Data from a preventive cardiovascular disease program indicates that as many as 9 out of 10 middle-aged Lithuanian residents tested have elevated blood cholesterol levels. According to data from the "Euroaspire IV" study (which examined residents from 24 European countries over approximately six months), Lithuanians are the worst in Europe at controlling their blood cholesterol levels. Meanwhile, according to the American Heart Association, as many as 75% of heart attack survivors state that their blood cholesterol levels were too high, and almost half of them (47%) did not even know their "bad" cholesterol indicators at all.
So, when is the right time to worry about cholesterol? What are the main indications to check if your cholesterol level exceeds the general cholesterol norm? Or perhaps, if your total cholesterol is within the normal range, you can forget about it? Is cholesterol really only a problem for adults and the elderly?
BRIEF: CHOLESTEROL LEVELS BY AGE
- Adults: total cholesterol < 5.2 mmol/L, LDL ("bad") < 2.6 mmol/L.
- Children and adolescents: total cholesterol is usually < 4.4 mmol/L, but is assessed individually (depending on age, sex, and risk factors).
- HDL ("good") cholesterol: for women > 1.2 mmol/L, for men > 1.0 mmol/L.
- Triglycerides: normal level < 1.7 mmol/L; elevated levels are often associated with metabolic disorders.
- Important: cholesterol norms depend on age and individual risk of cardiovascular disease, so results should be interpreted in context and with a doctor.
Cholesterol norm: what indicators are considered healthy?
The cholesterol norm defines what total cholesterol, LDL, and HDL indicators are considered safe for a healthy person, taking into account age and individual risk.
When evaluating cholesterol test results, it is important not to limit yourself to a single number. The cholesterol norm is determined by considering a combination of several indicators:
Total cholesterol – this is the primary guideline, indicating the total amount of cholesterol in the blood, but it does not reveal how this cholesterol is distributed between "good" and "bad."
LDL ("bad") cholesterol – considered the most important risk factor for cardiovascular disease, so its level is usually assessed most carefully.
HDL ("good") cholesterol and triglycerides – provide additional context to help assess overall lipid balance and metabolic characteristics.
In practice, the question often arises as to what cholesterol level in the blood is considered appropriate for a particular person. The cholesterol norm is not one specific number suitable for everyone; therefore, not only absolute numbers but also the overall health context, age, and sex are evaluated.
Cholesterol levels by age: which indicators should not be ignored?
The biggest risk factors that worsen cholesterol indicators are obesity, heredity (when a close family member suffers from dyslipidemia, especially from a young age), smoking, high blood pressure, and diabetes. At the same time, these mentioned factors also pose an increased risk of cardiovascular diseases, so those suffering from the aforementioned diseases and smokers should monitor their cholesterol indicators even more carefully.
For a healthy adult, the total cholesterol level in the blood should not exceed 5.2 mmol/L, and the "bad" (LDL) cholesterol level should not exceed exactly half of the total cholesterol norm – 2.6 mmol/L. Meanwhile, the "good" (HDL) cholesterol level in the blood should reach and exceed at least 1.0 mmol/L for men and 1.2 mmol/L for women; thus, the "good" cholesterol norm for women is slightly higher than for men.
If your overall cholesterol level is elevated, from 5.2 to 6.2 mmol/L, you already have a moderate risk of cardiovascular disease, and if it exceeds 6.2 mmol/L, this risk increases to high.
It is important to know that the level of total cholesterol alone is not sufficiently informative – the ratio of "bad" and "good" cholesterol also needs to be known.
With age, from approximately 40 years old, the total cholesterol norm for adults slightly increases, while for children – on the contrary: it is slightly lower than for adults. A child's total cholesterol norm should not exceed 5.0 mmol/L, but the exact norm, the ratio of "bad" and "good" cholesterol for a child, may vary depending on their age, sex, and other individual health factors.
Cholesterol norms table by age (mmol/L)
Age |
Total Cholesterol |
LDL ("bad") |
HDL ("good") |
Triglycerides |
Children (2–9 years) |
< 4.4* |
< 2.85* |
> 1.16* |
< 0.85* |
Children and adolescents (10–19 years) |
< 4.4* |
< 2.85* |
> 1.16* |
< 1.02* |
Adults |
< 5.2** |
< 2.6** |
Men: > 1.0** Women: > 1.2** |
< 1.7** |
* Cholesterol indicators for children and adolescents are indicative. Their assessment depends on age, sex, body mass index, heredity, and other individual risk factors, so the final interpretation should be provided by a doctor.
** Cholesterol norms for adults are also not uniform for everyone – target indicators may vary depending on overall cardiovascular disease risk, concomitant diseases, and other individual factors. Therefore, results are always recommended to be evaluated together with a doctor.
