11 mins read
Written by Lucía Camañas
June 11, 2025
Reviewed by:
Dr Thom Phillips
A cholesterol test offers key insights into our long-term heart health and metabolic status, but while routine, the results can feel both overwhelming and vague.
To help bring those numbers to life, we analysed over 24,000 anonymised cholesterol results from UK adults who used our home blood tests. This large dataset offers a snapshot of how cholesterol behaves across different stages of life, including the impact of menopause, BMI, and physical activity.
We’ve combined this data with a simple but thorough breakdown of how to interpret your own cholesterol profile to help you go beyond the numbers and into meaningful action.
A standard lipid panel typically measures four components:
Total cholesterol (TC)
LDL cholesterol (LDL-C): sometimes called “bad” cholesterol because it can lead to fatty layer (plaque) building up in your arteries.
HDL cholesterol (HDL-C): the so-called “good” cholesterol because it keeps the arteries clear.
Triglycerides (TG): a type of blood fat linked to insulin resistance and heart risk.
Cholesterol is a fatty substance found in your blood that is mainly produced by the liver (80%). The remaining cholesterol comes from the diet (20%), especially meat, poultry, and dairy.
While it used to be thought that eating cholesterol-rich foods significantly increased blood cholesterol, it’s now understood that your body tightly regulates cholesterol levels and that saturated and trans fats in the diet have a greater impact on raising cholesterol levels.[1][2]
Cholesterol often gets a bad reputation, but it plays a crucial role in how your cells work, helping your body produce vitamin D and hormones essential for healthy bones, teeth, and muscles. However, having too much cholesterol in your blood can lead to problems, potentially clogging your arteries and increasing the risk of heart disease.
LDL is traditionally labelled the “bad” cholesterol, and HDL the “good” one. High levels of circulating cholesterol, particularly LDL, are associated with plaque build-up in the arteries, which can increase the risk of heart attacks and strokes.
But LDL itself isn’t always harmful; it’s the small, dense form of LDL that poses the greatest risk for artery damage. These particles are more likely to sneak into artery walls and trigger inflammation.[3][4]
The full picture is more complex, especially when you factor in triglycerides, another type of fat, and HDL.
Triglycerides (TG), often overlooked, can be even more informative. TGs are produced when your liver converts excess sugar and carbohydrates into fat. Elevated TG levels may be a red flag for insulin resistance (a precursor to type 2 diabetes) even when your LDL is normal.
Looking at lipid values in isolation doesn’t tell you the full story. For example, someone may have “normal” LDL but very low HDL, or high TG levels with a misleadingly good total cholesterol.
A more reliable marker of risk? The TG/HDL ratio. This ratio is a key indicator for heart health and insulin resistance[6], one of the earliest stages of metabolic dysfunction.
A ratio <1.5 is considered optimal.
A ratio >2.5 may indicate increased cardiovascular and metabolic risk.[5]
We analysed the lipid profiles of about 24,000 UK adults who used a Forth home blood test between 2020 and 2025. What we found reinforces what clinicians have suspected, and adds some new twists.
Our data shows that age significantly impacts lipid levels, raising heart disease risk as people get older.
Across all ages, we observed a gradual rise in total cholesterol, with the steepest increase in women aged 50–59.
Measuring total cholesterol gives an indication of the full amount of cholesterol in your blood. However, a total cholesterol level that is high could be due to elevated levels of beneficial HDL cholesterol, thus not necessarily indicating an increased risk of heart disease.
To understand your heart health, explore the key cholesterol types, triglycerides and their ratios.
‘Good’ cholesterol rises slightly with age in women (1.55 to 1.80 mmol/L by 60+), perhaps offering some heart protection, and remains relatively stable in men (1.3 to 1.4 mmol/L).
While specific target ranges may vary, aiming for HDL levels above 1 mmol/L for men and above 1.2 mmol/L for women[7] is often considered protective.
Traditionally, higher HDL has been associated with a lower risk of heart disease. However, some studies suggest that both low and very high HDL levels may be linked to increased cardiovascular risk.[8][9] While the exact mechanisms are still being studied, this evidence highlights the importance of balance instead of just aiming for “more” when it comes to HDL.
‘Bad’ cholesterol climbs sharply with age, especially in women, jumping 40% from 2.43 mmol/L at ages 18–29 to 3.40 mmol/L at 60+. Men see a 32% rise, peaking at 3.31 mmol/L by age 60, and a slight decrease in those over 60.
