One in five young people in the United States had abnormal cholesterol in 2014, putting them at markedly higher risk for a heart attack later in life.

Heart attacks are the leading cause of death in the United States and treating cardiovascular disease costs $110 billion per year.

Although some forms of high cholesterol are almost entirely genetic, obesity and poor eating habits have driven the trend in younger people with this cardiovascular risk factor.

“Obesity seems to be playing a really important role in terms of cholesterol abnormalities,” Dr. Stephen Daniels, an American Heart Association spokesman who is chair of the department of pediatrics at the University of Colorado School of Medicine, said.

Children and teens who were overweight or obese were twice as likely as their peers to have high “bad” cholesterol and five times more likely to have low “good” cholesterol, a condition that can be genetic but often comes from unhealthy eating habits.

“We’re seeing the effects of poor lifestyle choices trickle down into the younger generation,” Katie Ferraro, MPH, a dietician and diabetes educator at the University of California San Francisco, said. “We don’t want to see adult diseases in children.”

Slightly more than 13 percent of young people had low HDL, or “good,” cholesterol, a rate that rose with body mass index (BMI). Eight percent had high non-HDL, or “bad,” cholesterol. Some had both.

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Statins Aren’t the Answer

While statins have revolutionized medical care for adults with high cholesterol, only children with a genetic condition, called familial hypercholesterolemia, are eligible to take the drugs. That condition affects less than 0.5 percent of the population, so it’s clear that lifestyle choices are driving the cholesterol epidemic in young people.

And what unhealthy lifestyle habits cause, only healthy lifestyle habits can cure.

“The kinds of lipid abnormality that you get from obesity, the focus for them would be reducing obesity, changing diet, and increasing physical activity,” Daniels said.

The numbers could have been worse. The rates are up only slightly from those published in 2010, contributing to the sense that obesity levels may have flattened out, Daniels said.

But abnormal cholesterol readings have been especially significant among girls and Hispanic boys since 2010.

It will take more time and effort to reverse the effects of generations of kids with poor diets and little exercise.

“The data suggests we could be doing a lot better on preventing obesity in the first place,” Daniels said.

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