While not as common of a problem as it is in adults, high cholesterol is far from uncommon in children as young as two years old.
The risk factors for high low-density lipoprotein (LDL) or “bad” cholesterol in children are the same as for adults, says Jon Dvorak, MD, a pediatrician at ProMedica Physicians Perrysburg Pediatrics. He says the number of children dealing with LDL has stabilized to about 10 to 15% of the population. The Centers for Disease Control and Prevention reports that more than 31% of American adults have high “bad” cholesterol. For children under 20, the undesirable level for LDL is anything greater than 130 (mg/dL). Overweight children are more likely to also have low high-density lipoprotein (HDL) or “good” cholesterol, which is increased through exercise.
While other conditions such as diabetes and high blood pressure play a role in high cholesterol, Dr. Dvorak says parents should be mindful of the two biggest risk factors for high cholesterol in youth: family history and being overweight.
“Parents should be aware of a family history of high lipids or premature cardiovascular disease (defined as disease at the age of 55 or younger in men, 65 or younger in women),” he says.
While family history and other conditions cannot be controlled, other risk factors can be lessened through behavior.
Reducing high cholesterol risk
Pediatricians refer to a “5210” plan when discussing diet and exercise regimens for children. These daily guidelines include:
- 5 servings of fruits and vegetables
- 2 hours or less of screen time
- 1 hour of vigorous exercise
- 0 sugary foods and drinks
The American Heart Association takes it a step further, suggesting no more than 30% of a child’s calories come from fat, with no more than 7% from saturated fats and total daily cholesterol should be less than 200 milligrams. The AHA also suggests children increase fish consumption to omega-3 fatty acids. (Try these kid-friendly crockpot fish tacos.)
“Kids with really high LDLs most of the time are going to be referred to pediatric cardiologists, mostly because there probably is a history of familial hypercholesterolemia (genetic disorder of high LDL levels),” Dr. Dvorak says. “But in today’s world, statins are most widely used for children, which is very similar to adults.”
While short-term studies of the affects of statins such as Lipitor have shown no health risks, long-term studies of adolescents’ muscle and liver toxicity — known adverse reactions to statins in adults — are still being monitored.
High cholesterol presents the same heart disease concerns in children as it does in adults.
“There is research evidence that there’s the presence of atherosclerotic disease (built-up plaque) in coronary arteries and the aorta as early as 10 years of age,” Dr. Dvorak says.
The CDC suggests all children should have their cholesterol checked once between the ages of 9 and 11, and again between the ages of 17 and 21.
Talk with your pediatrician if you think your child may be at risk for high cholesterol.