High cholesterol in kids: What causes high cholesterol in a child?

Though you might think of cholesterol as an adult-only health concern, it is an essential part of your child's health. Understanding childhood cholesterol and making simple lifestyle and dietary choices can help prevent serious health risks in your child's future.

What is cholesterol and how does it affect children?

Cholesterol is a fatty substance in the body that plays an important structural and functional role for cell membranes and hormones. Total cholesterol is made up of:

• Low-density lipoproteins (LDL): Produced primarily in the liver and gets deposited in blood vessel walls

• High-density lipoproteins (HDL): Removes excess LDL cholesterol from the bloodstream and sometimes referred to as "good" cholesterol

• Very low-density lipoproteins (VLDL): Produced in the liver and transported in the bloodstream to move cholesterol to the organs

• Triglycerides: Fatty acids from the meals your child recently ate are transported as triglycerides

Children of all ages can be at risk of developing dangerous levels of cholesterol when excessive levels of LDL ("bad" cholesterol) or triglyceride accumulate in blood. High levels of LDL can deposit on the walls of blood vessels, creating plaque, which can lead to future health risks like heart disease.  

What causes high cholesterol in a child?

High cholesterol in children can be passed on from parents to children, or can be caused by obesity and diet.

"Youth obesity is a leading cause of high cholesterol in children," says Nivedita Patni, M.D., Pediatric Endocrinologist at Children's Health℠ and Assistant Professor at UT Southwestern. "More than 43% of children with obesity have high cholesterol compared to less than 14% of kids who are not obese."

Children who have diabetes, kidney or liver disease, or hypothyroidism are also at risk of developing high cholesterol during childhood. Though some hereditary factors can be difficult to control, knowing your family history is important. You can also help keep your child's cholesterol in check by making sure they eat healthy, whole food nutrition and get plenty of exercise each day.

What is the normal cholesterol level for a child?

High cholesterol in children and adults is defined as total cholesterol over 200 mg/dL. Specifically, LDL or triglycerides greater than 130 mg/dL or HDL less than 40 mg/L are considered abnormal. For children, staying under these levels is considered healthy.

"The American Academy of Pediatrics and the National Heart, Lung and Blood Institute recommend universal lipid screening for children ages 9-11 and 17-21," says Dr. Patni. For children with other risk factors, cholesterol screening may occur sooner. Cholesterol screening for kids involves a non-fasting, non-HDL test. Any abnormal childhood cholesterol screenings should have at least two follow-up, fasting lipid profiles to evaluate overall cholesterol levels.

What should kids with high cholesterol eat?

You can help increase your child's good cholesterol by adding monounsaturated fats to your child's diet. These healthy fats can assist in bringing your child's cholesterol to a healthy level. Additionally, consuming whole grains along with high-fiber fruits and vegetables can aid cholesterol levels in your child as part of an overall healthy diet.

Foods that can help lower pediatric high cholesterol include:

• Canola oil

• Almonds

• Walnuts

• Tuna

• Swordfish

• Salmon

• Fruits

• Vegetables

• Whole grains

Avoid foods which can increase "bad" cholesterol. Saturated fat should make up no more than 8-10% of your child's overall fat intake. Trans fat should be avoided entirely.

Foods high in saturated fat that should be limited include:

• Beef

• Sausage

• Bacon

• Hot dogs

• Butter

• Ice cream

• Cheese

High trans-fat foods to avoid include:

• Microwave popcorn

• Margarine

• Fried foods

One way to reduce the risk of your child developing high cholesterol is to eat at home as often as possible. When you decide to eat out as a family, help your child avoid fried foods and sugary drinks, especially because portion sizes can be large.

How do I lower my child’s cholesterol?

"Lifestyle changes are the core to treating high cholesterol," says Dr. Patni. "It's important that parents work with their child to manage cholesterol levels and limit fat intake."

Beyond diet, there are a number of things you can do as a parent to help keep your child's cholesterol in check. Regular exercise, at least one hour of moderate to vigorous activity per week, can help to reduce your child's risk of developing high cholesterol or lower existing high cholesterol levels. Try to get out of the house with your child and enjoy a walk together or a game of kickball. In addition, limit screen time to less than two hours per day. This can help reinforce an active lifestyle, which will help to control your child’s cholesterol levels.

"For children with familial hypercholesterolemia, or other risk factors, such as liver or kidney disease, diabetes or hypothyroidism, cholesterol lowering medications are needed if elevated levels persist despite dietary and lifestyle changes," says Dr. Patni. Some cholesterol medications are approved for children 10 years and older, providing an option to get cholesterol under control during childhood before it becomes a more serious problem.

Learn more about pediatric high cholesterol

With childhood obesity, diabetes and other endocrine disorders on the rise, our nationally ranked pediatric endocrinologists at Children's Health are here to help. Learn more about our endocrinology program and services.

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