Updated 7th March 2022

The different types of cholesterol and healthy levels for your age

A healthy cholesterol level depends on a number of factors, including your age. As you get older, your cholesterol levels change naturally, and your health risks due to high cholesterol can increase. 

Cholesterol isn’t simply “bad,” though. Your body needs it to function properly, and there are several different types of cholesterol that can impact your health in a range of ways. 

Too much of the wrong kind can increase your risk of heart problems like coronary artery disease, where narrowing of the vessels decreases blood flow to the heart.

Unpublished ZOE research with over 1,000 people found that levels of “bad” cholesterol get higher as we get older, especially in women.

Our research, based on the largest nutrition study in the world, has also shown that responses to food are hugely personal and can make a big difference to your risk of developing conditions like heart disease.

You can take a free quiz to find out how ZOE can help you eat the right foods for you.

And read on to learn more about healthy cholesterol levels by age.

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Types of cholesterol and what they mean for your health

Cholesterol is a waxy substance that is similar to fat that travels around your body in your bloodstream. As fat and water don’t mix, your cholesterol moves around in little packets called lipoproteins. 

There are three types of lipoproteins:

  • High-density lipoprotein (HDL), or “good” cholesterol: This takes cholesterol from the tissues in your body to your liver. Your liver then gets rid of it. You need a high level of good cholesterol to keep down your risk of heart disease.

  • Low-density lipoprotein (LDL), or “bad” cholesterol: This carries cholesterol to the tissues in your arteries, potentially leading to buildups and blockages. High levels of LDL can contribute to atherosclerosis, or hardened arteries, and heart disease.

  • Very low-density lipoprotein (VLDL): This type of lipoprotein transports triglycerides, another type of fat that your cells store for energy later on, around the body. The more VLDL you have in your blood, the higher your risk of hardening of the arteries and heart problems.

Cholesterol is produced in your liver. Your body uses cholesterol as building blocks to make vitamin D, the acids in your bile, and the hormones that trigger vital reactions. But your body makes as much cholesterol as it needs — what’s in your food is extra.

Too much can lead to buildup of cholesterol on the walls of your blood vessels, making it harder for blood to pass through. 

As these buildups — composed of cholesterol and other deposits — grow over time, it can lead to hardening and narrowing of the blood vessels, leading to atherosclerosis. If this happens in the arteries around your heart or those leading to your brain, it can lead to serious health problems.

Cholesterol levels in men and women

Unpublished research from ZOE found that women have higher levels of “good” HDL cholesterol than men for most of their lives, thanks to the effect of the hormone estrogen.

But later in life, their levels of “bad” LDL cholesterol go up significantly, increasing their risk of coronary artery disease. 

Men have more “bad” LDL cholesterol than women, but our researchers saw that, on average, their levels start to drop around middle age.

Healthy cholesterol levels by age

As you get older, your risk of heart disease due to high cholesterol increases. Your cholesterol levels also change naturally, especially if you’re a woman.

The National Institutes of Health (NIH) break down healthy levels of cholesterol into people under 19 years of age and those over 20. They also provide different ranges for men and women over 20.

The units used to measure cholesterol are milligrams per deciliter (mg/dL). That means the number of milligrams of cholesterol or lipoprotein in 1/10th of a liter of blood.

In other countries, like the U.K., cholesterol is measured in millimoles per liter (mmol/L), which gives a much smaller number.

People younger than 19 years of age

  • Total cholesterol: Less than 170 mg/dL

  • LDL: Less than 120 mg/dL

  • HDL: Less than 100 mg/dL

  • Non-HDL: More than 45 mg/dL

Men older than 20 years of age

  • Total cholesterol: 125-200 mg/dL

  • LDL: Less than 130 mg/dL

  • HDL: Less than 100 mg/dL

  • Non-HDL: 40 mg/dL or more

Women older than 20 years of age

  • Total cholesterol: 125-200 mg/dL

  • LDL: Less than 130 mg/dL

  • HDL: Less than 100 mg/dL

  • Non-HDL: 50 mg/dL or more

How and when to test your cholesterol levels

High cholesterol doesn’t often cause obvious symptoms, and you might not know about it until more harmful conditions are developing.

