What you need to know about cholesterol levels

Cholesterol Levels: By Age, Gender, LDL, HDL & More

Maintaining a good cholesterol level is essential to preventing heart disease. Find out the difference between LDL & HDL, the ideal level at each age stage and the difference between men and women.

by Calvyn Ee

Medically Reviewed by Dr Chua Zi Wei.

What is Cholesterol?

There are two kinds of cholesterol found in your body. Blood cholesterol is a waxy, fat-like substance made in the liver and is an important component of your health. Blood cholesterol is responsible for forming the protective outer layer, or membrane, of cells; creating vitamin D and steroid hormones to keep bones, teeth and muscles healthy; and producing bile, which digests the fats you consume.

Then there is dietary cholesterol, which comes from foods derived from animals. As such, meat, poultry and dairy products contain dietary cholesterol. Your blood cholesterol levels are influenced by a mixture of fats and carbohydrates that you consume as part of your diet.

Various myths surrounding cholesterol levels have been debunked thanks to further scientific studies. For example, there is little correlation that consuming high cholesterol foods, most of which contain unhealthy saturated fats, will cause an increase in cholesterol levels. This directly increases a person’s risk of getting heart disease.

Nonetheless, it is advisable to watch your dietary intake as a precaution to safeguard your overall health. Regularly having a balanced and highly nutritious diet is always recommended practice.

Different Types of Cholesterol

Cholesterol is carried through the bloodstream via lipoproteins, as fat and cholesterol are unable to be dissolved. There are three types of cholesterol:

  • Low-density lipoproteins (LDL) are usually referred to as “bad cholesterol” and make up a majority of the body’s cholesterol. They carry cholesterol from the liver to the rest of the body; cells will extract fat and cholesterol from LDL particles. High LDL concentrations will eventually cause plaque buildup in the arteries, limiting blood flow and can cause atherosclerosis or other complications.
  • Very low-density lipoproteins (VLDL) are produced in the liver and transport triglycerides (another type of lipid) to your tissues, unlike LDL which only transports cholesterol. Nevertheless, high levels of VLDL are still harmful to the body. There is no direct way to measure one’s VLDL count, so a test will be conducted to instead check your triglyceride levels.
  • High-density lipoproteins (HDL) are called “good cholesterol.” HDL collects cholesterol in the bloodstream, from LDLs, and from the arteries before travelling to the liver. The liver will remove all this cholesterol from the body. A healthy HDL level can protect you from the risk of heart disease or a stroke.

While HDL is important for your body, it does not completely eliminate cholesterol from the body. It is therefore important to monitor your cholesterol levels and keep them low at all times.

What About Triglycerides?

If you are not familiar with triglycerides, they are a type of fat found in the body. Triglycerides make up most of the fat that you eat and travel through the bloodstream. Extra calories, alcohol and sugar are also stored in triglycerides. Specific hormones will periodically release triglycerides as the energy needed for the body.

Much like cholesterol, you should keep triglyceride levels low to preserve your overall health. High triglycerides are a risk factor for atherosclerosis and even pancreatitis, or the inflammation of the pancreas. High triglycerides are also a sign of other complications, such as type 2 diabetes and high blood pressure.

What are Ideal Cholesterol Levels?

High cholesterol does not cause any symptoms but does raise your risk of getting various medical complications. It is always important to have your cholesterol levels checked. The simplest way is through a blood test with a lipid profile. In fact, cholesterol screenings should be done early to get a better gauge of your cholesterol levels, then be able to plan ahead to manage those levels.

It might seem that everyone should always maintain optimal levels of cholesterol, but this is hardly true. Doctors will need to take into account a person’s current health, family history, age, weight, blood pressure, and potential risk factors before recommending an ideal level to maintain.

