred to as “bad” cholesterol because too much of it can build up in your arteries and form plaques, which increases the risk of heart disease or stroke. As a general rule, you should keep LDL levels low to prevent plaque formation.
• High-density lipoprotein (HDL): This is often referred to as “good” cholesterol as it absorbs excess cholesterol in the blood and carries it back to the liver to be flushed from the body. As a general rule, you want more HDL to lower your risk for heart disease and stroke.

The combination of your LDL and HDL cholesterol is called your total cholesterol. Dividing your total cholesterol number by your HDL cholesterol number provides you with your cholesterol ratio, the value of which can be used to predict your lifetime or 10-year risk for a heart attack or stroke.

There are many factors that can influence your cholesterol levels, including, diet, exercise, weight, genetics, and other health conditions.

Healthy Cholesterol Levels by Age and Gender

The recommended ranges for your cholesterol will vary based on age and assigned sex. As people get older, cholesterol levels rise naturally due in large part to changes in diet, less physical activity, and changes in hormone levels.

Cholesterol Levels in Adults

For most healthy adults 20 and older, the total cholesterol should be less than 200 mg/dL.

The following is a breakdown of total cholesterol levels by age and assigned sex:

Cholesterol Levels in Children

For teens and children 19 and younger, the total cholesterol should be less than 170 mg/dL.

The following is a breakdown of total cholesterol levels for those 19 and under:

How Often Should I Get My Cholesterol Checked?

High cholesterol usually has no symptoms. This is why it’s important to get your cholesterol levels checked. If you do have symptoms, they are often associated with related conditions like high blood pressure, which can cause fatigue, chest pain, and irregular heartbeat. 

According to the Centers for Disease Control and Prevention (CDC), most healthy adults should get their cholesterol checked every four to six years.

Your risk factors also determine how often your cholesterol should be checked. Adults who have a history of high cholesterol, heart disease, diabetes, or obesity need more frequent readings. Because older adults are more vulnerable to these conditions, they may be checked annually during a routine physical.

Children should have their cholesterol checked at least once between the ages of 9 and 11 and again between 17 and 20 years of age.

If a child has a family history of high cholesterol or heart disease or is overweight or obese, their pediatrician may recommend getting checked sooner and more often.

What Affects Cholesterol Levels?

There are a variety of factors that can affect cholesterol levels. Some risk factors are within your control, while others are not.

These include:

• Genetics: Examples include a family history of heart disease or an inherited condition called familial hypercholesterolemia.
• Sex: Males often have higher levels of LDL than females. But, LDL levels can increase after menopause.
• Weight: People who are overweight or obese are at increased risk of high cholesterol.
• Sedentary lifestyle: Lack of physical activity can increase the risk of overweight and obesity, which, in turn, increase cholesterol levels.
• Diet: Eating too many saturated and trans fats and not enough fiber can lead to high cholesterol.
• Age: Your body’s ability to clear cholesterol tends to progressively decrease as you age.
• Race and ethnicity: High cholesterol rates can vary by race/ethnicity, with the highest being among non-Hispanic Asian males and non-Hispanic White females. People who are Hispanic or South Asian have very high rates of lipid disorders and atherosclerotic disease.
• Smoking: Smoking can independently increase LDL and decrease HDL levels.
• Other medical conditions: A history of high blood pressure, heart disease, or diabetes is linked to an increased risk of high cholesterol.
  

How to Lower Cholesterol

Children and adults benefit from getting regular exercise, maintaining a healthy weight, and eating a well-balanced diet rich in fiber. Medications can also help when these lifestyle interventions fall short.

Here are some simple guidelines that can help reduce your “bad” LDL levels and increase your “good” HDL levels:

1. Eat Fruits, Vegetables, Nuts, and Seeds

Studies have shown that a diet rich in plants, such as fruits, vegetables, nuts, seeds, whole grains, and legumes, can reduce the risk of heart disease, stroke, and death.

Fruits and vegetables are rich in fiber which acts like a sponge, binding to cholesterol and helping clear it from the body.

Adults and children 9 years and over should consume 1.5 to 2 cups of fruit, 2.5 to 3 cups of vegetables, and 3 to 6 ounces of whole grains every day.

2. Reduce Unhealthy Fats

Saturated fat and trans fat are solid fats that can increase cholesterol and contribute to the buildup of plaques in the arteries. The American Heart Association (AHA) recommends that adults reduce saturated fat to less than 6% of total calorie intake.

For someone on a 2,000-calorie diet, that would equal 13 grams of saturated fat (the equivalent of 2 tablespoons of butter).