Regular testing can help you keep tabs on your cholesterol levels so that you can prevent the effects of high cholesterol further down the line.

Doctors can test your blood cholesterol with an easy blood test called a lipid profile. 

The Centers for Disease Control and Prevention (CDC) recommend that most otherwise healthy adults have a lipid profile test every 4–6 years. If you have a family history of high cholesterol or conditions like heart disease or diabetes, the CDC suggest you get tested more often.

Cholesterol, food, and eating for your body

Your liver produces enough cholesterol for it to complete its vital jobs around your body.

Although high LDL levels are associated with coronary artery disease as we’ve seen above, the previous notion that dietary cholesterol — which is the amount of cholesterol that we get from food — has a great effect on the risk of heart disease is now considered controversial

Researchers have found that while dietary cholesterol consumption can lead to higher serum cholesterol levels, it’s not clear how much this affects the risk of cardiovascular disease because studies have arrived at conflicting conclusions. 

Nevertheless, heart-healthy diets, such as the Mediterranean or DASH diets, inherently have relatively low cholesterol

While restricting the amount of cholesterol in your diet may not be the most important goal, eating a healthy diet is key to lowering your risk of cardiovascular disease. 

Eating the right foods for you

At ZOE, we run the largest nutritional study in the world, with over 15,000 participants so far. Our research has shown us that everyone responds differently to foods. 

After you eat, your blood fat and blood sugar levels rise and then fall again. This is normal, but some foods can lead to more severe or continued rises and dips. 

When repeated over time, this is associated with a greater risk of health conditions like coronary artery disease, stroke, and diabetes, which all have links to unhealthy cholesterol levels.

Also involved in these responses is your gut microbiome. This is the name for the community of trillions of different bacteria and other microorganisms that live in your gut. 

ZOE scientists have identified 15 “good” and 15 “bad” gut bugs, linked to a higher or lower risk of many metabolic diseases. Some of the “bad” bugs are associated with having lower levels of “good” cholesterol. 

With ZOE’s at-home test, you can discover your personal blood fat and blood sugar responses to what you eat, as well as the unique makeup of your gut microbiome. The ZOE program provides personalized nutrition advice to help you find the best foods for your body and your long-term health. 

You can take this free quiz to find out more.

Diet changes that may help cholesterol levels

Making a few other changes to your diet could make a difference to your blood cholesterol levels.

These could include: 

  • Eat less saturated fat. Eating foods high in saturated fats may lead to an increase in “bad” LDL levels — although more current research suggests the link isn’t as clear as scientists once thought. Foods like pizza, cheese, fatty meats including burgers, and cookies contain saturated fats. The occasional treat is fine. But if you’re looking to balance your cholesterol levels, it may be best to limit your intake of these and swap them for healthy fats from vegetable and fish oils.

  • Follow the “Mediterranean diet.” The Mediterranean diet is a healthy way of eating that involves plenty of vegetables, legumes like chickpeas and lentils, fruits, nuts, olive oil, whole grains, fish, and poultry, and very little red meat or unhealthy fats. It’s linked to better health during aging and a lower risk of factors that contribute to heart disease.

  • Manage your weight. In a study from 2016, people who lost 5–10% of their body weight saw a drop in triglycerides and “bad” LDL cholesterol without a drop in “good” HDL. If you have overweight, eating a healthy diet and being more active may help you to improve your cholesterol through weight management.

  • Try supplements. Some research supports the idea that red yeast rice and garlic supplements may reduce cholesterol. But scientists don’t agree on whether they can really help. You should speak to your doctor for advice on whether supplements could help your high cholesterol, and whether they might interact with any medication you’re already taking.

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Other ways to manage your cholesterol levels

We’ve looked at ways to manage your cholesterol levels through what you eat. But there are other lifestyle changes and healthcare decisions that can have an impact, too.

