High Cholesterol in Children

While high cholesterol has traditionally been viewed as an adult health concern, it's increasingly affecting children and adolescents. If you're a parent or caregiver, understanding this condition and what it means for your child's long-term health is important. Our pediatric cardiology experts, Guilherme Baptista De Faria, MD, and Nancy Hasenauer, APRN-NP, will walk through what you need to know about high cholesterol in kids. 

Understanding Childhood Cholesterol

Cholesterol is a waxy, fat-like substance your child's body needs to build cells and produce hormones. However, when cholesterol levels get too high in childhood, it can lead to plaque buildup in the arteries over time, increasing the risk of heart disease later in life. 

However, high cholesterol doesn't cause any symptoms you can see or feel. The only way to know if cholesterol levels are elevated is through a simple blood test. Most pediatricians and cardiologists recommend screening between ages 9-11 and again at 17-21. If there are risk factors for heart disease, such as a family history of high cholesterol or early heart disease, your doctor may want to test earlier. 

When your child's doctor orders cholesterol testing, they're requesting what's called a "lipid panel" or "lipid profile." This comprehensive blood test measures several important components of fats in the blood: 

• Total cholesterol: The overall amount of cholesterol in your child's blood
• LDL cholesterol ("bad" cholesterol): The type that can build up in artery walls
• HDL cholesterol ("good" cholesterol): The type that helps remove cholesterol from the arteries
• Triglycerides: Another type of fat in the blood that your body uses for energy 

Understanding all four of these measurements gives you and your doctor a complete picture of your child's cardiovascular health. 

What are healthy cholesterol levels for kids? 

According to pediatric guidelines, healthy cholesterol levels for children are: 

• Total cholesterol: Less than 170 mg/dL
• LDL cholesterol ("bad" cholesterol): Less than 110 mg/dL
• HDL cholesterol ("good" cholesterol): Greater than 45 mg/dL
• Triglycerides: Less than 90 mg/dL (ages 0-9) or less than 130 mg/dL (ages 10-19) 

If your child's numbers are higher than these, don't panic. Your pediatrician will work with you to create a plan that makes sense for your family. 

What about triglycerides? 

While most discussions about cholesterol focus on LDL and HDL, triglycerides are also important for your child's heart health. Triglycerides are the most common type of fat in the body and come from the foods we eat. When your child consumes more calories than their body needs—especially from carbohydrates and sugars—the extra calories are converted into triglycerides and stored in fat cells. 
  
High triglycerides (hypertriglyceridemia) in children can be concerning because: 

• They contribute to hardening and narrowing of the arteries
• Very high levels (especially above 400 mg/dL) can increase the risk of pancreatitis, a serious inflammation
• of the pancreas
• They often occur alongside other risk factors like obesity, pre-diabetes, or metabolic syndrome
• They're particularly responsive to dietary changes, which is good news for families 

What causes high cholesterol in kids? 

Genetic Predisposition: Sometimes high cholesterol can run in families, regardless of lifestyle. If you or other close family members have high cholesterol, or if anyone in your immediate family had a heart attack or stroke before age 55 (men) or 65 (women), your child may be at higher risk. 

Lifestyle Factors: Today's busy lifestyle plays a significant role in childhood cholesterol levels. Between processed convenience foods, increased screen time and packed schedules that leave little room for physical activity, many children aren't getting the nutrition and movement their bodies need. Having an overweight BMI, making less-than-ideal food choices and spending too much time sitting are factors we can actually change to improve cholesterol levels. 

What You Can Do to Help 

The good news is that most children with high cholesterol respond well to lifestyle changes. You don't need to put your child on a restrictive diet or overhaul your entire life overnight. Small, sustainable changes can make a real difference, such as: 

Focus on nutrition

Nutrition is the foundation of managing cholesterol in children. Here's what helps: 

• Increasing: Fruits, vegetables, whole grains, lean proteins and omega-3 rich fish
• Limiting: Saturated fats (fatty meats, butter, full-fat dairy), trans fats (processed foods), and added sugars
• Incorporating: Heart-healthy fats from sources like avocados, nuts and olive oil 

Remember, these changes benefit everyone in the family. You're not singling out your child—you're helping the whole family eat better together. Focus on gradual improvements that feel manageable rather than trying to be perfect. 

Get everyone moving 

Kids should aim for at least 60 minutes of physical activity most days. Before you worry about signing up for every sport, remember that movement doesn't have to be structured. Family walks, bike rides, active play, dancing in the living room—it all counts and helps manage cholesterol levels. 

Make it a family effort 

Here's an important point: lifestyle changes work best when the whole family participates. Kids learn from what they see you doing. When everyone eats healthier and stays active together, it feels normal instead of like a chore.  

When is medication needed? 

Most kids don't need medication; lifestyle changes are usually enough. However, your doctor may consider medication if: 

• Cholesterol stays very high despite lifestyle changes (usually after 6-12 months)
• There's a strong family history of early heart disease
• Your child has a genetic condition causing extremely high cholesterol  

If your pediatric specialist recommends medication, know that these medications are well-studied and safe when properly monitored. It doesn't mean you've failed, sometimes genetics just require extra help. 

When to Call Your Pediatrician

Reach out to your child's doctor if: 

• Your child is between 9-11 years old and hasn't been screened yet
• You have a family history of high cholesterol or early heart disease
• Your child is overweight or has other risk factors
• You need help implementing lifestyle changes
• You have concerns about your child's diet, activity level, or emotional well-being

Finding out your child has high cholesterol might feel overwhelming at first, but try to see it as an opportunity. You're catching this early. Remember, small changes add up over time. You don't have to be perfect. Focus on progress, work closely with your child's healthcare team, and develop an approach that fits your family's unique needs and lifestyle. 

Learn more about Lurie Children's Heart Center here.

Search our blog Search

---