High cholesterol is increasingly common among children and adolescents. While high cholesterol often has no obvious symptoms, it raises the risk for heart disease and other health problems later in life. The good news is that many effective lifestyle changes and treatment options are available to help control children’s cholesterol.
Understanding Cholesterol Levels in Children
Cholesterol testing is recommended for children starting between ages 9 and 11 years old. Additional risk factors, including obesity and a family history of cardiac or other diseases, may warrant testing earlier, from age two onward.
Here are the figures that are generally considered to be healthy levels of cholesterol in children:
- LDL cholesterol: Below 110 mg/dL
- HDL cholesterol: Above 45 mg/dL
- Total cholesterol: Below 170 mg/dL
Borderline or abnormal results mean your child’s levels are higher than desired. If their levels are borderline or abnormal, your doctor may recommend repeat testing in 6 to 12 months while implementing treatment plans.
What Causes High Cholesterol in Children?
Diet and lifestyle habits are the main contributors to increased cholesterol levels in most children. Genetics can also increase their risk. Some common causes include:
Unhealthy Diets
Diets with a significant content of saturated and trans fats, added sugars and refined carbohydrates drive up LDL cholesterol while lowering protective HDL cholesterol. These ingredients are found in large amounts in fast food, sweet snacks, fried foods, processed meats, pizza, desserts, and sugary drinks. Encouraging your child to eat an overall heart-healthy diet can prevent cholesterol problems.
Weight Status
Overweight or obese children are more prone to dyslipidemia. Excess body fat alters cholesterol metabolism and directly contributes to higher LDL and triglyceride levels compared to children who are at a healthy weight. Supporting your child in reaching or maintaining a moderate weight for their age and height can help avoid obesity-related cholesterol issues.
Family History
Dyslipidemia and early cardiovascular disease in close family members raise your child’s risk as well. Having one parent with elevated cholesterol increases the odds up to 50%. Inform your child’s doctor about any family history so they can plan screening and prevention appropriately.
Underlying Conditions
Chronic health conditions common in childhood, such as type 1 diabetes, nonalcoholic fatty liver disease, and hypothyroidism, negatively impact blood cholesterol markers. Polycystic ovary syndrome, kidney disease, and the use of certain medications can also trigger unhealthy elevations. Vigilantly managing any present medical conditions assists with normalizing associated cholesterol abnormalities.
Lack of Physical Activity
Kids who are physically inactive or spend much leisure time in sedentary behaviors such as watching TV, playing video games, and browsing the internet tend to have poorer cholesterol levels, too. Regular activity raises HDL cholesterol while lowering LDL cholesterol and triglycerides. Aim for your child to move their body energetically for 60+ minutes per day.
Genetic Cholesterol Disorders
Additionally, some children inherit rare genetic conditions such as familial hypercholesterolemia, where mutations prevent the body from removing LDL cholesterol from circulation properly. This causes exceptionally high total and LDL cholesterol from a young age without lifestyle factors, along with accelerated atherosclerosis development. Genetic testing can confirm suspected diagnoses.
Lifestyle Changes to Improve Cholesterol
Dietary and lifestyle changes should be the first approach in treating kids with elevated cholesterol levels. With commitment, these strategies can lower cholesterol significantly in many children:
Eat More Fruits, Vegetables and Whole Grains
- Focus on getting five or more servings of fruits/vegetables every day
- Opt for whole-grain pasta, breads, and cereals rather than refined options
- Reduce the quantity of sugary drinks and foods as well as saturated/trans fats
Increase Physical Activity
- Aim for 60+ minutes of moderate activity daily
- Reduce recreational screen time to under 2 hours/day
- Take family walks or bike rides, or enroll your child in sports
Achieve or Maintain a Healthy Body Weight
- Support your child in reaching or sustaining a healthy weight
- Be an active, positive role model around healthy eating and exercise
When all family members adopt these diet and lifestyle changes, it creates an encouraging, heart-healthy environment for your child to thrive in.
Cholesterol Medications for Children
If cholesterol remains uncontrolled after 6-12 months of lifestyle therapy, cholesterol-lowering medications may be appropriate for children aged ten and older.
- Statins: Statins are usually the first medication choice for kids. These drugs help the liver absorb LDL cholesterol out of the bloodstream. Statins can lower LDL significantly while raising HDL.
- Other Cholesterol Drugs: Other options such as bile acid sequestrants, cholesterol absorption inhibitors, fibrates, or niacin may be prescribed depending on your child’s needs.
Children with familial hypercholesterolemia may need medication earlier due to their inherited cholesterol processing disorder. Confer with your child’s physician to determine if and when medication is advised.
Alternative Supplements and Therapies
Some natural supplements show promise for improving cholesterol markers. Always discuss supplement use with your child’s doctor first to ensure safety and efficacy.
Helpful supplements may include:
- Soluble fiber from fruits, veggies, whole grains, and psyllium husk
- Fish oil that comes with omega-3 fatty acids EPA and DHA
- Plant sterols and stanols contained in certain kinds of margarine, juices, and supplements
Based on preliminary research, nutraceuticals such as red yeast rice extract, artichoke leaf, and bergamot orange extract may also lower LDL cholesterol.
Lastly, while evidence is limited in children, approaches such as stress reduction practices, sufficient sleep, and probiotic/prebiotic gut health support may lend small cholesterol-lowering effects.
Keeping Children’s Cholesterol in Check with Help from Imperial Center Family Medicine
By making heart-healthy adjustments to your family’s lifestyle, serving nutritious meals, managing weight, and discussing medication or supplements with your child’s doctor, you can effectively reduce cholesterol levels. Also, commit to yearly screenings to monitor your child’s levels.
And don’t worry because Imperial Center Family Medicine’s experienced child and adolescent healthcare professionals are here to help. Contact us today at 919-873-4437 or book a consultation online for personalized guidance in managing your children’s cholesterol and overall cardiovascular wellness.