Cholesterol is a waxy, fat-like substance attached to proteins and carried through the bloodstream. Cholesterol is a vital and necessary part of cellular function in the body. It is made in the liver and is also found in foods derived from animal products, such as meat, dairy and eggs. Cholesterol helps cell membranes produce bile, hormones and vitamin D.

There are two types of cholesterol: low-density lipoproteins (LDL), known as bad cholesterol, and high-density lipoproteins (HDL), known as good cholesterol. While small amounts of cholesterol are necessary, too much causes plaque buildup in arteries, which elevates the risk of heart disease and stroke.

LDL levels should be below 100 in men and women.
HDL levels should be above 50 in women and 40 for men.
Triglycerides, a type of fat found in blood, should be below 150 for men and women.

Total Cholesterol Levels

  • Acceptable: less than 170 mg/dL
  • Borderline: 170-199 mg/dL
  • High: 200 mg or greater

Following a healthy diet, avoiding foods high in saturated fats, exercising regularly and maintaining an ideal weight are easy ways to keep cholesterol levels in check. To improve cholesterol numbers, exercise is extremely important because being active will raise the HDL and lower LDL. Making slight changes to your diet can lower cholesterol, as well.

“What we really care about, nowadays, is your ratio of LDL to HDL,” ER physician Dr. Travis Stork explains.

The American Heart Association states that the ideal cholesterol ratio is 3.5:1 or lower.

“You should know these numbers and understand them, because it should dictate how you eat,” Dr. Travis says. “I would also argue that if you’ve ever made a recent change in your dietary habits then it’s worth rechecking your cholesterol. It’s amazing how much the foods we eat actually play into our cholesterol,” he adds.

At-Home Cholesterol Test

Cholesterol levels can be used as an indicator of heart health. Learn how an at-home cholesterol test works.

Read the Labels
Trans-hydrogenated fats, or trans fats, and saturated fats are both bad fats that raise LDL levels.

Trans fats are found in processed and fast foods. They lower HDL levels and increase your risk of heart disease, diabetes and infertility.

Saturated fats, found mainly in foods from animals and some plants, are the biggest dietary cause of high blood cholesterol, and are typically found in animal products such as butter, cheese, whole milk, ice cream, cream and fatty meats.

"Saturated fat has been proven to ruin your memory," Dr. Travis adds. "There are also thoughts that too much saturated fat can lead to Alzheimer's disease."

Trans fats can be found in snack foods like cookies, donuts, pizza, pies, baked goods and margarine. Read food labels carefully, as trans fats can go by different names such as: hydrogenated oils, partially hydrogenated oils and trans fatty acid. The American Heart Association recommends that less than seven percent of daily caloric intake should come from saturated fat and less than one percent should be from trans fat.

High Cholesterol in Children
As the incidence of childhood obesity reaches epidemic proportions, an astonishing number of children, as young as 8 years old, are taking medication to control their high cholesterol. But how young is too young to start children on a lifetime of medications? The American Academy of Pediatrics recommends testing children for cholesterol as early as age 2.

Dr. Beatrice Golomb is an Associate Professor of Medicine at University of California, San Diego who researches statins (medicine that lowers cholesterol). She is not convinced that the benefits of statins exceed the harm. Dr. Alan Lewis is a pediatric cardiologist at Children’s Hospital Los Angeles who believes in using statins with children only as a last resort. He believes that the benefits of the drugs outweigh the risks. 

"A lot of parents don't think about cholesterol in their kids," pediatrician Dr. Jim Sears says. "We're supposed to be checking it really early, even as early as age 2, especially if there's a family history of high cholesterol. In some families, you may be healthy, and exercise and eat right, but still, your cholesterol can be a little bit high."

"Some people are going to be predisposed, based on genetics, to have high cholesterol," Dr. Travis says. "That doesn't mean that you can't take steps in your life to lower your numbers. If you do all the right things, there are some people who still need to be on cholesterol-lowering medications."