By: Christopher Snyder, MD, FAAP & Brad McQuilkin, MD, FAAP
Some health concerns can sneak up on us. High cholesterol is one example—something that many parents don't realize can affect children and teens as well as adults. Health experts say that young people are more likely to have
high levels of cholesterol now than in past decades. And that sends up a red flag that families shouldn't ignore.
Here's why cholesterol matters—and why your child's doctor may recommend screening tests that can pinpoint potential risks.
What is cholesterol?
Cholesterol is, literally, a sticky subject. Many people are surprised to hear that our bodies need this thick, wax-like substance to stay healthy. The liver makes cholesterol naturally, sending it into our bloodstream to nourish all our cells and organs. In fact, our liver can manufacture all the health-giving cholesterol we need throughout life.
The sticky part?
Extra cholesterol we get from meat or dairy products—everything from milk to eggs to bacon to beef and more. Most of the time, our bodies can cleanse away this excess supply. But when we consume too much, a thick buildup can form in our arteries (the tubes that carry blood from the heart to the rest of the body). This buildup can block blood flow, setting the stage for life-threatening
heart attacks and
strokes.
What's the difference between "good" and "bad" cholesterol?
Pediatricians love it when parents ask this question, because it helps explain what they may see on a child's
cholesterol screening results.
HDL cholesterol—or "good" cholesterol—helps cleanse away LDL cholesterol, the "bad" kind that can build up in our arteries. But keep in mind that healthy levels of HDL cholesterol don't mean your child's heart is fully protected. An unhealthy diet, too little exercise and other factors can boost LDL cholesterol so high that the body can't cope. This is one sign that your child needs support to get cholesterol levels under control.
One more substance measured in cholesterol screenings:
triglycerides. These are specific types of fat that, when combined with too much LDL and too little HDL cholesterol, can contribute to dangerous buildup in your child's arteries. Consider this another warning sign that your child needs help adopting a heart-healthy lifestyle.
I thought cholesterol was an adult issue. Are kids really at risk?
There are two excellent reasons to screen kids for unhealthy cholesterol levels. First, new studies show that imbalances of HDL and LDL cholesterol in childhood are closely linked to
heart disease in mid-life. Finding out that your child has cholesterol issues gives you the chance to help them
learn heart-healthy habits early.
The second reason is that, for some kids, cholesterol can't be controlled through diet, exercise and other lifestyle choices. These kids have an inherited disorder known as familial hypercholesterolemia, or
FH. Though FH is fairly rare—affecting 1 in 250 children—it can cause heart problems early in life.
This article gives more details on FH and how it can be successfully treated in kids.
When should kids have their first cholesterol screening?
The American Academy of Pediatrics (AAP) recommends that all children have cholesterol tests between 9 and 11 years of age. However, your child's pediatrician may recommend screening as early as
age 2 if:
Close relatives, such as a parent or grandparent, have had heart problems or unhealthy cholesterol levels
Family members have a known history of FH
Your child's health history isn't fully known—for example, if your child is adopted and you received only partial information about their family's health
Your child has symptoms such as
high blood pressure,
diabetes or
obesity
What would a healthy cholesterol report look like?
This chart, below, shows how cholesterol (or lipid profile) test results are scored. If your child's total cholesterol is 170 or lower, they're doing well in terms of heart health. Total cholesterol above 200 or LDL levels above 130 call for changes in your diet, activity and other daily habits. Depending on the total picture, your pediatrician may suggest cholesterol control steps if your child's levels are in the "borderline" range.
Cholesterol Levels in Children & Adolescents |
|---|
Classification
| Total Cholesterol* | Low-Density Lipoprotein (LDL)*
|
Acceptable | <170 | <110
|
Borderline | 170-199 | 110-129 |
High | >200
| >130 |
*Milligrams per deciliter (mg/dL) of blood
If my child's cholesterol is high, how can I help?
The best way to support your child is to make heart-healthy living a priority for the whole family. Here are the basic steps to take together.
This article shares more tips for heart-healthy living that will benefit you and your kids.
Your child's cholesterol level: 4 things to remember
- Cholesterol screening helps your child's doctor spot problems that may lead to heart problems in adulthood.
Most kids can lower their cholesterol levels by changing how they eat, getting more exercise and maintaining a healthy weight. These habits have the greatest lifelong impact when they're learned early.
Some kids have inherited risks for high cholesterol. If your child's cholesterol levels are elevated, your doctor can screen for genetic risks and recommend the right plan to address them.
If you're worried about your child's heart—or any aspect of their health—your pediatrician is ready to help.
More information
About Dr. Snyder
 Christopher S. Snyder, MD, FAAP, past Chair of the American Academy of Pediatrics (AAP) Section on Cardiology and Cardiac Surgery, is Director of Pediatric Cardiology with the Children's Hospital of Richmond at Virginia Commonwealth University Rainbow Babies and Children's Hospital, Case Western Reserve University School of Medicine. Dr. Snyder is also a member of the Virginia AAP chapter.
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About Dr. McQuilkin
 Brad McQuilkin, MD, FAAP is a member of the AAP Section on Cardiology and Cardiac Surgery and a pediatric cardiologist with the Children's Hospital of Richmond at Virginia Commonwealth University. Dr. McQuilkin is a member of the Virginia AAP chapter as well.
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