The optimal cholesterol levels a person should achieve are as follows (measured in millimoles per litre, or mmol/L):

  • Total cholesterol (TC): < 5.2 mmol/L
  • Triglycerides (TG): < 1.7 mmol/L
  • LDL: < 2.6 mmol/L; may also depend on a person’s cardiovascular risk
  • HDL: ≥ 1.6 mmol/L

Ideal Levels by Age

Cholesterol Level by Age & Gender

Do note the following points:

  1. The total cholesterol figure is a combination of LDL and HDL counts in the body.
  2. HDL levels should ideally be higher, but a higher figure does not mean you are better protected from the risks of complications due to high cholesterol.
  3. Targets may vary depending on a person’s overall status. A personalised plan may be drawn up for different people based on what works best for that person’s health and current cholesterol levels. Some people may be recommended to a plan where optimal levels are below 1.8 mmol/L, for example.

Myths Surrounding Cholesterol Levels

There are still myths about cholesterol and cholesterol levels that most people continue to believe, despite medical science having disproven these claims. These include:

  1. You will know when you have high cholesterol: High cholesterol does not present any symptoms. However, complications arising due to high cholesterol can cause symptoms.
  2. All cholesterol is bad: Untrue, especially since HDL is needed to deliver excess cholesterol to the liver to remove it from the body
  3. Only men are at higher risk of getting high cholesterol: High cholesterol affects everyone, regardless of a person’s gender.
  4. Cholesterol levels are affected by exercise and diet: These are not the only factors that affect your cholesterol levels. Smoking, blood pressure, and obesity – there are a few other risk factors that can alter these levels.

Be sure to speak to your doctor if there may be claims you have heard but are unsure if they are true or otherwise. Various healthcare organisations have also put out useful materials to raise awareness.

When Should You Check Your Cholesterol Levels?

Cholesterol levels should be checked as early in life as possible. It is recommended that you start cholesterol screenings as young as 20 years old, with regular checks in a two to four-year period. After reaching the age of 40, annual checkups are highly recommended.

For those below 20 of age, the first test can be performed when they are between 9 to 11 years old. If you have a family history of high cholesterol, cardiovascular disease or stroke, you may need to have tests conducted at an earlier age (some recommend starting as early as age 2).

Getting an early check-up can help you with monitoring your cholesterol levels, and then taking the appropriate steps to manage those levels and keep them within the ideal range recommended by the doctor.

It becomes important to undergo screening if you may have particular risk factors, especially for cases of obesity, diabetes, heart disease or other complications.

Maintaining Ideal Cholesterol Levels

There are a number of ways you can take charge of your cholesterol levels, either with the help of medical treatment or through lifestyle changes you can adopt.

Medical Treatment

In some people, high cholesterol levels are an inherited complication due to genetics. For them, changing lifestyle habits alone will not be sufficient to maintain optimal cholesterol levels.

Statins are the most commonly used medication to control cholesterol levels. These medications reduce the amount of cholesterol the liver produces. Statins generally decrease LDL levels while promoting HDL levels. This helps reduce the risk of blockages developing in the arteries, thereby reducing the risk of heart conditions or stroke. The use of statins will be recommended based on various factors, especially if you may have any liver complications. Statins also have a chance of causing some side effects, so your doctor will consult you on this beforehand.

There are also bile acid sequestrants or bile acid-binding resins. These basically “bind” to bile acids, preventing their use as part of the digestion process. Thus, this forces the liver to produce more bile using excess cholesterol in the body, thereby reducing cholesterol levels.

For those who might have a high triglyceride count, fibrates may be recommended to lower triglyceride levels. These also have the added benefit of boosting HDL levels in the body.

Other medications that may be prescribed include:

  • Cholesterol absorption inhibitors: For those who have side effects from statin prescriptions (or sometimes used together with statins), these may be prescribed instead. This medication reduces the absorption of cholesterol through the intestines, thereby reducing the amount of cholesterol delivered to the liver.
  • Proprotein Convertase Subtilisin/Kexin Type 9 (PCSK9) inhibitors: Delivered via injections, this medication promotes better absorption of cholesterol by the liver. This may be prescribed under specific circumstances, such as if a person has poor tolerance to statins or other types of medications.

