Lipid Profiles in Elite and Collegiate Athletes: A Scoping Review

CONTEXT: The effects of regular physical activity and its influence on lipid metabolism is well established. However, the extent to which elite and collegiate athletes exhibit distinct lipid profiles remains an area of ongoing research. OBJECTIVE: To map the literature on lipid profiles in collegiate and elite athletes, summarize variations by sex, sport, and competitive level, and identify gaps to guide future research. DATA SOURCES: A comprehensive search of PubMed, Cochrane, and SPORTDiscus identified English-language studies on lipid profiles in professional and collegiate athletes, published between January 2010 and January 2025. STUDY SELECTION: Studies were screened and selected in Rayyan. STUDY DESIGN: Scoping review. LEVEL OF EVIDENCE: Level 4, scoping review of Level 1-3 studies. DATA EXTRACTION: Lipid values along with factors associated with variation across athlete populations were extracted. RESULTS: A total of 31 studies met inclusion criteria, representing 5921 athletes (3271 men, 2650 women; mean age, 24.3 years). Most cohorts were male (84%) and elite-level (77%), whereas women were not represented in many of the sports. High-density lipoprotein (HDL), low-density lipoprotein (LDL), and total cholesterol (TC) were reported most consistently. Mean lipid values included HDL 59.3 ± 14.0 mg/dl, LDL 94.3 ± 20.4 mg/dl, TC 168.0 ± 19.8 mg/dl, triglycerides (TG) 86.8 ± 28.4 mg/dl, and VLDL 38.2 ± 29.5 mg/dl. Female athletes showed higher HDL and lower LDL and TG than male athletes. Elite athletes reported higher HDL, TC, and TG, and minimal differences in LDL, compared with collegiate athletes. Lipid levels varied by sport and sex. Female runners reported the highest (73.5 mg/dl) and female soccer players the lowest (37.7 mg/dl) HDL, and judo athletes showed the highest LDL (139.4 mg/dl) and TG (143.6 mg/dl). CONCLUSION: Lipid profiles among elite and collegiate athletes vary considerably by sex, sport, and competition level. Standardized, sex-balanced studies are needed to clarify the role of lipid metabolism in athlete health, cardiovascular risk, and performance. Further research is needed using rigorous, standardized, and sex-balanced methodologies to clarify the impact of lipid profiles on athlete health and performance, and to guide evidence-based strategies for cardiovascular risk assessment and management in athletic populations.