High Cholesterol in Children - An Overview

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Why Children Develop High Cholesterol

Just like adults, children too can have high cholesterol levels that may lead to health issues when they grow up. To be sure, the body actually needs small amounts of cholesterol—a soft, waxy substance produced by the liver and forms a portion of all the body’s cells—to function well. But too much of it can be detrimental to one’s health.

A top concern is the development of atherosclerosis, or the hardening and narrowing of the artery due to deposits of excess cholesterol and other substances along the artery wall. Over time, this buildup of cholesterol, called plaque, constricts blood flow to the heart that can lead to coronary heart disease.

High cholesterol in children is mainly due to three factors. One is genes. Children who come from a family with a history of high cholesterol may inherit the condition. The two other factors—diet and obesity—are interconnected. Kids who routinely eat a high-fat, high-cholesterol diet may develop elevated cholesterol. And if a bad diet is coupled with lack of exercise, the child runs the risk of becoming obese, a condition that can aggravate his cholesterol problems.

Screening Cholesterol Levels in Children

Cholesterol levels are measured through a blood test. The child’s total cholesterol and LDL cholesterol, or “bad cholesterol,” in the blood are screened to check if his cholesterol numbers, measured in milligrams per deciliter (mg/dL), fall within the normal range. Here are the acceptable levels, borderline levels and high levels of cholesterol in children and adolescents aged 2 to 19 years:

Total cholesterol (mg/dL)

  • Acceptable: Less than 170
  • Borderline: 170 to 199
  • High: 200 or greater

LDL cholesterol (mg/dL)

  • Acceptable: Less than 110
  • Borderline: 110 to 129
  • High: 130 or greater

Ways to Reduce High Cholesterol

Children found to have high cholesterol values will be advised by a physician to change their diet and to increase physical activity. The family’s support and encouragement is crucial. Parents can help their child lower his cholesterol numbers by keeping these suggestions in mind.

  • Provide the child foods that are low in fat and cholesterol. Remember, though, that this tip is only for children aged 2 and above.
  • Offer a healthy diet based on the Dietary Guidelines for Americans to children 2 years and older.The diet should include low-fat dairy and dairy products. Babies and toddlers 12 months to 2 years old who are overweight or obese, or who have a family background of obesity, high cholesterol or heart disease, should be given reduced-fat milk.
  • Help the child to get regular exercise and stay within his ideal weight.
  • Opt for unsaturated fat (plant-based fat such as olive oil, canola oil and peanut oil) over saturated fat (animal-based fat, fat from coconut and palm oils).
  • Introduce the child to a variety of foods to ensure he gets all the nutrients his growing body needs.
  • Children who have a greater risk of heart disease and have elevated LDL are advised to seek help from a professional nutritionist and to engage in regular physical activity.

Medicating Children with High Cholesterol

If diet modification and increased physical workout do not reduce their cholesterol levels, medication might be the answer for kids who are at least 8 years old. The American Academy of Pediatrics recommends medical treatment for children 8 years and older with the following findings:

  • An LDL of more than 190 mg/dL, with no risk factors for heart disease and a diet change that did not work
  • An LDL level of more than 160 mg/dL, with a family history of early heart disease or other risk factors, including obesity, hypertension or smoking.
  • An LDL higher than 130 mg/dL, with diabetes

Some cholesterol-lowering medications prescribed for children are cholestyramine, colestipol and colesevelam. A child’s cholesterol levels are normally tested again three months after a dietary change or medical treatment.

The medical community is, however, divided about giving children drugs to treat cholesterol, because of concerns over safety and long-term side effects. Before agreeing to medicate, discuss with the doctor the best treatment approach for your child.


American Academy of Pediatrics

American Heart Association

Cleveland Clinic

University of Maryland Medical Center