Lifestyle Changes

The best way to maintain healthy cholesterol levels is to take charge of your own health. Lifestyle changes are generally the best method to reduce high cholesterol levels without requiring any medical intervention.

A Balanced Diet

A heart-healthy diet is one of the best ways to manage cholesterol levels. Consider spicing up your dietary needs with foods such as:

  • Whole grains
  • Oats
  • Legumes
  • Beans
  • Nuts
  • Vegetable oils (i.e., sunflower oil)
  • Fatty fish and some seafood
  • Soluble fibre
  • Foods with plant sterols

Saturated fats and trans fats are the biggest culprits of high cholesterol levels. It is advisable to have less of these in your dietary plan; the American Heart Association recommends that saturated fats be limited to less than 6 per cent of your daily calorie intake. Saturated fats are usually found in red/processed meats and full-fat dairy products, while trans fats can be found in some margarine, biscuits and cakes.

You can find various alternatives to your favourite foods that you can choose from. If you need some ideas, consider looking up the DASH diet for a guide on healthy meal preparation. In the case of fats, pick monounsaturated fats, found in canola and olive oil, as well as avocados. Polyunsaturated fats, found in salmon and mackerel, are also a good idea.

Try to use other cooking methods such as steaming, broiling, poaching or grilling. Frying foods generally requires a lot of oil, so keeping fried stuff off the menu is a great move. You can find many healthy recipes to try on the Internet.

Moderation is key in planning out your or your loved one’s diet. You do not need to cut out certain foods entirely, but reduce the overall intake of said foods. Eggs, some dairy products and some seafood (like prawns) are examples of foods to reduce in quantity. Some seafood contains healthy omega-3 fats, which have various health benefits such as reducing blood pressure.

Keep away from sugar additives sugary drinks or sweet foods (like candy), too. These are liable to increase LDL and triglyceride levels.

Both smoking and vaping put you at higher risk of raising LDL and reducing HDL levels. Quitting has both long- and short-term benefits: within 20 minutes of quitting, your blood pressure and heart rate will gradually improve, and within three months, your blood circulation and lung functions will return to normal.

Smoking also negates the body’s ability to transport cholesterol back to the liver to be broken down. This occurs due to the various chemical components that can be absorbed into the bloodstream, impairing various bodily functions.

Regular Physical Activity

Keeping fit and staying active comes with a number of overall benefits to your health. Firstly, you reduce your risk of developing various health complications – namely heart conditions. Secondly, it does a lot of good at keeping you at a healthy weight. Thirdly, it promotes HDL levels, as being sedentary can reduce your overall HDL count.

It is generally advised to maintain at least 150 minutes of physical activity in a week. You do not have to meet that target almost immediately as you could potentially strain yourself more than you ought to. Set small goals first, then slowly increase the targets as your stamina increases. You can then plan for a simple routine of 30-minute sessions a day, as an example.

Losing Weight

Being overweight or obese is a risk factor for a variety of health complications, and not just atherosclerosis or cardiovascular disease. Even a small loss of weight as low as 5 to 10 per cent is still able to improve your cholesterol and triglyceride levels. The more weight you can shed, the better your levels improve. Keeping track of your calorie intake can be beneficial; you do not have to cut out your favourite foods entirely, but abiding by a set daily calorie limit can do wonders to help you lose weight.

Drink in Moderation

If you regularly consume alcohol, you will need to cut down on the amount you consume daily. Some alcohol intake does have some correlation to better HDL levels, but moderation is key. Keep it limited to two drinks a day if you are below the age of 65, and a single glass a day if you are above 65.

Stay Positive

If left untreated, stress and other negative emotions can impair your health over time. If you are feeling very stressed out, or are unable to cope with problems in your life, consider seeking help from loved ones or from a trained counsellor or therapist. Find healthy ways for you to deal with your emotional or psychological issues instead of bottling them up or lashing out. There is always help available to see you through the hard times.

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About the Writer
Calvyn Ee
Calvyn is an aspiring author, poet and storyteller. He spends his time reading, gaming and building stories with his action figure photography.
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