What You Need to Know About Your Cholesterol Levels

By: Lainey Younkin, M.S, R.D.  |  EatingWell.com May 2016
The good, the bad and the total: What is cholesterol—and is it important to know your levels?
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Keeping your cholesterol levels in a healthy range can reduce your risk for heart disease. Knowing your cholesterol numbers is a important part of taking care of your heart. Here, we break down what your cholesterol numbers mean and what healthy cholesterol levels are for men, women and children.

What Is Cholesterol?

Cholesterol is a waxy substance found in all cells of the body. You need it to make vitamin D, hormones and other substances. In fact, your body makes all the cholesterol that you need. But the foods we eat can also contain cholesterol. Dietary cholesterol is only found in animal products, such as meat, cheese and eggs. Plants and plant oils do not have any cholesterol.
Read More: 10 Foods That Lower Cholesterol
Cholesterol is carried through the body by high-density lipoproteins (HDL) and low-density lipoproteins (LDL). LDL is considered the "bad" cholesterol because it deposits plaque in your arteries. HDL is "good" because it transports the bad cholesterol from the arteries back to your liver, where it is removed from the body.
People with high LDL cholesterol have a greater risk of heart disease, while a high HDL is protective against heart disease.

High Cholesterol Levels

Genetics and diet can cause high LDL cholesterol. Some people inherit genes that cause their bodies to make too much LDL, but eating foods high in saturated and trans fats (think: cheese, red meat and fried foods) can also raise LDL. Therefore, changing your diet can lower your LDL cholesterol—but if you have a family history of high cholesterol, changing your diet might not make a difference.
Too much LDL cholesterol is dangerous because it can build up as plaque in your arteries. If the plaque breaks away from the artery wall it can form a clot in your bloodstream, leading to a heart attack or stroke. This is why doctors care about your cholesterol levels and why you should too.
In recent years, the medical community has moved away from focusing solely on cholesterol numbers and instead concentrating on how to lower overall risk of heart disease. Cholesterol is just one of many risk factors for heart disease. Smoking, diabetes and high blood pressure also increase heart disease risk, so your doctor may focus on managing these conditions first, even if your cholesterol is high.
Physicians use an online calculator created by the American Heart Association to determine someone's risk of developing heart disease in the next 10 years. "If your 10-year risk is relatively low, then it almost does not matter what your cholesterol is," says Bryan Woodward, M.D., family physician at Signature Healthcare in Charlotte, North Carolina. "The exception is if someone's LDL is greater than 190 mg/dL." On the other hand, "If the risk is high, then a patient warrants a good look at whether or not they should be treated with a statin [drug that reduces cholesterol]," Woodward says. "Statins not only lower cholesterol, but also have been shown to decrease the risk of cardiovascular events, independent of how much they lower cholesterol."
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Gender Differences: Cholesterol Levels in Men & Women

Heart disease is the number-one killer of both men and women in the United States. More men have heart disease than women, but it's important for everyone to keep their heart healthy. The healthy cholesterol ranges are the same for men and women (see below), and the National Institutes of Health recommends that everyone age 20 and older get their cholesterol checked every five years. However, most doctors use guidelines set by the U.S. Preventive Services Task Force, a panel of health experts that publishes screening recommendations. Based on the most recent clinical evidence, the USPSTF recommends that all men get their cholesterol checked starting at age 35, but if they have an increased risk of heart disease to begin checking earlier. The USPSTF recommends women get their cholesterol measured only if they have an increased heart disease risk based on other factors.

Cholesterol Levels in Children

The USPSTF does not recommend routine cholesterol screening for children, but the American Academy of Pediatrics (AAP) recommends all children between ages 9 and 11 get their cholesterol checked, due to the growing childhood obesity epidemic. Woodward says, "If a child is obese (BMI >30) or there is a strong family history of hyperlipidemia, then I recommend a one-time screening in adolescence to identify those who are significantly elevated and may prompt closer monitoring." However, he points out that it is unusual for a child to develop heart disease since it takes many years of high cholesterol to cause cardiovascular disease. "Instead, screening children helps us identify those kids that may be at risk and would benefit from lifestyle changes mostly to treat or prevent obesity," he says, like getting kids to be more active and eat a healthier diet.
Related: 5 New Things to Know About Cholesterol

Healthy Cholesterol Ranges

Physicians measure cholesterol levels with a simple blood test called a lipoprotein panel or lipid panel. It measures total cholesterol, LDL cholesterol, HDL cholesterol and triglycerides.
Triglycerides are a type of fat in your bloodstream and are also associated with increased risk of heart attack and stroke. Don't eat anything for 9-12 hours before the test for the best results.

Adult Cholesterol Ranges

Total Cholesterol:
<200 mg/dL Desirable
200-239 mg/dL Borderline high
=240 mg/dL High
LDL Cholesterol:
<100 mg/dL Optimal
100-129 mg/dL Near optimal
130-159 mg/dL Borderline high
160 – 189 mg/dL High
=190 mg/dL Very high
HDL Cholesterol:
<40 mg/dL Major risk factor for heart disease
=60 mg/dL Protective against heart disease
Triglycerides:
<150 mg/dL Normal
150-199 mg/dL Borderline high
200-499 mg/dL High
=500 mg/dL Very high

Child Cholesterol Ranges

Total Cholesterol:
<170 mg/dL Acceptable
170-199 mg/dL Borderline
>200 High
LDL Cholesterol:
<110 mg/dL Acceptable
110-129 mg/dL Borderline
>130 High

Bottom Line on Cholesterol Numbers:

While cholesterol is important, it is only one of many factors that determine your risk of developing heart disease. It's beneficial to know your cholesterol levels, but might be more beneficial to know your 10-year risk of developing cardiovascular disease. Next time you're at the doctor, ask him or her for a holistic view of your health that includes all your risk factors. You can't control your age, gender or family history, but you can control your diet, exercise, weight and other lifestyle factors.
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