Facts about cholesterol

Cholesterol is a waxy substance that can be found in all parts of your child's body. It aids in the production of cell membranes, some hormones, and vitamin D. The cholesterol in blood comes from two sources: the foods your child eats and his/her liver. However, your child's liver makes all of the cholesterol your child's body needs.

Cholesterol and other fats are transported through the blood stream in the form of round particles called lipoproteins. The two most commonly known lipoproteins are low-density lipoproteins (LDL) and high-density lipoproteins (HDL).

What is LDL (low-density lipoprotein) cholesterol?

This type of cholesterol is commonly called "bad" cholesterol. It can contribute to the formation of plaque build-up in the arteries, known as atherosclerosis.

LDL levels should be low. To help lower LDL levels, help your child to:

• avoid foods high in saturated fat, dietary cholesterol, and excess calories
• increase exercise
• maintain a healthy weight

What is HDL (high-density lipoprotein) cholesterol?

This type of cholesterol is known as "good" cholesterol, and is a type of fat in the blood that helps to remove cholesterol from the blood, preventing the fatty build up and formation of plaque.

HDL should be as high as possible. It is often possible to raise HDL by:

• exercising for at least 20 minutes three times a week
• avoiding saturated fat intake
• decreasing body weight

For some children, medication may be needed. Because raising HDL can be complicated, you should work with your child's physician on developing a therapeutic plan.

Checking blood cholesterol levels

A cholesterol screening is an overall look at, or profile of, the fats in the blood.

Physicians in the past felt that children were at little risk for developing high cholesterol levels and other risk factors for heart diseases affecting the coronary arteries and blood vessels until later in life. However, many physicians now realize that children are increasingly at risk for having high blood cholesterol levels as a result of one, or more of the following:

• Sedentary lifestyles (playing video games and watching TV instead of participating in vigorous exercise)
• High-fat junk food and fast-food diets
• Obesity
• Family history of high cholesterol levels

Children and adolescents with high cholesterol are at higher risk for developing heart disease as adults. Many physicians are recognizing that keeping blood cholesterol levels in normal ranges throughout one's lifetime may be of great benefit in reducing the likelihood of developing coronary artery disease and high blood pressure.

Cholesterol testing for children

The National Heart, Lung, and Blood Institute (NHLBI), a division of the National Institutes of Health, recommends that cholesterol testing begin at age 2 for any child who has the following:

• At least one parent who has been found to have high blood cholesterol (240 milligrams or greater)
• A family history of early heart disease (before age 55 in a parent or grandparent)

The NHLBI also recommends that children who have demonstrated risk factors, such as obesity, should have cholesterol and other lipids tested periodically by their physicians.

A full lipid profile shows the actual levels of each type of fat in the blood: LDL, HDL, triglycerides, and others. Consult your child's physician regarding the timeliness of this test.

What is a healthy blood cholesterol level?

Blood cholesterol is very specific to each individual. A full lipid profile can be an important part of your child's medical history, and important information for your child's physician to have. In general, healthy levels are as follows:

• LDL - less than 130 milligrams (mg)
• HDL - greater than 35 mg (less than 35 mg puts your child at higher risk for heart disease)

The NHLBI recommends the following guidelines for cholesterol levels in children and teenagers (ages 2 to 19) from families with high blood cholesterol or early heart disease:

Statistics about cholesterol

Elevated cholesterol is a risk for many Americans. Consider these statistics:

• About 30 percent of American adults have total cholesterol levels between 200 and 239.
• More than 25 percent of the adult US population has blood cholesterol levels greater than 240, which is considered high risk.
• Up to one-third of young adults have a blood cholesterol level higher than 200 mg.
• According to the American Heart Association, high blood cholesterol that runs in families will affect the future of an unknown (but probably large) number of children.

What are triglycerides?

Triglycerides are another class of fat found in the bloodstream. The bulk of your child's body fat tissue is in the form of triglycerides.

The link between triglycerides and heart disease is under clinical investigation. However, many children with high triglyceride levels also have other risk factors such as high LDL levels or low HDL levels.

What causes elevated triglyceride levels?

Elevated triglyceride levels may be caused by medical conditions such as diabetes, hypothyroidism, kidney disease, or liver disease. Dietary causes of elevated triglyceride levels may include obesity and high intakes of fat, alcohol, and concentrated sweets.