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What is 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 produce 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).

Types of cholesterol

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. Lower LDL levels protect against heart disease. Familial hypercholesterolemia is a genetic cause of high LDL.

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. Higher HDL levels generally protect against heart disease.

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 but other data in adults is less clear. Many children and adolescents with high triglyceride levels also have other risk factors, such as high LDL levels or low HDL levels, or carry excess weight. Rarely, very high triglyceride levels are seen in children with genetic lipid disorders such as lipoprotein lipase deficiency.

Genetic forms of high cholesterol

There are some types of high cholesterol that can be due to genetic disorders. Examples include elevated lipoprotein(a) and Lipoproteinlilpase deficiency.

Frequently Asked Questions

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.

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:

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.

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.

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.

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 cholesterolLDL cholesterol
AcceptableLess than 170 mgLess than 110 mg
Borderline170 to 199 mg110 to 129 mg
High200 mg or higher130 mg or higher

To help lower LDL levels, help your child to:

  • Avoid foods high in saturated fat, trans fat, dietary cholesterol, and excess calories
  • Increase exercise
  • Naintain 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.