Worrying about cholesterol levels sounds like something you can put off until at least middle age. But with rates of high cholesterol increasing among children, it’s quickly becoming a concern for all ages.

No matter how old you are, having high cholesterol can increase your risk of heart disease. When children experience elevated cholesterol at a young age, it can set the stage for ill health down the road.

What Is Cholesterol?

Cholesterol is a sticky, waxy substance manufactured by your liver. The cholesterol the body produces is essential and helps nourish all your cells and organs.

The problems start when you accumulate excess cholesterol that can build up in your arteries. This extra cholesterol comes from foods (primarily animal products) that are high in fat, such as red meat, eggs and dairy.

There are two types of cholesterol in your blood:

• Low-density lipoprotein (LDL): LDL is sometimes called “bad” cholesterol. That’s because it’s the main culprit for causing cholesterol buildup in the arteries.
• High-density lipoprotein (HDL): HDL is sometimes called “good” cholesterol because it helps remove some of the bad LDL cholesterol from the blood.

Together, LDL and HDL add up to your total cholesterol count. And when there’s a big imbalance — especially having too little HDL and too much LDL — it increases your child’s risk of future heart disease.

What Causes High Cholesterol in Kids?

In many cases, kids inherit a tendency toward high cholesterol from their parents. A family history of high cholesterol increases the risk of having elevated levels even at very young ages.

Genetics can play a major role in high cholesterol. One inherited condition is called familial hypercholesterolemia (FH). While uncommon, children born with FH can have dangerously elevated LDL cholesterol starting at birth.

Childhood obesity and diabetes can also impact cholesterol levels. Both conditions are rising in children and teens, putting more young people at risk of high cholesterol.

The Importance of Cholesterol Screening for Children

According to the American Academy of Pediatrics, all children should begin having cholesterol screenings between the ages of 9 and 11. In cases of strong family history or other risk factors, your child’s doctor may recommend screening as early as two years old.

Cholesterol screening involves a simple blood test, typically done after fasting for eight to 12 hours. Depending on the results, family history and other risk factors, your child’s doctor may recommend repeat screenings every few years.

A blood test for cholesterol measures LDL and HDL cholesterol levels as well as the levels of triglycerides (another type of fat) in the blood. For children and teens, healthy overall cholesterol levels should be below 170, with LDL levels below 110.

Heart-Healthy Habits for Kids

It’s never too early to think about your children’s heart health. Cholesterol levels and heart disease risk are closely linked to lifestyle. Even if your children have inherited high cholesterol, emphasizing healthy lifestyle habits can help manage the condition.

Heart-healthy habits that help lower cholesterol include:

• Eating a healthy, whole-food diet: Diets high in ultraprocessed foods contain unhealthy amounts of added sugar, saturated fat and cholesterol. Focus on limiting those foods and snacks and replacing them with healthy sources of lean protein, whole grains and fresh fruits and vegetables.
• Getting regular physical activity: Encourage your child to get at least an hour of physical activity every day. Physical activity could include anything from playing an organized sport to walking the dog or bouncing on a trampoline.
• Maintaining a healthy weight: Children with overweight or obesity are at increased risk of high cholesterol and associated heart conditions. Prioritizing a healthy diet and daily activity will help your child maintain a healthier weight.
• Managing stress: Teens and even younger children often experience stress just like adults. Teaching them ways to relax and unwind is important for their long-term health.
• Make health goals a family affair: Help everyone in your family establish a healthy lifestyle by using our Family Goal Setting checklist below.

In some cases, lifestyle changes alone aren’t enough to manage high cholesterol. Your child’s doctor will help determine if medications, such as statins, are an appropriate treatment.

Ask your child's primary care provider about cholesterol screening today. If your child needs a referral to a heart doctor, our pediatric general cardiologists are here for you.