What Should My Cholesterol Be? Lower Than You Think

This article is an excerpt from the Shortform summary of "The China Study" by Colin Campbell. Shortform has the world's best summaries of books you should be reading.

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Many doctors will tell you that blood cholesterol levels below 200 milligrams per deciliter (mg/dL) are healthy. However, some doctors say even these levels of cholesterol in the blood are unsafe. This may leave you wondering, “What should my cholesterol be?”

Studies show that there may be no such thing as “healthy” cholesterol levels. We’ll cover the research linking blood cholesterol to many of the most common diseases in the West and look at why there is no healthy cholesterol range.

Recommended Cholesterol Levels: Diseases of Affluence and Blood Cholesterol

Researchers working on the China Study found that a subject’s blood cholesterol level was one of the strongest predictors of developing “rich” diseases, or diseases of affluence. The lower your cholesterol, the lower your risk of heart disease and at least ten cancers, including lung, liver, colon, breast, and brain cancers.

American women, who eat a “rich” diet, die from breast cancer at a rate five times higher than women in rural China, who eat a “poor” diet. American men die from coronary heart disease at a rate 17 times higher than men in rural China. 

The “Healthy” Cholesterol Range

How much cholesterol is too much? And what are healthy cholesterol numbers? This study indicated that no number is too low, and that any cholesterol in the blood contributes to disease.

That blood cholesterol was linked to so many Western diseases was surprising at the time. But what particularly shocked the researchers was how little cholesterol it took to increase your disease risk. Cholesterol levels of high-risk populations were so low that researchers initially doubted their results. 

Healthy Cholesterol Levels in America and China

Western scientists in the 1980s believed that blood cholesterol never got below 140-150 mg/dL. They even thought cholesterol levels this low could pose health problems.

But they had determined the lower limit of blood cholesterol by examining only Western subjects. In the China Study, the average cholesterol level for adults ages 35 to 64 was 127 mg/dL. This meant the average cholesterol level in China was lower than what Western researchers thought was even possible.

For context, the American average is 215 mg/dL. We think we’re doing pretty well when our cholesterol is around 170 mg/dL, and doctors tell us to try to keep our cholesterol levels below 200 mg/dL. But 170 mg/dL was high for the Chinese subjects, and researchers found that those in China with blood cholesterol levels around 170 were the most likely to die of diseases of affluence, typically Western diseases.

Researchers were clearly wrong to think that with such overall low cholesterol levels in China, there would be no further association between cholesterol and Western diseases. As blood cholesterol decreased from 170 mg/dL to 90 mg/dL, coronary heart disease and cancer rates decreased. They concluded that even small amounts of cholesterol in your blood put you at risk.

In conclusion, there is no “healthy” cholesterol range. What should my cholesterol be? As close to 0 as possible. The typical recommended cholesterol levels are far too high.

The Lifestyle Heart Trial and Healthy Cholesterol Levels

Even if you currently have high cholesterol, you should aim to get your cholesterol levels below 200 mg/dL. It’s possible, as shown in the Lifestyle Heart Trial.

In this well-known study, Dean Ornish treated two groups with heart disease and high cholesterol. He treated Group A with only lifestyle changes. He put Group B on a standard treatment plan.

The Diet of Group A

  • A low-fat, plant-based diet
  • Up to 10% of their calories could come from fat
  • They could eat as much as they wanted of the foods on their list, which included fruits, vegetables, and grains.
  • The only animal products allowed were egg whites and one cup of nonfat milk or yogurt.


Group A:

  • Cholesterol dropped from an average of 227 mg/dL to 172 mg/dL. “Bad” LDL cholesterol decreased from 152 mg/dL to 95 mg/dL.
  • Over one year, 82% reversed their heart disease, indicated by a reduction in artery blockage.

Group B:

  • Patients experienced a 162% increase in chest pain.
  • Artery blockage increased by an average of 8%.

What should my cholesterol be? As low as possible, but definitely below 200 mg/dL. Health organizations such as the American Heart Association and the National Cholesterol Education Program tell us that a cholesterol level of 200 mg/dL should be our target, even though studies show that 35% of heart attacks happen to people whose cholesterol is well below 200 mg/dL. There’s really no such thing as a healthy cholesterol range.

What Should My Cholesterol Be? Lower Than You Think

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Here's what you'll find in our full The China Study summary :

  • Why animal proteins (meat, milk) might cause cancer, diabetes, and other diseases
  • Why the medical institution is structured to hide the truth about disease and food
  • The precise diet you'll need to eat to live longer and feel happier

Amanda Penn

Amanda Penn is a writer and reading specialist. She’s published dozens of articles and book reviews spanning a wide range of topics, including health, relationships, psychology, science, and much more. Amanda was a Fulbright Scholar and has taught in schools in the US and South Africa. Amanda received her Master's Degree in Education from the University of Pennsylvania.

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