Heart Conditions in Children - Cholesterol, LDL, HDL, Triglycerides

Content provided by the Faculty of the Harvard Medical School
Excerpted from a Harvard Special Health Report

Facts about cholesterol:

Cholesterol is a fat-like, waxy substance that can be found in all parts of your child's body. It aids in the production of cell membranes, some hormones, and vitamin D. The cholesterol in blood comes from two sources: the foods your child eats and his/her liver. However, your child's liver makes all of the cholesterol your child's body needs.

Cholesterol and other fats are transported through the blood stream in the form of round particles called lipoproteins. The two most commonly known lipoproteins are low-density lipoproteins (LDL) and high-density lipoproteins (HDL).

What is LDL (low-density lipoprotein) cholesterol?

What is HDL (high-density lipoprotein) cholesterol?

This type of cholesterol is commonly called "bad" cholesterol. It can contribute to the formation of plaque build up in the arteries, known as atherosclerosis.

LDL levels should be low. To help lower LDL levels, help your child to:

  • avoid foods high in saturated fat, dietary cholesterol, and excess calories.

  • increase exercise.

  • maintain a healthy weight.

This type of cholesterol is known as "good" cholesterol, and is a type of fat in the blood that helps to remove cholesterol from the blood, preventing the fatty build up and formation of plaque.

HDL should be as high as possible. It is often possible to raise HDL by:

  • exercising for at least 20 minutes three times a week.

  • avoiding saturated fat intake.

  • decreasing body weight.

For some children, medication may be needed. Because raising HDL can be complicated, you should work with your child's physician on developing a therapeutic plan.

Checking blood cholesterol levels:

A cholesterol screening is an overall look at, or profile of, the fats in the blood.

Physicians in the past felt that children were at little risk for developing high cholesterol levels and other risk factors for heart diseases affecting the coronary arteries and blood vessels until later in life. However, many physicians now realize that children are increasingly at risk for having high blood cholesterol levels as a result of one, or more of the following:

  • sedentary lifestyles (playing video games and watching TV instead of participating in vigorous exercise)

  • high-fat junk food and fast-food diets

  • obesity

  • family history of high cholesterol levels

Children and adolescents with high cholesterol are at higher risk for developing heart disease as adults. Many physicians are recognizing that keeping blood cholesterol levels in normal ranges throughout one's lifetime may be of great benefit in reducing the likelihood of developing coronary artery disease and high blood pressure.

Cholesterol testing for children:

The National Heart, Lung, and Blood Institute (NHLBI), a division of the National Institutes of Health, recommends that cholesterol testing begin at age 2 for any child who has the following:

  • at least one parent who has been found to have high blood cholesterol (240 milligrams or greater)

  • a family history of early heart disease (before age 55 in a parent or grandparent)

The NHLBI also recommends that children who have demonstrated risk factors, such as obesity, should have cholesterol and other lipids tested periodically by their physicians.

In 2008, the American Academy of Pediatrics (AAP) published updated guidelines that added more specific recommendations to those above, including testing of children older than 2 years whose family health history is unknown. The AAP also recommends that physicians should consider giving cholesterol-lowering medications (statins) to children more than 8 years old who have high LDL blood levels.

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Kids who grow quickly as toddlers or teens tend to have lower cholesterol levels as adults, new research says. A 2007 study in the Journal of Epidemiology and Community Health also found that people who become overweight after age 15 are more likely to have higher cholesterol levels.