Cholesterol is a waxy, fat-like substance in every cell. The liver makes it,
and it is also in foods such as meat and dairy. The body needs some. Too much
in the blood sticks to artery walls and narrows or blocks them, putting a
child or teenager at risk of coronary artery disease and other heart diseases.
There are no symptoms
**There are usually no signs or symptoms that a child or teen has high
cholesterol.** Nothing will prompt the test. That is why the schedule below
exists, and why it is easy to skip.
When to test
| First test | Between ages 9 and 11 |
| Repeat | Every 5 years |
| Earlier start | From age 2, where there is a family history of high cholesterol, heart attack or stroke |
When and how often depends on age, risk factors and family history.
What the test reports, and the healthy levels
| Measure | What it is | Healthy under 20 |
|---|---|---|
| Total cholesterol | Everything, LDL and HDL together | Less than 170 mg/dL |
| Non-HDL | Total minus HDL — LDL plus others such as VLDL | Less than 120 mg/dL |
| LDL | "Bad": the main source of buildup and blockage | Less than 110 mg/dL |
| HDL | "Good": helps remove cholesterol from arteries | More than 45 mg/dL |
| Triglycerides | Another blood fat that raises heart disease risk |
Note that HDL is the one where a higher number is better, which is easy to
misread on a results sheet.
What causes it
Three main factors: an unhealthy diet, especially high in saturated fats;
a family history of high cholesterol, especially where one or both parents
have it; and obesity. Some diseases also cause it — diabetes, kidney
disease, and certain thyroid diseases.
Treatment
Lifestyle changes are the main treatment:
- Being more active — regular physical activity, and less time sitting in
front of a television, computer, phone or tablet - Healthy eating — limiting saturated fat, sugar and cholesterol, and
eating plenty of fresh fruit, vegetables and whole grains - Losing weight, where the child is overweight or has obesity
One practical note that does more than it looks: **if everyone in the family
makes these changes, it is easier for the child to stick to them** — and it
improves everyone else's health at the same time.
Where lifestyle changes are not enough, a provider may consider cholesterol
medicines if the child:
- Is at least 10 years old
- Has LDL above 190 mg/dL even after six months of diet and exercise
changes - Has LDL above 160 mg/dL and is at high risk of heart disease
- Has familial hypercholesterolemia, an inherited disorder causing very
high blood cholesterol
Source: MedlinePlus, U.S. National Library of Medicine.
Licence: CC0 1.0 (public domain) · Adapted from medlineplus.gov
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