Background: Osteoporosis is a major clinical problem in elderly men and women. The correlation between total cholesterol and bone mineral density remains controversial. NHANES is the cornerstone for national nutrition monitoring to inform nutrition and health policy.

Methods: Sample sizes and the location of the study and the time when it was conducted: we obtained 4236 non-cancer elderly from NHANES (National Health and Nutrition Examination Survey) database from 1999 to 2006. Data were analyzed with the use of the statistical packages R and EmpowerStats. We analyzed the relationship between total cholesterol and lumbar bone mineral density. We performed research population description, stratified analysis, single factor analysis, multiple equation regression analysis, smooth curve fitting, and threshold effect and saturation effect analysis.

Results: A significant negative association between serum cholesterol levels and bone mineral density of the lumbar spine in US non cancer affected older adults aged 60 years or older. Older adults ≥ 70 years of age had an inflection point at 280 mg / dl, and those with moderate physical activity had an inflection point at 199 mg / dl, The smooth curves they fitted were all U-shaped.

Conclusions: There is a negative association between total cholesterol and lumbar spine bone mineral density in non-cancer elderly greater than or equal to 60 years of age.