Cholesterol, LDL, HDL, and Triglycerides in Children and Adolescents

Cholesterol, LDL, HDL, and
Triglycerides in Children and Teens

What is
cholesterol?

Cholesterol is a fat-like, waxy substance. It can be found in all parts of your
child’s body. It helps make cell membranes, some hormones, and vitamin D. The
cholesterol in blood comes from 2 sources. The first source is from the foods your
child
eats. The second source is from his or her liver. Your child’s liver can make all
of the
cholesterol he or she needs.

Cholesterol and other fats are carried through the blood. They are in the form of
round
blobs called lipoproteins. There are 2 main types of lipoproteins. One type is
low-density lipoproteins (LDL). The other type is high-density lipoproteins (HDL).

What is LDL cholesterol?

What is HDL cholesterol?

LDL is often called “bad” cholesterol.
But the body does need LDL. If your child’s LDL level is high, it can
cause plaque to form in the arteries. This is known as atherosclerosis.
It is also known as hardening of the arteries. Atherosclerosis can lead
to heart disease. It is a risk factor for heart attacks.

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

  • Not eat foods high in saturated
    fat or cholesterol

  • Not eat too
    many foods with sugar and refined carbohydrates

  • Not eat too
    many calories

  • Get more exercise

  • Keep a healthy weight

This type of cholesterol is known as
“good” cholesterol. It helps remove LDL from the blood. It also helps
prevent plaque in the blood vessels.

HDL should be as high as possible. To
help raise HDL, your child should:

  • Exercise for at least 20 minutes,
    3 times a week

  • Not eat foods with saturated fat

  • Lose excess weight

What are
triglycerides?

Triglycerides are another type of fat found in the blood. Most of your teen’s body
fat
is in the form of triglycerides.

High
levels of triglycerides are linked with a higher risk of heart disease.

High triglyceride levels may be caused by any of these: 

  • Diabetes
  • Hypothyroidism
  • Kidney disease
  • Liver disease
  • Gene that causes high triglyceride levels in families (familial
    hypertriglyceridemia)
  • Obesity
  • Eating a lot of high-fat or sugary foods
  • Drinking a lot of alcohol

Should my
child have a blood lipid test?

A
lipid screening is a test to look at the levels of the fats in the blood. In the past,
doctors felt that children and teens were not at risk for high cholesterol levels.
But
we now know that children and teens are at risk. This is due to things such as:

  • Being inactive from too much screen time and not enough exercise

  • High-fat or high-sugar diets

  • Obesity

  • Family history of high cholesterol levels

Children and teens with high cholesterol are at higher risk for heart disease as
adults. Keeping blood cholesterol levels in the normal range reduces this risk.

Lipid
testing by age

Your child may need to fast before the blood test. This depends on
the type of lipid test done. Fasting means your child should not eat food or drink
anything but water before the test.

  • Under age 2. Lipid testing is
    not advised.
  • Ages 2 to 8. Testing is
    advised if your child has other risk factors for heart disease. These include
    diabetes, high blood pressure, obesity, exposure to cigarette smoke, or a family
    history of these. Other risk factors include family history of early coronary artery
    disease or lipid disorder, kidney disease, or other chronic inflammatory diseases.

  • Ages 9 to 11. Testing is
    advised. This can be done with either a fasting or non-fasting lipid profile.
  • Ages 12 to 16. Testing is not
    advised. This is because of changing lipid levels during puberty. But testing is
    advised if your child has risk factors as noted above.
  • Ages 17 to 21. Testing is
    advised. This is because lipid levels are more stable after puberty.

Understanding the test results

A
full lipid profile can be an important part of your child’s health information. It
shows
the levels of each type of fat in the blood. These include LDL, HDL, triglycerides,
and
total cholesterol. Your child’s doctor can tell you what the results should be for
your
child. In general, healthy levels are:

  • LDL of less than 130 mg/dL

  • HDL of greater than 35 mg/dL (less than 35 mg/dL puts your teen at higher risk
    for heart disease)

Some
children and teens (ages 2 to 19) have families with high cholesterol or early heart
disease. In these cases, the National Heart Lung and Blood Institute advises these
levels for cholesterol:

Total cholesterol

LDL-cholesterol

Acceptable

Less than 170 mg/dL

Less than 110 mg/dL

Borderline

170 to 199 mg/dL

110 to 129 mg/dL

High

200 mg/dL or greater

130 mg/dL or greater

Treating
high cholesterol in your child or teen

If
the results of your child’s lipid tests are abnormal, your child’s doctor will work
with
you to create a treatment plan. Most children and teens will not need medicine. A
healthy diet, weight loss, and more physical activity may bring your child’s blood
lipid
levels to normal. The doctor will track lipid levels and help your child make lifestyle
changes. Your child’s doctor will talk with you about medicine if needed.