High cholesterol, if left untreated, can cause heart disease.

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Environmental risk factors for high cholesterol, including poor diet and exercise, often occur in early childhood. Inherited risk factors, like having a family history of heart disease, can also increase a child’s overall risk of high cholesterol.

Diagnosing and treating high cholesterol early may prevent clogged arteries, ultimately decreasing the risk of heart attack and stroke later in life.

High cholesterol is an asymptomatic disease. There are no documented symptoms associated with high cholesterol in adults. The same is true for children.

High cholesterol won’t have a noticeable impact — such as stroke, heart attack, or severe organ failure — until there’s substantial plaque buildup in the arteries.

There are a variety of reasons a child may develop high cholesterol, including the presence of other underlying health conditions, diet, and genetics.

These risk factors do not guarantee a child will develop heart disease under these conditions, but a doctor may want to start testing early if one or more of these factors are present. Testing may begin as early as 2 years.

Health conditions

Certain health conditions are associated with high cholesterol in children and adolescents. These conditions can include:

Some medications may also increase the risk of a child developing high cholesterol. Isotretinoin is a medication used to treat severe acne, but it also increases triglycerides in the bloodstream.

Corticosteroids used in steroid therapy, some forms of chemotherapy, and certain combinations of antiretroviral medications can also increase cholesterol levels.

Diet

A diet primarily made up of processed foods or foods high in saturated and trans fats can lead to high cholesterol.

Fried foods, dairy products, and foods high in sugar can tip the balance of healthy fats in the blood, causing an excess of fatty lipids in the bloodstream.

Cholesterol is primarily found in animal products like meats, cheeses, ice cream, and eggs. Plants like beans, nuts, and high fiber fruits produce small amounts of cholesterol.

Genetics

Family history can affect a child’s risk of developing high cholesterol. Familial hypercholesterolemia and familial hypertriglyceridemia, for example, are genetic mutations that affect the fatty lipids in the body.

A child may also be predisposed to high cholesterol if there’s a family history of early heart disease. Early heart disease is characterized as a heart attack or stroke before the age of 55 in a family member assigned male at birth, or before the age of 65 in a family member assigned female at birth.

The only way to know whether your child has high cholesterol is through a lipid panel.

A lipid panel can assess the following:

  • Low-density lipoprotein (LDL) can block the arteries in high quantities. Generally speaking, the lower the level of LDL cholesterol, the better.
  • High-density lipoprotein (HDL) moves cholesterol away from the heart to the liver to be excreted. Generally speaking, the higher the level of HDL cholesterol, the better.
  • Total cholesterol combines the LDL and HDL cholesterol levels. This figure is compared to the level of HDL cholesterol to gauge a person’s risk of heart disease and stroke. Generally speaking, the lower the total cholesterol level, the better.
  • Triglycerides are another type of fat (lipid) found in the bloodstream. Generally speaking, the lower the triglyceride level, the better.

Acceptable cholesterol levels in children fall within this range:

  • LDL (“bad”) cholesterol: less than 110 mg/dL
  • HDL (“good”) cholesterol: more than 45 mg/dL
  • Total cholesterol: less than 170 mg/dL
  • Triglycerides: less than 75 mg/dL until age 9, less than 90 mg/dL until age 19

Borderline high cholesterol levels in children fall within this range:

  • LDL (“bad”) cholesterol: 110–129 mg/dL
  • HDL (“good”) cholesterol: N/A
  • Total cholesterol: 170–199 mg/dL
  • Triglycerides: 75–99 mg/dL until age 9, 90–129 mg/dL until age 19

High cholesterol levels in children fall within this range:

  • LDL (“bad”) cholesterol: 130 mg/dL or higher
  • HDL (“good”) cholesterol: N/A
  • Total cholesterol: 200 mg/dL or higher
  • Triglycerides: 100 mg/dL or higher until age 9, 130 mg/dL or higher until age 19

The National Heart, Lung, and Blood Institute recommends two screenings during childhood. The first screening should be between the ages of 9 and 11. The second screening should be between the ages of 17 and 21.

Consult with a pediatrician or other healthcare professional for more personalized screening guidance.

Eating a balanced diet and getting regular physical activity is the best way to reduce high childhood cholesterol levels.

Most of a child’s daily nutrition should come from:

Children ages 6 to 17 should get at least 60 minutes of moderate physical activity all or most days of the week. Examples of moderate activity include:

  • brisk walking
  • jogging or running
  • cycling or skating
  • climbing
  • swimming

A doctor or other healthcare professional can make recommendations specific to your child. In some cases, medication to manage high cholesterol may be appropriate.

This may include:

You can support your child by keeping track of your cholesterol levels and encouraging healthy choices for the entire family.

If you’re not already, you can do the following:

  • Read nutrition labels and limit items with high cholesterol, saturated fat, and trans fat.
  • Incorporate more fruits, vegetables, whole grains, nuts, beans, and legumes into your meals.
  • Limit sugar-rich foods and beverages, such as soda and juice, pastries and cakes, syrups, and candy.
  • Swap whole milk, cheese, and yogurt products with low fat or nonfat versions.
  • Opt for lean cuts of meat and poultry, and remove any visible fat or skin.
  • Replace saturated fats, including animal fats, coconut oils, and palm oils, with unsaturated fats, such as olive, canola, and peanut oils.
  • Use fat-free cooking techniques — like baking, broiling, poaching, grilling, and steaming — when preparing meat, fish, and poultry.
  • Steam-fry food in water, tomato juice, or low sodium stock instead of deep-frying with butter, lard, or shortening.
  • Commit to exercising as a family. For example, you can walk little ones to and from school, bike or skate around the neighborhood, and play sports.

You can reduce your child’s risk of high cholesterol by establishing healthy habits early on.

It’s important to help your child:

  • reach or maintain a moderate weight
  • stay physically active
  • eat more fruits and vegetables
  • limit saturated fats and added sugars

Eating foods that nourish the body and getting the required amount of exercise can help keep the body’s natural processes in check.

Early diagnosis and treatment can help improve your child’s cholesterol levels and reduce the risk of long-term damage or complications.

A typical care plan involves eating a balanced, nutritious diet, staying active, and taking any medications as prescribed.

If left untreated, high cholesterol in children can lead to heart disease in adulthood.

Catasha Gordon is a sexuality educator from Spencer, Oklahoma. She’s the owner and founder of Expression Over Repression, a company built around sexual expression and knowledge. You can typically find her creating sex education materials or building some kinky hardware in a fresh set of coffin nails. She enjoys catfish (tail on), gardening, eating off her husband’s plate, and Beyoncé. Follow her everywhere.