While it’s true that high LDL levels correlate with heart disease risk in large populations, relying solely on the total LDL number can be insufficient for accurately assessing cardiovascular risk.
The total LDL number doesn’t tell the whole story, as it does not differentiate between different shapes and sizes of LDL particles. Having many small, dense LDL particles is associated with increased heart risk, even if your LDL cholesterol is within a normal range. On the other hand, having fewer small, dense particles may lower your risk, even if your total LDL is slightly elevated.
Smaller, denser LDL particles are more likely to contribute to plaque build-up in arteries, increasing the risk of cardiovascular disease. Tests like NMR Lipoprofile can accurately measure LDL size and number, helping to identify hidden risk even when cholesterol levels appear normal. When paired with a broader blood test that includes markers like ApoB, triglycerides, and inflammation, such as our Advanced Cholesterol Test, it gives a more complete picture of your cardiovascular risk, empowering more targeted, preventative action to protect long-term heart health.
Triglycerides also increase, peaking at ages 50–59 (1.31 mmol/L overall), with men hitting 1.43 mmol/L; a 32% jump from young adulthood. These higher levels, seen from age 40 onward, suggest a potential increase in the prevalence of small dense LDL in older populations and signal greater heart risks.
The triglyceride to HDL ratio, a sign of heart and diabetes risk, peaks at 50–59, especially in men (1.1), showing midlife as a high-risk period.
Data from over 12,500 samples confirm that:
Women generally have higher HDL levels than men across all age groups, and levels show a shift towards higher HDL in older women.
LDL levels moderately increase after menopause (23% increase)
Triglycerides slightly increase after menopause (15% increase)
This rise in cholesterol aligns with oestrogen decline during menopause, which is known to negatively affect lipid metabolism. Oestrogen usually helps maintain high HDL and lower LDL, but once levels fall, the balance can shift unfavourably.
The increase in both LDL and triglycerides after menopause points towards a potential increase in cardiovascular risk, particularly because the rise in triglycerides suggests a greater likelihood of having more of the harmful small dense LDL particles, which directly contribute to arterial plaque formation.
Published studies have shown the influence of hormone replacement therapy (HRT) on cholesterol and triglycerides levels, with effects varying by formulation and administration route[10][11].
Our data suggests that HRT is associated with slightly higher HDL, lower LDL, and substantially lower triglyceride levels in women closer to the typical age of perimenopause (40s). These effects seem less pronounced in older post-menopausal women.
Our data suggests that HRT’s ability to improve cholesterol and heart health weakens in older postmenopausal women (aged 60+), likely due to age or years after menopause. This may stem from reduced hormone sensitivity, less healthy blood vessels, or other age-related changes.
This finding supports the consideration of HRT during perimenopause or early menopause, particularly in women in their 40s, to improve cholesterol and reduce heart risk (if benefits outweigh risks). For older postmenopausal women, HRT seems less effective at improving cholesterol, suggesting lifestyle changes (like exercise or diet) may better manage high cholesterol and heart risk in older age.
Also, these findings highlight the need for personalised menopause care to guide HRT decisions. Further studies are needed to clarify when and for whom HRT best protects heart health.
The Body Mass Index (BMI) is a measure of weight relative to height often used to assess health. It categorises individuals as underweight, normal weight, overweight, or obese.
However, BMI alone is considered a limited metric because it doesn’t show where fat is stored in the body or distinguish between types of fat[12]. This is important because visceral fat (the kind that builds up around organs, especially the liver) is much more harmful than fat just under the skin.
This is why we have looked at the trends of the different types of fats in the blood according to BMI. Our data shows that higher body weight is closely tied to unhealthy cholesterol levels. Specifically, adults with obesity (BMI over 30) have 38% higher levels of triglycerides compared to those with a normal weight (BMI under 25).
We also found that good cholesterol (HDL) falls as BMI rises, further widening the TG/HDL gap, a warning sign for heart and metabolic health.
In the UK, where over 60% of adults carry extra weight, this pattern is common[13] and highlights how excess weight, especially abdominal fat, affects metabolic health even before other clinical symptoms like diabetes appear.
Our data suggest that getting active, even a few hours a week, can improve cholesterol and protect the heart.
