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Cholesterol and Your Child

Last Updated November 2023 | This article was created by familydoctor.org editorial staff and reviewed by Leisa Bailey, MD

High cholesterol can begin in childhood. High cholesterol levels are likely to continue to rise as a child grows into a teen and adult. This increases your child’s risk for cholesterol-related health problems.

What are the risks of high cholesterol levels?

Your child’s body needs some cholesterol to protect nerves, make cell tissues, and produce certain hormones. But too much cholesterol damages blood vessels. It builds up along blood vessel walls. This forms sticky, fatty deposits called plaque. Studies show that plaque can begin to form in childhood. It is more likely to form when a child’s cholesterol levels are high.

High cholesterol levels increase your child’s risk of heart disease and stroke when he or she gets older. Heart disease is the leading cause of death in the United States. The risk is higher in people who:

  • Have a family history of heart disease or strokes
  • Have diabetes
  • Are overweight or have obesity
  • Have unhealthy eating habits
  • Are not physically active
  • Smoke or are exposed to second-hand smoke

Where does cholesterol come from?

The liver makes all the cholesterol your child’s body needs. He or she also gets cholesterol from food, including animal products such as eggs, meats, and dairy products.

What is the difference between “good” cholesterol and “bad” cholesterol?

Low-density lipoproteins (LDL) are often called “bad” cholesterol. They deliver cholesterol to the body. Some people’s bodies make too much LDL cholesterol. LDL levels also are increased by eating foods high in saturated fat, trans fats, and dietary cholesterol.

High-density lipoproteins (HDL) are often called “good” cholesterol. They remove cholesterol from the blood. A healthy level of HDL may help protect against heart disease. Exercise can increase the amount of HDL cholesterol the body produces. Avoiding trans fats and following a healthy diet also can increase HDL levels.

Sometimes cholesterol levels are high because of a high LDL level. This increases the risk for heart disease or stroke. Other times, cholesterol levels are high because of a high HDL  level. This does not increase the risk for heart disease or stroke.

Should my child be tested for high cholesterol levels?

The American Academy of Pediatrics recommends all children be tested for hyperlipidemia (fat levels in the blood) between the ages of 9 and 11. Your child should have a cholesterol test if there is a family history of high cholesterol. Your doctor will also recommend testing if your child or teen has diabetes.

What causes high cholesterol levels in children?

The following are factors that can cause high cholesterol levels in children:

  • Family history of high cholesterol levels (for example, a parent who has high cholesterol levels)
  • Lack of physical activity
  • Obesity

Path to improved well being

You can help your child maintain a healthy weight by making healthy choices. Teach him or her to make healthy food choices and be physically active. Here are a few tips:

  • Offer your child at least 5 servings of fruits and vegetables each day. For example, have healthy snacks such as apples, bananas, carrots, and celery readily available.
  • Include plenty of low-fat proteins, vegetables, and whole grains in the meals you make.
  • Avoid saturated fat and trans fats. Saturated fats are usually found in animal products (for example, fried or fatty meats). You can also find them in dairy products (for example, cheese and butter). Many snack foods (for example, cookies and chips) are high in saturated fat. Trans fats are usually found in processed foods (for example, doughnuts and crackers). They are also in fried foods (for example, French fries and onion rings).
  • Avoid fast-food dining. If you do eat at a fast-food or sit-down restaurant, choose the healthiest options available. Try a salad with a grilled or broiled piece of meat and a fruit cup.
  • Limit your child’s screen time (TV, computer, cell phone, or game station) to no more than 1 to 2 hours a day. Set a good example by limiting your own screen time, too.
  • Encourage your child to find physical activities he or she enjoys and get active. Aim for at least 1 hour of active play every day.
  • Make physical activity part of your whole family’s lifestyle. Take a walk, go for a bike ride, or do chores together. Plan active family outings.

Things to consider

Healthy eating and physical activity are the first choice to lower a child or teen’s high cholesterol levels. If these don’t help, your family doctor may consider prescribing a cholesterol-lowering medicine. This type of medicine may be needed if your child has diabetes or is overweight or has obesity.

Not all medicines are safe for use in children. Do not give your child a cholesterol-lowering medicine that isn’t specifically prescribed to him or her.

Questions to ask your doctor

  • Should I have my child’s cholesterol level tested?
  • If my child’s cholesterol level is high now, will it always be high?
  • How often should my child’s cholesterol level be tested?
  • Does my child need to see a specialist?
  • Do you recommend any other diagnostic tests?
  • What are our options for cholesterol treatment?
  • What are the benefits, risks, or side effects of these treatments?

Resources

Centers for Disease Control and Prevention: Abnormal Cholesterol Among Children and Adolescents

National Institutes of Health, MedlinePlus: Cholesterol

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