Cholesterol is a type of fat in the blood that is needed for building hormones and cells. Everyone needs to have some cholesterol in their blood. The amount of cholesterol and saturated fats we eat affect the level of cholesterol in our blood. Cholesterol comes from animal products such as meat, eggs, and dairy products. If we eat less cholesterol and saturated fat, we will have less cholesterol in our blood.
Cholesterol has several parts: high-density lipoproteins (HDL), low-density lipoproteins (LDL), and triglycerides. HDL is called the "good" cholesterol because it carries cholesterol away from the arteries to the liver. The liver helps the body get rid of cholesterol. The LDL is called "bad" cholesterol. If you have too much LDL, the LDL deposits cholesterol on the inner walls of the arteries. As a result your arteries become clogged. The HDL, LDL, and triglycerides together are called "total cholesterol."
People who have higher-than-normal levels of cholesterol have a higher risk of developing clogged or narrowed blood vessels that carry blood to the heart muscle. This narrowing is called coronary heart disease (CHD). Lower cholesterol levels, can reduce the chances of having heart disease.
Many children and teenagers who have high cholesterol continue to have high cholesterol when they are adults. Reducing their cholesterol levels with proper diet and exercise gives children a better chance of having low cholesterol when they are adults.
Cholesterol levels for children are as follows:
Total LDL HDL
Cholesterol Cholesterol Cholesterol
Normal <170 <100 >60
Borderline 170-200 100-130 40-60
Abnormal >200 >130 <40
The normal diet of children younger than 2 years is high in fat and therefore high in cholesterol. It is not appropriate to test children younger than 2 years. Cholesterol levels of children may be checked between the ages of 2 and 5 years old, often when they start kindergarten. The American Academy of Pediatrics and the American Heart Association agree that children who are at high risk for heart disease should be screened soon after they are 2 years old.
A child is at high risk of developing heart disease as an adult if parents, siblings, grandparents, aunts, or uncles have high blood cholesterol or early heart disease. Early coronary heart disease includes heart attack, angina (chest pain), stroke, or bypass surgery in men less than 50 years old or women less than 60 years old. The information about grandparents is important because other relatives might not yet be old enough to have developed heart disease.
Doctors do not always agree on when to check the cholesterol levels of children who are not high risk. Testing all children is costly and only about half of children with high cholesterol levels will have high cholesterol as adults. Healthy diets and good exercise habits can be started for all children without knowing their cholesterol levels.
If your child's cholesterol is borderline high or abnormal, it will be checked again 1 to 2 weeks after the first test. Cholesterol levels do vary somewhat day to day, so it is important to confirm that the cholesterol is high.
Children with confirmed high total cholesterol greater than 200 (95th percentile) will then have blood drawn for a lipid profile or panel. This test measures the levels of LDL, HDL, and triglycerides, as well as total cholesterol. Treatment will start and the level of cholesterol will be checked again in about 2 to 4 months.
If your child has a total cholesterol level that is borderline high between 170 and 199, treatment can start without the lipid panel. Your child's total cholesterol will probably be rechecked every year.
Children with normal total cholesterol below 170 (75th percentile) do not need their cholesterol checked again until they become adolescents. Most health care providers check the total cholesterol level of adults every 5 years as long as it remains in the normal range.
Lipid panels are not done for all children because it requires fasting for at least 12 hours. Lipid panels also cost much more than the total cholesterol test. In addition, the lipid panel requires blood drawn from a vein, a more difficult procedure than pricking a finger.
If your child has abnormally high cholesterol (higher than 95th percentile), everyone in your family should have their total cholesterol checked. Very often the close relatives of children with high cholesterol also have high cholesterol. Discovering that other family members have high cholesterol will further encourage you to start your family on a healthier diet and exercise program.