  • Exercise. As well as helping you to manage your body weight, which could have links to high cholesterol levels, exercise may also boost your “good” HDL function. So, go on walks, dance around your living room, get gardening — it could all help your cholesterol balance.

  • Avoid smoking. Research has shown that smoking can reduce HDL levels and increase triglycerides in your blood. Smoking also contributes to your risk of heart disease all on its own by causing plaque buildup along your artery walls, as well as a range of other harmful effects. If you smoke, look for help quitting. And if you don’t smoke, try to keep it that way.

  • Speak to your doctor. You may have inherited a medical condition like familial hypercholesterolemia. This can make it difficult to manage cholesterol levels without medical support. If you find your levels are consistently high despite putting measures in place to balance them, speak to your doctor about the next steps.

Summary

We often think of cholesterol as being bad for us, but it’s actually vital for the healthy functioning of your body. 

There are several types of cholesterol or — more accurately — lipoproteins, which carry cholesterol around your body. Healthy cholesterol levels are based on a combination of these. They also vary by age and sex. 

Too much cholesterol in your blood can increase your risk of hardened arteries and heart problems like coronary artery disease. 

Your body makes its own cholesterol, but the foods you eat, other lifestyle factors, or underlying conditions can add to this. 

Following the Mediterranean diet has been linked to a lower risk of high cholesterol. But everyone’s body responds differently to the foods they eat. 

ZOE’s at-home test can help you identify the foods that are best for your unique metabolism and your long-term health goals.

Take our free quiz to find out more.

Sources

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Dietary cholesterol and cardiovascular risk: A science advisory from the American Heart Association. Circulation. (2020). https://www.ahajournals.org/doi/full/10.1161/CIR.0000000000000743#

Dietary cholesterol and the lack of evidence in cardiovascular disease. Nutrients. (2018). https://www.mdpi.com/2072-6643/10/6/780

Effects of exercise on HDL functionality. Current Opinions in Lipidology. (2019). https://www.ncbi.nlm.nih.gov/labs/pmc/articles/PMC6492243/ 

Effects on cardiovascular risk factors of weight losses limited to 5–10%. Translational Behavioural Medicine. (2016). https://pubmed.ncbi.nlm.nih.gov/27528523/ 

Eggs and beyond: is dietary cholesterol no longer important? The American Journal of Clinical Nurition. (2015). https://academic.oup.com/ajcn/article/102/2/235/4614547?login=true

Familial hypercholesterolemia 101. (n.d.). https://thefhfoundation.org/familial-hypercholesterolemia 

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High cholesterol: lowering cholesterol without tablets. Institute for Quality and Efficiency in Health Care (IQWiG). (2006). https://www.ncbi.nlm.nih.gov/books/NBK279316/

Impact of Mediterranean diet on chronic non-communicable diseases and longevity. Nutrients. (2021). https://www.ncbi.nlm.nih.gov/labs/pmc/articles/PMC8231595/ 

Lowering your cholesterol with TLC. (n.d.). https://www.nhlbi.nih.gov/files/docs/public/heart/chol_tlc.pdf

Managing blood pressure with a heart-healthy diet. (n.d.). https://www.heart.org/en/health-topics/high-blood-pressure/changes-you-can-make-to-manage-high-blood-pressure/managing-blood-pressure-with-a-heart-healthy-diet

Mediterranean diet and the hallmarks of ageing. European Journal of Clinical Nutrition. (2021). https://www.nature.com/articles/s41430-020-00841-x 

Saturated fat: part of a healthy diet. Current Nutrition Reports. (2018). https://pubmed.ncbi.nlm.nih.gov/30084105/ 

Smoking and cardiovascular disease. (n.d.). https://www.cdc.gov/tobacco/data_statistics/sgr/50th-anniversary/pdfs/fs_smoking_CVD_508.pdf 

Smoking intensity and lipoprotein abnormalities in active smokers. Journal of Clinical Lipidology. (2009). https://www.ncbi.nlm.nih.gov/labs/pmc/articles/PMC2802067/ 

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