For both women and men, there is a general trend of increasing median HDL levels with increasing hours of exercise. People exercising just 0–5 hours a week have an average HDL of 1.48 mmol/L, which climbs to 1.56 mmol/L with over 15 hours; a 5% boost. Women see a bigger lift, with HDL jumping 14% from 1.62 to 1.84 mmol/L, while men improve 11% from 1.30 to 1.44 mmol/L. Even 6–10 hours of exercise per week starts to nudge HDL up to 1.49 mmol/L.
We have also seen a decreasing trend in triglyceride levels with increasing exercise hours.
This reduction in triglycerides is particularly important, as it’s a key indicator that your liver is better at handling carbohydrates and sugar, reducing the production of problematic small dense LDL and improving metabolic flexibility.
People exercising 0–5 hours per week have higher triglyceride levels (1.22 mmol/L) compared to those exercising 6–10 hours (1.05 mmol/L) or more than 15 hours (1.06 mmol/L). This trend holds for both men and women, with men starting at higher levels (1.32 mmol/L vs. 1.14 mmol/L for women).
Not quite. Triglyceride levels are lowest with 6–10 or over 15 hours of exercise per week, but the difference between these is small. This suggests that exercising about 6–10 hours per week (roughly an hour a day) is enough to significantly improve triglyceride levels for most people. Studies confirm that regular exercise, even at moderate levels, can cut triglycerides by 5–10%[14]. Adding activities like brisk walking or cycling could lower heart disease risk, especially for those who currently exercise little.
Younger (18–29) and older (60+) adults see the biggest drops, like women over 60 whose levels fall from 1.26 to 0.98 mmol/L with more exercise.
This trend suggests that staying active is beneficial for lipid profiles regardless of age, helping to mitigate the general rise in cholesterol and triglyceride levels observed as people get older.
Now that we’ve seen how lipids behave across the population, what should you do with your own numbers? Here’s a practical guide.
| Marker | Optimal Range |
| Total Cholesterol (TC) | <5 mmol/L (context dependent) [7][15][16] |
| LDL-C | <3 mmol/L (or <2.6 mmol/L for higher-risk individuals) [15][16] |
| HDL-C | >1.2 mmol/L (women), >1.0 mmol/L (men) [7] |
| Triglycerides (TG) | <1.13 mmol/L [17] |
| TG/HDL Ratio | <1.5 (ideal), >2.5 (high risk) [5] |
Is your LDL high because of overall particle number or small dense LDL?
Are your triglycerides elevated despite normal LDL?
Is your TG/HDL ratio above 2.5, potentially indicating insulin resistance?
Have your numbers changed over time, particularly around menopause or significant weight gain?
Lucía is an accomplished Health Writer with a focus on Lifestyle Medicine, bringing two decades of experience in the healthcare ecosystem, spanning the NHS, medicines regulation, and digital health. She collaborates with leading healthcare organisations transforming complex data into meaningful and impactful content that informs and inspires.
Having transitioned from a clinical pharmacy background, she now focuses on lifestyle interventions, driven by a passion for addressing the root causes of chronic diseases through holistic, preventative approaches.
A dedicated advocate for personalised medicine, Lucía champions a health system that acknowledges unique patient stories and prioritises comprehensive, tailored care. She believes Social Prescribing and Lifestyle Medicine through nutrition, movement, and stress management can revolutionise healthcare by optimising wellness and preventing disease. Currently pursuing an MSc in Clinical PsychoNeuroImmunology (cPNI), she explores the interplay of mind, body, and immune system. Her studies, grounded in evolutionary biology, inform her holistic perspective and evidence-based writing.
Through her content, Lucía blends scientific insights with a commitment to patient-centered care, empowering readers to make informed health choices and fostering a transformative approach to health.
Credentials: MPharm, PGDip (Clinical Pharmacy), PGCert (Mental Health Therapeutics), MSc Clinical PsychoNeuroImmunology student
Check your cholesterol and heart health with our at-home blood test kit. This test measures your total cholesterol alongside your good (HDL) and bad (LDL) cholesterol levels, plus triglycerides, which are a key indicator of cardiovascular risk. It also includes Apolipoprotein A and B, proteins that give deeper insight into cholesterol transport and balance, and Lipoprotein(a), an inherited risk factor linked to heart disease and stroke.
If you're concerned about your heart health, our advanced cholesterol blood test is an easy and accurate way to check your levels.
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Results in 2 working days
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Thom works in NHS general practice and has a decade of experience working in both male and female elite sport. He has a background in exercise physiology and has published research into fatigue biomarkers.
Dr Thom Phillips
Head of Clinical Services
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