Teen cholesterol levels have been improving, according to research.

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Even teens and kids need their cholesterol levels checked. Getty Images

A new report on childhood cholesterol levels delivers some promising news, but it’s not time to cheer.

Cardiovascular health among youths still has plenty of room for improvement.

The study, published today in JAMA, looked at indicators of blood lipid health in U.S. children ages 6 to 19 years old between 1999-2016. Researchers noted numerous “favorable trends” over that 17-year period, including lower average cholesterol levels, lower average triglycerides, and improved HDL (good) cholesterol.

The study used data from the National Health and Nutrition Examination Survey (NHANES), including more than 26,000 youths, about half of whom were female.

“At a high level in general across youth, things are getting better,” Dr. Amanda Marma Perak, assistant professor of pediatric cardiology and preventive medicine at Northwestern’s Feinberg School of Medicine and first author of the study, told Healthline.

“We found that really all the different lipid indicators were improving over the time course of this study… So that was good news,” she said.

The findings were in line with two prior national survey studies, one from 1988-1994 and the second from 2007-2012 that both indicated improvements in youth and adolescent cholesterol levels.

Despite these favorable trends, they don’t tell the full story.

Perak’s research found that only about half (47-51 percent) of youths in the study had ideal lipid level profiles.

About one-quarter (19-25 percent) had at least one adverse lipid level.

“There’s still significant room for improvement,” said Dr. David Fagan, vice chair of pediatrics at Cohen Children’s Medical Center, New Hyde Park, NY.

Fagan wasn’t involved in the research.

The report cuts both ways: highlighting general improvements to cholesterol levels in the past decades while making the shortcomings of youth cardiovascular health dreadfully apparent.

Cholesterol is just one factor in overall cardiovascular fitness, part of what the American Heart Association calls “Life’s Simple 7.” The seven factors are blood pressure, cholesterol, blood sugar, activity level, diet, body weight, and smoking.

“If we take this study in the context of overall cardiovascular health, it’s one indicator of overall cardiovascular health,” said Fagan.

Cholesterol levels are part of a cluster of other childhood health issues that need addressing.

Childhood obesity has more than tripled since the 1970s and about 1 in 5 school age children has obesity in the United States, according to the CDC. Unlike the obesity epidemic, which is highly visible and combating it has become a major public health goal, childhood cholesterol is talked about far less publicly.

“Cholesterol is one of these silent risk factors that kids who have abnormal cholesterol, they don’t feel any different. So parents may not be aware,” said Perak.

Both obesity and cholesterol levels in childhood are significant risk factors for cardiovascular disease later in life. Unfortunately, Perak points out, they frequently “travel together.”

“A lot of abnormal cholesterol that I see clinically is in children who also have the obesity risk factor and also have poor diet and exercise, lack of exercise,” she said.

Cholesterol is an initiator of atherosclerosis, the buildup of plaques on arterial walls, which can eventually lead to heart attack. Obesity is associated with numerous serious health problems, including cardiovascular disease and diabetes.

But kids are unlikely to ever have heart attacks or other visible episodes of cardiovascular disease. So tracking indicators like cholesterol is almost entirely preventative — a way of ensuring health in adulthood.

The goal is to keep ideal blood lipid levels and weight from childhood onward.

For parents, because cholesterol levels are not obvious, the best thing to do is to be aware of current recommendations by the American Academy of Pediatrics. Children should have cholesterol screenings performed between the ages of nine and eleven, and then again between the ages of seventeen and twenty-one.

In addition to proper screening, improving cardiovascular health during childhood (and, frankly, for people of all ages) is about lifestyle.

“Across the life course the first and most important thing is to optimize the lifestyle habits: to optimize the diet, make sure you’re getting enough exercise, make sure that you’re avoiding sitting around, make sure that you’re controlling body weight — those sorts of things are important for everybody,” said Perak.