Good heart health is like a building block: It’s cumulative.

The earlier you try to start making healthy lifestyle choices, the better off you can be as you get older. Think about making small changes now that will lead to big changes years later. It’s like a train altering its course slightly, which leads to a big difference in its final destination.

This is particularly true when it comes to high cholesterol.

Cholesterol is a fatty substance your liver makes. It’s also found in certain foods. Your body needs some cholesterol to function properly. But having too much of the bad type of cholesterol — high LDL cholesterol — puts you at risk for having a heart attack or stroke.

Cholesterol in your bloodstream can build up in blood vessel walls, causing blockages that can lead to:

  • reduced blood flow to the heart and increased risk of heart attacks
  • decreased blood flow to the brain and increased risk of stroke

According to the Centers for Disease Control and Prevention (CDC), having high cholesterol raises your risk of heart disease.

Your total cholesterol level is the overall amount of cholesterol found in your blood. It consists of:

  • low-density lipoproteins (LDL)
  • high-density lipoproteins (HDL)
  • triglycerides

LDL is also called “bad” cholesterol because it blocks your blood vessels and increases your risk of heart disease. HDL is considered “good” cholesterol because it helps protect you from heart disease. The higher your HDL, the better.

Finally, total cholesterol includes a triglycerides count. These are another type of fat that can build up in the body and are considered the “building blocks” of cholesterol.

High levels of triglycerides and low levels of HDL raise your risk for heart disease.

The American Heart Association recommends that all adults have their cholesterol checked every 4 to 6 years, starting at 20 years old, which is when cholesterol levels can start to go up.

As we age, cholesterol levels tend to rise. Men are generally at a higher risk than women for higher cholesterol. However, a woman’s risk goes up after she enters menopause.

For those with high cholesterol and other cardiac risk factors such as diabetes, more frequent testing is recommended.

Cholesterol chart for adults

According to the 2018 guidelines on the management of blood cholesterol published in the Journal of the American College of Cardiology (JACC), these are the acceptable, borderline, and high measurements for adults.

All values are in mg/dL (milligrams per deciliter) and are based on fasting measurement.

Total cholesterolHDL cholesterolLDL cholesterolTriglycerides
GoodLess than 200 (but the lower the better)Ideal is 60 or higher; 40 or higher for men and 50 or higher for women is acceptableLess than 100; below 70 if coronary artery disease is presentLess than 149; ideal is <100
Borderline toModerately elevated200–239n/a130–159
150–199High240 or highern/a160 or higher; 190 considered very high
200 or higher; 500 considered very highLown/aless than 40n/a

Children who are physically active, have a healthy diet, aren’t overweight, and don’t have a family history of high cholesterol are at a lower risk for having high cholesterol.

Current guidelines recommend that all children have their cholesterol checked between ages 9 and 11 years old, and then again between ages 17 and 21 years old.

Children with more risk factors, like diabetes, obesity or a family history of high cholesterol, should be checked between ages 2 and 8 years, and again between ages 12 and 16 years.

Cholesterol chart for children

According to the JACC, the following are the recommended cholesterol levels for children:

All values are in mg/dL (milligrams per deciliter):

Total cholesterolHDL cholesterolLDL cholesterolTriglycerides
Good170 or lessGreater than 45Less than 110Less than 75 in children 0–9; less than 90 in children 10–19
Borderline170–19940-45110–12975-99 in children 0–9; 90–129 in children 10–19
High200 or highern/a130 or higher100 or more in children 0–9; 130 or more in children 10–19
Lown/aLess than 40n/an/a

The good news is that lifestyle changes are reasonably effective in helping you reduce cholesterol levels. They’re also fairly straightforward and can be done at any age.

Changes include:

Exercise

Physical activity helps you lose weight and boosts your HDL cholesterol. Aim for 30 to 60 minutes a day of moderate cardiovascular exercise, such as biking, jogging, swimming, and dancing, at least 5 times a week.

Eat more fiber

Add more fiber to your diet, such as replacing white breads and pastas with whole grains.

Eat healthy fats

Healthy fats include:

These are all fats that won’t raise your LDL levels.

Limit your cholesterol intake

Reduce the amount of high-saturated fatty foods like:

Quit smoking

Smoking decreases HDL cholesterol. If you smoke, quitting can help you better manage your cholesterol levels.

It’s important to remember that everyone is different.

Family history and whether or not you have other conditions, such as diabetes or obesity, play a role in your individual risks.

Talk to your doctor about your cholesterol levels and ask what they think your numbers should be.

“The key is to have normal cholesterol levels throughout your lifetime.

“One misconception is that people can have poorly controlled cholesterol for years and then decide to take action. By then the plaque could already have built up,” says Dr. Eugenia Gianos, cardiologist at NYU Langone Medical Center.

Limit your alcohol intake

The American Heart Association recommends drinking alcohol in moderation, which means, on average, no more than two drinks per day for men and no more than one drink per day for women.

Drinking too much alcohol can raise levels of triglyceride fats in the blood stream and lead to conditions such as:

Lose Weight

Losing excess body weight can help to lower your cholesterol levels.

To lose weight, here are a few tips.

  • Try making healthy dietary changes, and working on portion control.
  • Choose lean proteins, whole grains, fruits, and vegetables.
  • Limit unhealthy fats, processed foods, and sugary snacks.
  • Try to add more physical activity to your weekly routine to increase your calorie burn so the number of calories you’re consuming is less than the number you’re burning off.