High Cholesterol: High Cholesterol in Children

Adults are not the only people affected by high cholesterol. Children also may have high levels of cholesterol, which can cause health problems when the child gets older. Too much cholesterol leads to the build-up of plaque on the walls of the arteries, which supply blood to the heart and other organs. Plaque can narrow the arteries and block the blood flow to the heart, causing heart problems. Cholesterol also is related to health problems, including stroke.

What Causes High Cholesterol in Children?

Cholesterol levels in children are linked to three risk factors:

• Heredity (passed on from parent to child)
• Diet
• Obesity

In most cases, kids with high cholesterol have a parent who also has elevated cholesterol.

How Is High Cholesterol Diagnosed in Children?

Health care professionals can check cholesterol in school-age children with a simple blood test. Conducting such a test is especially important if there is a strong family history of heart disease or if a parent of the child has high cholesterol. The blood test results will reveal whether a childs cholesterol is too high. In children, cholesterol levels are borderline high if they are from 170 to 199 mg/dL. Cholesterol levels are considered high if they exceed 200mg/dL.

How Is High Cholesterol in Children Treated?

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

• Eat foods low in total fat, saturated fat, trans fat and cholesterol. The amount of total fat a child consumes should be 30% or less of daily total calories. This suggestion does NOT apply to children under the age of two. Saturated fat should be kept to less than 10% of daily total calories while trans fat should be avoided as much as possible.
• Select a variety of foods so your child can get all the nutrients he or she needs.
• Exercise regularly. Regular aerobic exercise, such as biking, running, walking, and swimming, can help raise HDL levels (the "good" cholesterol) and lower your child's risk for cardiovascular disease.

Here are some examples of healthy foods to give your child.

• For breakfast: Fruit, cereal, oatmeal and yogurt are among the good choices for breakfast foods. Use skim or 1% milk rather than whole or 2% milk (after age 2, or as recommended by your doctor).
• For lunch and dinner: Bake or grill foods instead of frying them. Use whole-grain breads and rolls to make a healthier sandwich. Also, give your child whole-grain crackers with soups, chili, and stew. Prepare pasta, beans, rice, fish, skinless poultry, or other dishes. Always serve fresh fruit (with the skin) with meals.
• For snacks: Fruits, vegetables, breads and cereals make great snacks for children. Children should avoid soda and fruit drinks.

If changes in diet and exercise do not lower your child's cholesterol, medication may be considered for children older than 10. Some drugs used to treat cholesterol in children include Questran (cholestyramine), Colestid (colestipol), and WelChol (colesevelam). Recent studies in children with very high cholesterol have supported the safe use of statin drugs, medication used to lower cholesterol in adults.

A child's cholesterol levels should be retested after three months of dietary changes and/or medication.

Reviewed by the doctors and dietitians in the Department of Preventive Cardiology and Rehabilitation at The Cleveland Clinic Heart Center (2005).