What is cholesterol?

Cholesterol is a waxy, fat-like substance that's found in all the cells in the body. The liver makes cholesterol, and it is also in some foods, such as meat and dairy products. The body needs some cholesterol to work properly. But if your child or teen has high cholesterol (too much cholesterol in the blood), he or she has a higher risk of coronary artery disease and other heart diseases.

What causes high cholesterol in children and teens?

Three main factors contribute to high cholesterol in children and teens:

• An unhealthy diet, especially one that is high in fats
• A family history of high cholesterol, especially when one or both parents have high cholesterol
• Obesity

Some diseases, such as diabetes, kidney disease, and certain thyroid diseases, can also cause high cholesterol in children and teens.

What are the symptoms of high cholesterol in children and teens?

There are usually no signs or symptoms that your child or teen has high cholesterol.

How do I know if my child or teen has high cholesterol?

There is a blood test to measure cholesterol levels. The test gives information about:

• Total cholesterol - a measure of the total amount of cholesterol in your blood. It includes both low-density lipoprotein (LDL) cholesterol and high-density lipoprotein (HDL) cholesterol.
• LDL (bad) cholesterol - the main source of cholesterol buildup and blockage in the arteries
• HDL (good) cholesterol - HDL helps remove cholesterol from your arteries
• Non-HDL - this number is your total cholesterol minus your HDL. Your non-HDL includes LDL and other types of cholesterol such as VLDL (very-low-density lipoprotein).
• Triglycerides - another form of fat in your blood that can raise your risk for heart disease

For anyone aged 19 or younger, the healthy levels of cholesterol are

Type of CholesterolHealthy LevelTotal CholesterolLess than 170mg/dLNon-HDLLess than 120mg/dLLDLLess than 100mg/dLHDLMore than 45mg/dL

When and how often your child or teen should get this test depends on his or her age, risk factors, and family history. The general recommendations are:

• The first test should be between ages 9 to 11
• Children should have the test again every 5 years
• Some children may have this test starting at age 2 if there is a family history of high blood cholesterol, heart attack, or stroke

What are the treatments for high cholesterol in children and teens?

Lifestyle changes are the main treatment for high cholesterol in children and teens. These changes include:

• Being more active. This includes getting regular exercise and spending less time sitting (in front of a television, at a computer, on a phone or tablet, etc.)
• Healthy eating. A diet to lower cholesterol includes limiting foods that are high in saturated fat, sugar, and trans fat. It is also important to eat plenty of fresh fruits, vegetables, and whole grains.
• Losing weight, if your child or teen is overweight or has obesity

If everyone in the family makes these changes, it will be easier for your child or teen to stick to them. It is also an opportunity to improve your health, and the health of the rest of your family.

Sometimes these lifestyle changes are not enough to lower your child or teen's cholesterol. Your health care provider may consider giving your child or teen cholesterol medicines if he or she:

• Is at least 10 years old
• Has an LDL (bad) cholesterol level that is higher than 190 mg/dL, even after six months of diet and exercise changes
• Has an LDL (bad) cholesterol level that is higher than 160 mg/dL AND is at high risk for heart disease
• Has an inherited type of high cholesterol