KidsMD Health Topics

LDL, HDL & triglycerides

  • Cholesterol

    Cholesterol is a waxy, fatlike substance that can be found in all parts of the body. The cholesterol in your child’s blood comes from two sources:

    • from the foods he eats
    • produced by his liver

    While the body needs cholesterol to aid in the production of cell membranes, some hormones and vitamin D, your child's liver makes sufficient amounts of cholesterol for this. Too much cholesterol may lead to excess being deposited in the arteries, which can lead to heart disease.

    Cholesterol and other fats are transported through the blood stream in the form of particles called lipoproteins. The two most common lipoproteins are low-density lipoproteins (LDL) and high-density lipoproteins (HDL).

    LDL cholesterol

    This type of cholesterol is commonly called "bad" cholesterol. It can contribute to the formation of plaque build up in the arteries, known as atherosclerosis. LDL levels should be low.

    HDL cholesterol

    This type of cholesterol is known as “good” cholesterol. It’s a type of fat in the blood that helps to remove LDL cholesterol from the blood, preventing the fatty build up and formation of plaque. HDL should be as high as possible.

    Triglycerides

    Triglycerides are another class of fat found in the bloodstream, and they make up the bulk of your child’s fat tissue. Some studies have shown a link between triglycerides and heart disease. Many children and adolescents with high triglyceride levels also have other risk factors, such as high LDL levels or low HDL levels.

    Heart Center
    Boston Children's Hospital
    300 Longwood Avenue
    Boston MA 02115
    617-355-4278

  • How common is high cholesterol?

    High cholesterol is a risk for many Americans. Consider these statistics:

    • About 107 million American adults have total cholesterol levels of 200 or higher, which is considered borderline high-risk. That's 48 percent of the adult U.S. population.
    • About 37.2 million adults in the United States have blood cholesterol levels greater than 240, which is considered high-risk.
    • According to the American Heart Association, high blood cholesterol that runs in families will affect the future of an unknown (but probably large) number of children and adolescents.

    What causes high cholesterol levels in children?

    Many physicians are now beginning to realize that children and adolescents are increasingly at risk for high blood cholesterol levels as a result of one or more of the following:

    • sedentary lifestyles (playing video games, watching TV instead of participating in vigorous exercise)
    • high-fat junk food and fast food diets
    • obesity
    • family history of high cholesterol levels

    What causes high levels of triglycerides?

    Elevated triglyceride levels may be caused by medical conditions such as:

    Dietary causes of elevated triglyceride levels may include obesity and high intakes of fat and concentrated sweets.

    How do I know if my child’s cholesterol and triglyceride levels should be checked?

    The National Heart, Lung and Blood Institute (NHLBI), a division of the National Institutes of Health, recommends that cholesterol testing begin at age 2 for any child who has:

    • at least one parent who has been found to have high blood cholesterol (240 milligrams or greater)
    • a family history of early heart disease (before age 55 in a parent or grandparent)

    The NHLBI also recommends that children and adolescents who have demonstrated risk factors, such as obesity, should have cholesterol and other lipids, including triglycerides, tested periodically by their physicians.

    How does my child’s doctor check cholesterol and triglyceride levels?

    A simple blood test is used to check cholesterol and triglyceride levels. Your child’s doctor will be able to determine total cholesterol as well as the HDL and LDL levels.

    What is a healthy blood cholesterol level?

    In general, healthy levels are as follows:

    • LDL - less than 130 milligrams (mg)
    • HDL - greater than 45 mg (less than 35 mg puts your adolescent at higher risk for heart disease)

    The NHLBI recommends the following guidelines for cholesterol levels in children and teenagers (ages 2 to 19) from families with high blood cholesterol or early heart disease:

      Total cholesterol LDL cholesterol
    Acceptable Less than 170 mg Less than 110 mg
    Borderline 170 to 199 mg 110 to 129 mg
    High 200 mg or higher 130 mg or higher

    What is a healthy triglyceride level?

    A healthy triglyceride level is less than 150 mg.

    How can I help my child manage his cholesterol and triglyceride levels?

    To help lower LDL levels, help your child to:

    • avoid foods high in saturated fat, trans fat, dietary cholesterol, and excess calories
    • increase exercise
    • maintain a healthy weight

    It is often possible to raise HDL by:

    • exercising for at least 20 minutes five times a week.
    • maintaining a healthy body weight.

    You can often also manage your child’s triglyceride level with lifestyle changes involving changes in diet—particularly increasing intake of omega-3 fatty acids (found in fish) and eating fewer simple carbohydrates such as bread and pasta—and increased exercise.

    In some cases, your child’s doctor may prescribe medication to manage cholesterol and triglyceride levels, especially when diet and exercise don’t produce the desired results.

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