Kids and Cholesterol: Keeping Cholesterol Under Control

Image for childrens iron supplementsHigh cholesterol is a health problem we often associate with adults, but children can also be affected. High cholesterol levels, along with other factors that put adults at risk for heart problems (high blood pressure, diabetes, lack of physical activity, and being overweight or obese), also put children at risk later in life.

For instance, high cholesterol levels play a role in forming fatty plaque build-up in arteries, causing the arteries to harden. This condition, known as atherosclerosis, can start in childhood. If not addressed, it can lead to coronary artery disease in adulthood.

Should My Child Be Screened?

The National Heart, Lung, and Blood Institute (NHLBI) recommends that all children have a cholesterol screening when they are between the ages of 9 and 11 years old. However, if high cholesterol levels run in your family or if your child has certain risk factors, he or she may need cholesterol screening before then. Discuss this with your child's doctor. All children should be checked again between the ages of 17-21 years.

There are 2 types of cholesterol often discussed: “good” cholesterol, also known as HDL cholesterol, and “bad” cholesterol, also called LDL cholesterol. LDL cholesterol is the main culprit of heart problems, so keeping levels low is important. For children, this means making sure that their LDL cholesterol level is less than 110 mg/dL (milligrams per deciliter). Here are cholesterol level guidelines from NHLBI:

LDL Cholesterol Levels in Children and Teens 2-19 Years Old

Acceptable less than 110 mg/dL
Borderline 110-129 mg/dL
High 130 mg/dL or greater

Total Cholesterol Levels in Children and Teens 2-19 Years Old

Acceptable less than 170 mg/dL
Borderline 170-199 mg/dL
High 200 mg/dL or greater

Cholesterol Medication

Children older than 8 years old who have very high LDL cholesterol levels, usually 190 mg/dL or greater, may be given medications called statins. Statins work by lowering cholesterol levels in the blood. A doctor may prescribe this medication if your child has been diagnosed with familial hypercholesterolemia. Hypercholesterolemia is an inherited condition in which a person is born with high levels of LDL cholesterol. Diet and exercise may not be enough to lower the cholesterol levels to a safer level.

Healthy Lifestyle Tips

Regardless of your child’s cholesterol levels, a proper diet and exercise are important to keep cholesterol levels under control, as well as maintain overall health. Here are some ways you can incorporate a nutritious diet and physical activity into your child’s life:

  • Encourage your child to eat plenty of fruits, vegetables, and whole grains.
  • Choose lean meats. Lean cuts of meat (beef, pork, lamb) include round, sirloin, tenderloin, and chuck. For poultry, the leanest choice is skinless, white breast meat. Be sure to include fish, beans (peas, dried beans, lentils), and tofu in meals as healthy alternatives to meat.
  • Limit foods that are high in cholesterol.
  • Limit foods that are high in saturated or trans fat.
  • Consume nonfat or low-fat milk and dairy products.
  • When cooking, do not use solid fats. Instead, use vegetable oil.
  • Avoid foods and drinks with a lot of sugar. Encourage your child to drink water.
  • Those muffins, donuts, and cupcakes on the grocery store shelf may not be the best snack option for your kids. Opt for healthy snacks, like fresh fruit, vegetables with low-fat dip, popcorn, and low-fat yogurt.
  • Get out and play! Encourage your young child to play as much as possible. As your child grows, encourage them to continue to be physically active every day. It's also important that you limit how much time your child spends watching TV, playing video games, and using the computer. Total screen time should be less than 2 hours a day.

Children will often look to adults as lifestyle examples. Therefore, to encourage healthy habits, it is important that the entire family is involved in eating right and exercising. Doing so will ensure that both you and your children can lead healthy lives together.

RESOURCES:

American Heart Association
http://www.heart.org

Kids Health—Nemours Foundation
http://kidshealth.org

CANADIAN RESOURCES:

Canadian Cardiovascular Society
http://www.ccs.ca

Heart and Stroke Foundation of Canada
http://www.heartandstroke.com

REFERENCES:

2008 Physical Activity Guidelines for Americans. US Department of Health and Human Services website. Available at: http://www.health.gov/paguidelines/guidelines/default.aspx#toc. Published October 2008. Accessed January 22, 2016.

Children and cholesterol. American Heart Association website. Available at: http://www.heart.org/HEARTORG/Conditions/Cholesterol/UnderstandYourRiskforHighCholesterol/Children-and-Cholesterol_UCM_305567_Article.jsp. Updated May 12, 2014. Accessed January 22, 2016.

Children and cholesterol. American Heart Association website. Available at: http://www.heart.org/HEARTORG/Conditions/Cholesterol/UnderstandYourRiskforHighCholesterol/Children-and-Cholesterol_UCM_305567_Article.jsp#.VqJZn1KzK7E . Updated May 1`2, 2014. Accessed January 22, 2016.

Cholesterol and your child. Nemours' Kids Health website. Available at: http://kidshealth.org/parent/medical/heart/cholesterol.html Updated July 2013. Accessed January 22, 2016.

Familial hypercholesterolemia. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated December 14, 2015. Accessed January 22 ,2015.

NHLBI integrated guidelines for pediatric cardiovascular risk reduction. EBSCO DynaMed website. Available at: http://ebscohost.com/dynamed. Updated February 12, 2013. Accessed January 22, 2016.

Last reviewed January 2016 by Michael Woods, MD