Cholesterol norm for women: the menopause period is important
Cholesterol levels in women change with age, especially during menopause. The level of "good" (HDL) cholesterol in women should reach and exceed at least 1.2 mmol/L (whereas for men – ≥ 1.0 mmol/L). Thus, the "good" cholesterol norm for women is slightly higher than for men.
It is important to know that after menopause, when estrogen levels decrease, "good" cholesterol levels also decrease, while "bad" cholesterol levels increase. This increases the risk of cardiovascular disease. Therefore, women over 45 years of age need to check more frequently.
Cholesterol norm for men: earlier testing recommended
For men, regular cholesterol tests are recommended to start a little earlier, especially if they have a family history of cardiovascular disease, lead a sedentary lifestyle, or have harmful habits.
Men often have a higher risk of cardiovascular disease in youth than women (estrogens tend to lower total cholesterol and increase "good" cholesterol in women). For this reason, it is important for men to pay early attention to their lipid indicators and their changes.
It is important to mention that regardless of gender, cholesterol control is an important factor in preventing cardiovascular diseases, so both men and women should strive to lead a healthy lifestyle and regularly check their blood cholesterol levels.
Cholesterol levels in children: unfavorable statistics worldwide
Unfortunately, various studies worldwide and statistics show that the problem of the bad and good cholesterol ratio is increasing and... not only in older age. Along with the unfavorable statistics of obesity in young people and children, decreasing physical activity, and worsening nutrition – the number of children with dyslipidemia is also increasing. Dyslipidemia (or hypercholesterolemia, hyperlipidemia) is a disease of elevated blood cholesterol when a person's blood cholesterol level increases or the ratio between LDL – low-density lipoproteins ("bad") and HDL – high-density lipoproteins ("good") is disrupted, or triglyceride levels increase. This disease is a major risk factor for cardiovascular diseases.
It is worth noting a very large-scale study of children and adolescents recently conducted in the USA. Although we are often used to comforting ourselves that "we are still far from America's problems," unfortunately, the statistics on childhood obesity in Lithuania are unforgiving: according to data from the Center for Health Education and Disease Prevention, as many as one-fifth of children aged 2–17 are already of abnormal weight, meaning they are overweight or obese. Data from a study published in the USA in 2024 showed that out of 3.2 million young people aged 9–21, about 11% had cholesterol levels tested, and as many as 30% (one out of three tested) had at least one lipid indicator deviation. The study also revealed that the higher the body mass index (e.g., a child or adolescent is overweight or obese), the more frequent the cholesterol deviation.
In China, the cholesterol problem began to be observed and studied even earlier – almost ten years ago, unfavorable cholesterol trends were already reported, observing schools studied in China for a decade. Almost 3250 children aged 6 to 18 were studied for a decade, and it was observed that "bad" cholesterol levels in this age group were increasing.
How does diet help maintain "good" cholesterol levels, or how to reduce "bad" cholesterol?
It's easy to guess that maintaining proper cholesterol levels or reducing cholesterol is related to lifestyle and dietary changes. We have prepared a recommended plan for lowering cholesterol, which you can find in the article "How to lower cholesterol: a 3-month plan and common mistakes".
"Bad" cholesterol levels are particularly adversely affected by hydrogenated and partially hydrogenated fats, which are abundant in processed foods, fast food, and many baked goods. We have prepared a detailed article on processed trans fats and other products that increase cholesterol: what not to eat when cholesterol is high.
Studies conducted by the aforementioned American Heart Association show that a vegetarian diet helps reduce both total and "bad" cholesterol, so it is very important for people of all ages to include more vegetables, whole grains, nuts, and fish in their diet.
It's also very important to consume more fiber – it helps to "bind" cholesterol in the digestive tract and thus reduces its absorption into the bloodstream. An adult should get at least 10–25 g of fiber per day from food. It is abundant in:
whole grain cereals, for example, oatmeal, oat bran;
fruits, for example, apples, bananas, oranges, pears, plums;
legumes, for example, beans, lentils, chickpeas.
It's important to know that you shouldn't completely avoid fats – unsaturated fats are important for various functions of our body, including the control of "bad" cholesterol, and dairy products are an important source of protein and calcium. Read more about cholesterol-lowering products in the article.
In addition to dietary changes, regular physical activity is also important: at least 150 minutes per week of brisk walking, jogging, or cycling. Proper nutrition and physical activity will also help with weight control – if you are overweight or obese, even a 5–10% reduction in body weight can already have a positive effect on the ratio of "bad" and "good" cholesterol.
Food supplements for a better "good" and "bad" cholesterol ratio
Due to the fast pace of life, financial, social, or other circumstances, we cannot always take care of ourselves one hundred percent and in the best way. Therefore, it is natural that when trying to lower cholesterol (or keep it within normal limits), we look for food supplements to lower cholesterol.
