Cholesterol is a type of fat, or lipid, that naturally occurs in a child’s bloodstream and is produced primarily by the liver. Cholesterol levels in children can be influenced by a number of factors, including age, gender, ethnicity and a child's diet. Children with high blood cholesterol levels are at risk of developing certain types of heart disease in adulthood.
Age and Cholesterol Screening
Blood fat levels fluctuate during childhood and adolescence. Cholesterol levels are low at birth and rise during childhood, peaking around the onset of puberty. Levels tend to decrease during puberty as sex hormone levels rise and then increase again. Because of these normal fluctuations, the American Academy of Pediatrics recommends that all children should be screened at least once for high cholesterol between the ages of 9 and 11 and again between age 17 to 21. Additional cholesterol testing is recommended for children with specific risk factors.
Blood cholesterol measurements typically include total cholesterol along with high and low density lipoproteins, known respectively as HDL and LDL. LDL is considered "bad" cholesterol because high levels can provoke the formation of blood vessel blockages called plaques. HDL is called "good" cholesterol because it tends to work against plaque formation. Doctors look at all three values to determine if a child's cholesterol level is normal.
A normal total cholesterol level in children and adolescents is less than 170 milligrams per deciliter, or mg/dL. A level of 170 to 199 mg/dL is borderline, and values of 200 mg/dL or more are high. Normal LDL is less than 110 mg/dL during childhood. LDL values of 110 to 129 md/dL are borderline, and values of 130 mg/dL or more are abnormally high. Normal HDL among children is greater than 45 mg/dL. Levels of 40 to 45 mg/dL are borderline, and less than 40 mg/dL is abnormally low.
Elevated Cholesterol Levels in Children
Elevated cholesterol levels in childhood increase the risk for early plaque formation and heart disease, known as cardiovascular atherosclerosis. Children with high cholesterol levels also tend to have high levels during adulthood. Risk factors for high cholesterol levels in children include being overweight, having a diet high in saturated fats, living a sedentary lifestyle and having family members with heart disease.
Managing Cholesterol Levels
For most children, maintaining normal cholesterol levels can be as simple as encouraging healthy habits. Dietary guidelines for children -- guidelines endorsed by the American Academy of Pediatrics -- recommend a balanced diet with enough exercise to maintain an appropriate weight. A balanced diet contains fruits, vegetables, fish, whole grains and low-fat dairy products with limited amounts of sugar-sweetened beverages and salt. Children with a medical condition that affects their cholesterol or with other risk factors may need additional measures to manage their cholesterol level.
- The HDL Handbook: Biological Functions and Clinical Implications; Tsugikazu Kamoda (ed.)
- Pediatrics; Lipid Screening and Cardiovascular Health in Childhood; Stephen R. Daniels, M.D., Ph.D., and Frank R. Greer, M.D., and the Committee on Nutrition
- National Heart, Lung and Blood Institute: Expert Panel on Integrated Guidelines for Cardiovascular Health and Risk Reduction in Children and Adolescents: Summary Report
- Pediatrics: Cholesterol in Childhood
- American Academy of Pediatrics: Physicians Recommend All Children Ages 9 to 11 Be Screened for Cholesterol
- Children's National Medical Center: Pediatric Hyperlipidemia