High cholesterol is becoming more common among children and teenagers. Although high cholesterol doesn’t often present noticeable symptoms, it can significantly increase the risk of heart disease and other health issues later in life. The good news is that with the right approach, cholesterol levels can be managed effectively through lifestyle changes and, when necessary, medications.

Understanding Cholesterol Levels in Children

Cholesterol testing is recommended for children between the ages of 9 and 11, though earlier testing may be necessary if there are additional risk factors such as obesity or a family history of heart disease. Healthy cholesterol levels for children generally include:

• LDL cholesterol (bad cholesterol): Below 110 mg/dL
• HDL cholesterol (good cholesterol): Above 45 mg/dL
• Total cholesterol: Below 170 mg/dL

If your child’s cholesterol levels are higher than recommended, your doctor may suggest further testing and potentially a treatment plan to help bring the numbers down.

Causes of High Cholesterol in Children

Several factors contribute to high cholesterol in children, with diet and lifestyle being the most significant influences. Genetics can also play a role in raising cholesterol levels. Some common causes include:

Unhealthy Diets

A diet rich in trans fats, saturated fats, refined carbohydrates, and added sugars can increase LDL cholesterol and reduce HDL cholesterol. Fast food, sugary drinks, fried foods, processed snacks, and desserts are prime culprits. Encouraging a heart-healthy diet can help prevent cholesterol-related issues in children.

Weight Status

Children who are overweight or obese are more likely to have higher LDL cholesterol and triglyceride levels. Extra body fat disrupts normal cholesterol metabolism, making it essential to help your child achieve or maintain a healthy weight to avoid cholesterol complications.

Family History

If a child has a family history of high cholesterol or early cardiovascular disease, their risk for similar problems is higher. Having a parent with elevated cholesterol can increase their likelihood of developing high cholesterol by up to 50%. It’s important to inform your child’s doctor about family history for proper screening and preventive care.

Underlying Health Conditions

Conditions like type 1 diabetes, nonalcoholic fatty liver disease, hypothyroidism, polycystic ovary syndrome, and kidney disease can all negatively affect cholesterol levels. Proper management of these health issues can help keep cholesterol levels in check.

Lack of Physical Activity

Children who spend much of their time being sedentary, such as watching TV or playing video games, are more likely to have unhealthy cholesterol levels. Regular physical activity helps raise HDL cholesterol while lowering LDL cholesterol and triglycerides. Aim for at least 60 minutes of physical activity daily.

Genetic Disorders

Some children inherit genetic conditions like familial hypercholesterolemia, which prevents the body from properly clearing LDL cholesterol from the bloodstream. This leads to abnormally high cholesterol levels from a young age, which can contribute to early heart disease.

Lifestyle Changes to Manage Cholesterol

Diet and lifestyle changes should be the first step in managing high cholesterol in children. With commitment, these changes can significantly improve cholesterol levels in many children:

Healthy Eating

• Encourage at least five servings of fruits and vegetables each day.
• Choose whole grains like whole-wheat bread, pasta, and cereals.
• Limit sugary foods and drinks, as well as trans and saturated fats.

Physical Activity

• Promote at least 60 minutes of moderate physical activity every day.
• Reduce screen time to less than two hours per day.
• Activities like walking, biking, or participating in sports are great options.

Weight Management

• Help your child achieve or maintain a healthy weight by supporting healthy eating habits and regular physical activity.
• Be a role model for healthy lifestyle choices within the family.

Medications for High Cholesterol in Children

If cholesterol levels remain high despite 6-12 months of lifestyle changes, medications may be necessary for children aged 10 and older.

Statins

Statins are commonly prescribed for children with high cholesterol. These medications help lower LDL cholesterol by aiding the liver in removing cholesterol from the bloodstream, while also raising HDL cholesterol levels.

Other Medications

Other medications like bile acid sequestrants, cholesterol absorption inhibitors, fibrates, or niacin may be used based on individual needs.

For children with familial hypercholesterolemia, medications might be needed earlier due to the inherited nature of the condition. Your doctor will determine the best treatment plan.

Natural Supplements and Alternative Therapies

Some natural supplements have shown potential in improving cholesterol levels. However, it’s important to discuss any supplements with your child’s doctor before starting them. Some helpful supplements include:

• Soluble fiber: Found in fruits, vegetables, whole grains, and psyllium husk, this fiber can help lower cholesterol.
• Fish oil: Rich in omega-3 fatty acids (EPA and DHA), fish oil may help improve cholesterol levels.
• Plant sterols and stanols: These are found in certain margarine brands, juices, and supplements and can help lower cholesterol.

Research into nutraceuticals such as red yeast rice extract, artichoke leaf, and bergamot orange extract suggests they may lower LDL cholesterol, although more studies are needed.

While some approaches like stress reduction, sufficient sleep, and gut health support may offer mild cholesterol-lowering effects, the primary focus should be on diet and exercise.