Is My Child At Risk Of High Cholesterol?
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Is My Child At Risk Of High Cholesterol?

The first signs of heart disease can start in childhood. Here’s what to look for—how you can help.

Too much of a good thing isn’t always a good thing, especially when it comes to your body’s cholesterol levels. Children and adults alike need a certain amount of cholesterol—an essential part of your body’s cells—to produce hormones and aid digestion. But too much can clog your arteries and, eventually, cause heart disease—the leading killer of American adults.

Almost 13 million children and adolescents in the United States are obese, a main risk factor for high cholesterol. The number of cases of high cholesterol in children hasn’t been determined, but research shows a significant link between childhood high cholesterol and elevated risks of heart disease in adulthood.

The 4-1-1 on cholesterol
Cholesterol comes in two main forms: low-density lipoproteins (LDL) and high-density lipoproteins (HDL). HDL is “good” cholesterol that helps carry excess LDL cholesterol from the arteries to the liver, where it’s passed from the body. LDL, or “bad” cholesterol, can block your arteries, leading to a host of heart problems, like heart attack, stroke, coronary heart disease and high blood pressure.

LDL levels are affected by diet, age, exercise and your genes. Over time, a diet high in saturated and trans fats and too little exercise can cause cholesterol to build up in your arteries. Though adults are typically more susceptible to heart disease, the rise in obesity among Americans raises concerns about children. Children with high cholesterol may not feel the effects until later in life, but the risks are alarming nonetheless.

What you need to know about screening
Because obesity is so prevalent, the American Academy of Pediatrics (AAP) recommends screening children between the ages of 9 and 11 for high cholesterol. The AAP also recommends children between the ages of 2 and 10 be screened if they fall within one or more of these groups:

  • Parents or grandparents who have suffered a heart attack or have blocked arteries at age 55 or earlier in men, or 65 or earlier in women
  • Parents or grandparents with cholesterol levels of 240mg/dL or higher
  • Unknown family health background
  • Characteristics associated with heart disease, such as high blood pressure, diabetes, obesity and smoking

“We really need these guidelines because we are seeing an increase in numbers of obese children,” says Nora Bolanos, MD, a pediatrician and department chair at Osceola Regional Medical Center in Kissimmee, Florida. “This has consequences with their cholesterol levels, high blood pressure, headaches and their self-esteem.”

How parents can help
“Some small percentage is genetic, but a high percentage [of obesity] is more environmental,” Dr. Bolanos says. “It's connected to physical activity and how many calories they're taking in.”

There is yet another connection between obesity in parents and their children. “Once we detect a child with a high level of cholesterol, we start the child and the family on a plan,” Bolanos says. This typically includes a low-cholesterol, low-fat diet and exercise regimen. A diet rich in vegetables, lean proteins and whole grains can help lower a child’s intake of artery-blocking fats.

“There needs to be teamwork between parents, the pediatrician and even the school, because that's where kids get a lot of their fatty food,” she says. Since changing the school menu isn’t likely, it’s all the more important for children to know how to make the healthiest picks in the cafeteria and eat well outside of school.

When to get your child retested
Bolanos recommends screening your child after about three months of diet and exercise. If the child has adhered to a healthy diet and increased activity and the cholesterol levels still haven’t gone down, your child may be referred to a specialist. An endocrinologist or cardiologist may consider starting your child on cholesterol medication.

According to the AAP, medication should only be considered for kids 10 years of age or older. Statins are commonly used to treat high cholesterol in both children and adults with high cholesterol. 

Even with medication, it’s important to keep children on a healthy diet plan and encourage plenty of exercise. Experts recommend limiting intake of saturated fats to less than 10 percent of daily calories and dietary cholesterol to less than 300 milligrams (mg) per day. If levels remain high, a stricter target is used, limiting saturated fats to less than 7 percent of daily calories and keeping cholesterol below 200 mg. Limiting the amount of fast food and processed junk kids eat is a simple and effective way to improve a child’s cholesterol levels.