How can young adults lower their cholesterol?

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A diagnosis of high cholesterol is most common in adults between the ages of 40–59 years but can also occur in young adults and children.

A 2021 study found that roughly 27% of young adults had elevated low density-lipoprotein (LDL) cholesterol of 130 milligrams per deciliter (mg/dL) or above, and 9% had LDL cholesterol of 160 mg/dL or above.

The young adults did not have atherosclerotic cardiovascular disease (ASCVD), which occurs due to a buildup of plaque in the artery walls and includes conditions such as coronary heart disease.

Elevated LDL cholesterol in young adults between the ages of 18–39 years increases the risk of ASCVD in later life.

Being aware of cholesterol levels in early adulthood may help people begin treatment to lower LDL levels earlier and reduce the risk of cardiovascular problems later on.

To check cholesterol levels, the National Heart, Lung, and Blood Institute advises the following screening recommendations for young people:

• Ages 19 years or under: People ages 9–11 can start screening and have a test every 5 years. For people with a family history of high cholesterol, heart attack, or stroke, people can have screening from the age of 2 years.
• Ages 20 years and above: Young adults require screening every 5 years.

Learn about healthy cholesterol levels by age.

A combination of lifestyle modifications and medications can help lower cholesterol levels and keep them within a healthy range.

It is important to identify any risk factors for high cholesterol levels, such as family history of high cholesterol. A family history of high cholesterol may mean people have more difficulty removing LDL cholesterol from the body. Genetic changes can cause familial hypercholesterolemia (FH), an inherited disorder that causes high cholesterol.

The following prescription medications can help lower cholesterol:

• Statins: These are the most common type of cholesterol-lowering drug. Statins may help reduce the risk of heart attack and stroke.
• Bile acid sequestrants: Doctors may prescribe bile acid sequestrants if statins are unsuitable or ineffective.
• PCSK9 inhibitors: People inject PCSK9 inhibitors underneath the skin every 2–4 weeks.

Medications for treating FH include:

• mipomersen
• ezetimibe (Zetia)
• lomitapide

These medications can cause side effects, so it is important to discuss any potential risks with a doctor before beginning treatment.

Eating a heart-healthy diet can help lower LDL cholesterol. This includes limiting saturated fats and sugars and focusing on fruits, vegetables, and whole grains.

Reaching and maintaining a moderate weight can also help reduce LDL cholesterol. Losing 3–5% of body weight may help to lower LDL cholesterol and increase HDL cholesterol, which is beneficial for health.

Read about 15 foods that lower cholesterol.

Smoking increases the risk of heart disease, as it damages the blood vessels and increases the rate at which the arteries harden. Quitting smoking can help reduce the risk of heart disease.

People can talk with a doctor for help to quit or use online resources such as Smokefree.

People can also limit alcohol intake to help lower cholesterol levels. Excess alcohol increases cholesterol and triglyceride levels in the blood.

People can avoid alcohol or drink it in moderation, following these guidelines:

• for males, no more than 2 drinks per day
• for females, no more than 1 drink per day

Learn about triglyceride and cholesterol levels.

Physical activity can play an important role in managing cholesterol levels. Regular exercise can help lower LDL cholesterol, lower triglycerides, and increase HDL cholesterol.

People can aim for 2 hours and 30 minutes of moderate-intensity exercise every week for adults and 1 hour of physical activity each day for children and adolescents. Moderate-intensity exercise includes brisk walking or cycling.

Learn more about exercise and cholesterol.

FH is an inherited disorder where people are born with high LDL cholesterol levels, which continue to increase over time. Without treatment, FH increases the risk of heart disease by 20 times.

Treatment for FH can help prevent complications. Diet and exercise can help but are not enough to reduce LDL cholesterol on their own. People will also need to take drugs or have medical treatment to reduce LDL levels by 50% or more.

Other causes of high cholesterol can include:

• a diet high in saturated fats
• lack of physical activity
• smoking
• stress
• drinking excess alcohol

Without treatment, FH can cause fatal complications. Depending on the type of FH, people may develop heart disease by the time they are 30 years old.

Without early diagnosis and treatment, homozygous FH, a rare type of FH, can cause heart disease in the first 10 years of a child’s life. Early diagnosis and treatment of FH can result in an excellent outlook.

A combination of treatments, including lifestyle changes and medication, may help lower LDL cholesterol levels.

Research from 2021 suggests that keeping LDL cholesterol levels in a healthy range throughout young adulthood and middle age can help reduce the risk of ASCVD throughout a person’s lifetime.

High cholesterol is more common in older adults but can also affect young adults, adolescents, and sometimes children.

Genetic disorders can cause high cholesterol in young people. Other risk factors include a diet high in saturated fats, lack of physical activity, smoking, and excess alcohol.

Lifestyle, dietary changes, and prescription medications can help lower cholesterol.