High cholesterol in children

Adults are not the only people suffering from high cholesterol. Children can also have high cholesterol, which can lead to health problems, especially heart problems, as the child grows. Too much cholesterol leads to plaque buildup on the walls of the arteries that supply blood to the heart and other organs. Plaque can narrow arteries and block blood flow to the heart, causing heart problems and strokes.

What causes high cholesterol in children?

Cholesterol levels in children are mainly associated with three risk factors:

Heredity
Diet
Obesity

In most cases, children with high cholesterol have parents who also have high cholesterol.

How is high cholesterol diagnosed in children?

Doctors can check cholesterol levels in school-age children with a simple blood test. This test is especially important if there is a family history of heart disease or if the child's parents have high cholesterol. The results of the blood test will show if the child's cholesterol level is too high.

Experts recommend that all children be screened once between the ages of 9 and 11 and again between the ages of 17 and 21.

Selective screening is recommended for children with a family history of high cholesterol or low blood lipids or a family history of premature heart disease (55 years or younger for men, 65 years or younger for women). Screening is also recommended for children with a body mass index greater than the 95th percentile in children aged 2–8 years or older children (12–16 years) with a body mass index greater than the 85th percentile and who have other risk factors such as like exposure to tobacco smoke, diabetes or high blood pressure.

The first screening is recommended after the age of 2 years, but no later than 10 years. Children under 2 years of age should not be screened. If the fasting lipid profile is normal, the child should be reassessed after three to five years.

For overweight or obese children with high blood lipids or low levels of "good" HDL cholesterol, weight control is the primary treatment. This means better nutrition with nutritional advice and increased physical activity.

For children aged 10 years and older with extremely high cholesterol levels (or high levels with a family history of early heart disease), drug therapy should be considered.

How to treat high cholesterol in children?

The best way to treat cholesterol in children is with a diet and exercise program that involves the whole family. Here are some tips.

Eat foods that are low in total fat, saturated fat, trans fat, and cholesterol. The amount of total fat consumed by a child should be 30% or less of the total calories per day. This offer does NOT apply to children under the age of two. Saturated fats should make up less than 10% of your total daily calories, and trans fats should be avoided. For high-risk children, saturated fat should be limited to 7% of total calories and dietary cholesterol to 200 milligrams per day.
Choose a variety of foods so your child can get all the nutrients they need.
Regular exercise. Regular aerobic exercise, such as cycling, running, walking, and swimming, can help raise your HDL (“good” cholesterol) levels and reduce your child's risk of heart disease.

Here are some examples of healthy foods that can be given to a child.

For breakfast: Fruit, unsweetened cereal, oatmeal, and low-fat yogurt are good breakfast choices. Use skim or 1% milk instead of whole or 2% milk (after 2 years or as directed by a physician).
For lunch and dinner: cook or fry food instead of frying it. Use whole grain bread and rolls for a healthier sandwich. Also give your child whole-grain crackers with soups, chili, and stews. Prepare pasta, beans, rice, fish, skinless poultry, or other dishes. Always serve fresh fruit (with the skin on) with your meal.
For snacks: Fruits, vegetables, breads and cereals are great snacks for kids. Children should avoid carbonated drinks, juices and fruit drinks.

If diet and exercise alone do not improve your child's cholesterol levels, your child may need to take medications such as statins to lower cholesterol levels.

A child's cholesterol levels should be checked and monitored after diet changes or medications are started, as recommended by the healthcare provider.