One of the most popular cholesterol supplements is Omega-3 fatty acids. Omega fatty acids are essential fatty acids that the human body does not produce itself (synthesize), so they must be obtained either through food or food supplements. These acids are vital for brain, cardiovascular function, vision, and reducing inflammatory processes.
Unfortunately, obtaining a sufficient amount of these Omega-3 fatty acids is quite difficult, as they are abundant in non-first-choice products – we usually eat too little of them: fatty fish, seafood, seaweed, flaxseeds, chia seeds, walnuts.
Therefore, the world is constantly looking for ways to supplement their diet with food supplements containing Omega-3. For this reason, studies are constantly being conducted to investigate the effect of one or another preparation on cholesterol.
Studies show that proper Omega-3 consumption can significantly reduce triglyceride levels in the blood, especially in children under 13 years of age. Another study was conducted where one group of patients treated with statins was additionally given large amounts of Omega-3 fatty acids, while the other group was treated only with statins and a placebo (for 8 weeks this group received olive oil instead of Omega-3 fatty acids). At the end of the study, the "bad" cholesterol level in the blood of the patient group treated with both statins and Omega-3 decreased by as much as 67.5 percent more compared to the group treated only with statins.
Thus, not only dietary and lifestyle changes are important, but also the proper use of food supplements.
When and how often to check cholesterol levels
The American Academy of Pediatrics recommends that all children between the ages of 9 and 11 have their cholesterol levels checked. However, if a child is at risk (parents, grandparents have suffered from cardiovascular diseases or had complaints about high cholesterol, the child is overweight or obese, inactive, eats a lot of processed, fast food), doctors recommend starting cholesterol tests as early as two years of age. If cholesterol levels are within normal limits, it is advisable to repeat the test after 5 years. In Europe, countries do not follow a single recommendation regarding the age of children, but some countries perform prophylactic cholesterol tests for children even earlier, for example, German pediatricians recommend testing children from 6 years of age.
People aged 20-40 who are not in an increased risk zone should have cholesterol tests every 4-6 years, and those over 40 – every year or two. For people over 65, cholesterol levels are recommended to be monitored constantly, or – every year.
In summary:
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Normal cholesterol levels in the blood depend on age, gender, and individual risk factors.
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Cholesterol levels by age help to orient within general limits, but the final assessment should be discussed with a doctor.
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Cholesterol levels in women before menopause are often more favorable, while cholesterol levels in men require earlier monitoring.
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Regular tests and a healthy lifestyle help maintain stable cholesterol levels.
Frequently Asked Questions:
What is a normal cholesterol level in the blood?
For a healthy adult, total cholesterol is usually considered normal when it is less than 5.2 mmol/l, and "bad" (LDL) cholesterol is less than 2.6 mmol/l. However, target levels may vary depending on individual risk of cardiovascular disease, so test results should always be evaluated with a doctor.
Is a cholesterol level of 5.5 mmol/l dangerous?
A cholesterol level of 5.2 to 6.2 mmol/l is generally considered elevated, but risk is assessed not only by a single number. It is also important to know the ratio of LDL ("bad") to HDL ("good") cholesterol, triglyceride levels, and other risk factors for heart disease.
What should "bad" (LDL) cholesterol be?
In most cases, it is recommended that LDL cholesterol be less than 2.6 mmol/l. For people with a higher risk of cardiovascular disease, doctors may recommend even lower target levels.
What is considered a good "good" (HDL) cholesterol level?
"Good" cholesterol (HDL) levels should be greater than 1.0 mmol/l for men and greater than 1.2 mmol/l for women. HDL helps remove excess cholesterol from blood vessels, so higher levels are considered beneficial for heart health.
At what age should cholesterol be checked?
Most specialists recommend starting cholesterol tests from age 20, and even earlier if there are hereditary or other risk factors. For children, preventive tests are usually recommended at 9–11 years of age, but in cases of increased risk, they may be performed earlier.
Can cholesterol be high even if a person feels well?
Yes. High cholesterol often does not cause any symptoms, so it is often detected only after blood tests. For this reason, regular prophylactic screening is important even for people who feel well.
Can diet affect cholesterol levels?
Yes, lifestyle changes can significantly affect cholesterol levels. Increased consumption of fiber, vegetables, whole grains, and fish, and reduced intake of trans fats and highly processed foods can help maintain a more favorable ratio of "good" to "bad" cholesterol.
Can cholesterol be too low?
Yes, although high cholesterol is more commonly discussed, very low total cholesterol levels can also be associated with certain health problems. Cholesterol plays important functions in the body – it is involved in the formation of hormones, vitamin D, and cell membranes. Therefore, very low levels should always be evaluated with a doctor and in the context of overall health.