Foods rich in saturated and trans-fat include:

• Fatty meats
• Cured meats like bacon and sausage
• Poultry meat, fried foods
• Full-fat dairy, including butter, cream, and ice cream
• Baked goods
• Fast food
• Shortening
• Microwave popcorn
• Frozen pizza
• Fried foods, including french fries, doughnuts, and fried chicken.
• Nondairy coffee creamer
• Stick margarine

3. Increase Healthy Fats

Healthy fats, such as omega-3 fatty acids found in seeds like nuts, seeds, fatty fish, and fish oil can help increase your HDL.

Good food sources of omega-3s include:

• Flaxseed
• Chia seeds
• Walnuts
• Salmon
• Herring
• Sardines
• Mackerel
• Soybean oil
• Oysters
• Sea bass
• Edamame
• Shrimp
• Refried beans
• Tuna
• Kidney beans
• Whole wheat bread
• Eggs
• Low-fat milk
  

Lower-fat cooking methods may also help to reduce cholesterol. You can make swaps such as using olive oil or soybean oil instead of butter. Aim to bake, broil, steam, poach, or grill more often and reduce the amount of frying.

4. Exercise Regularly

Physical activity is beneficial for overall health, including heart health. Being physically active is associated with a healthier weight and improvement in cholesterol levels.

Adults should aim for a minimum of moderate-to-intense aerobic activity of 150 minutes per week and muscle training twice weekly. This might seem overwhelming, but you can reap the benefits by exercising in 10-minute intervals.

School-aged children should get at least 60 minutes of physical activity daily, while preschoolers are encouraged to move throughout the day.

The best way to start an exercise program is to find something you enjoy doing. When you can, make it a family affair by going on a bike ride, a walk, or engaging in a game of basketball, kickball, or tag.

If you have an existing health condition and are not exercising regularly, consult with your healthcare provider before starting an exercise program.

5. Quit Smoking

Smoking can independently raise LDL and lower HDL levels. This is because tobacco smoke contains a substance called acrolein that interferes with HDL’s ability to transport cholesterol back to the liver for clearance. It also makes LDL “stickier” and more likely to cling to arterial walls.

The AHA recommends quitting smoking and avoiding secondhand smoke to improve cholesterol.

Smoking also causes the narrowing of blood vessels, a factor that promotes the buildup of plaque on the artery walls and hardening of the artery walls, called atherosclerosis (“hardening of the arteries”). Diseases linked to atherosclerosis are today the leading cause of death in the United States.

6. Maintain a Healthy Weight

Carrying too much weight in the abdomen (belly) can increase the risk of heart disease. It is also associated with increased LDL and decreased HDL levels. The loss of as little as 5% to 10% of your body weight has been shown to improve cholesterol levels.

For children 12 and older with obesity, weight loss medications may be appropriate in addition to exercise, behavioral therapy, and dietary changes.

7. Medications

If lifestyle changes alone don’t help to reduce your cholesterol, you may need medications. The decision to start medication will also depend on your medical history, age, weight, and if you have any other risk factors for heart disease, including high blood pressure or diabetes.

There are many different types of medications used to treat cholesterol, including:

• Statins like Lipitor (atorvastatin), Pravachol (pravastatin), and Crestor (rosuvastatin)
• Bile acid sequestrants like Prevalite (cholestyramine), Welchol (colesevelam), and Colestid (colestipol)
• Cholesterol absorption inhibitor called Zetia (ezetimibe)
• PCSK9 inhibitors like Praluent (alirocumab) and Repatha (evolocumab
• Citrate lyase inhibitors like Nexletol (bempedoic acid) and Nexlizet (bempedoic acid-ezetimibe)
  

Medication may be indicated in children if your child has familial hypercholesterolemia. The Food and Drug Administration (FDA) has approved certain statins starting at age 8 under the direction of a qualified pediatrician.

When to See a Healthcare Provider

It’s important to get your cholesterol checked every four to six years. You may need to get it checked more frequently if you are older and/or have a history of high cholesterol, heart disease, diabetes, or obesity.

If you need help managing your cholesterol levels, reach out to your healthcare provider. They may be able to recommend lifestyle changes and/or medications that can help.

Summary

Cholesterol levels tend to rise with age, so the recommended ranges for your cholesterol will depend on your age. Many factors affect your cholesterol levels in addition to age, including those over which you have control. If lifestyle changes cannot keep your cholesterol levels at a healthy level, your healthcare professional may recommend medication.

Keeping your cholesterol levels in the normal range is important in the prevention of heart disease. If you’ve recently had a cholesterol screening and your levels are high, there are many lifestyle changes you can make to get them in a healthier range.