Should your child be checked for high cholesterol?  What do the lab test mean?  And what is cholesterol anyway?  Well, here goes... cholesterol is white crystalline substance found in animal tissues.  It is vital for cell membranes and can be turned into hormones (like estrogen, testosterone, and cortisol), vitamin D, and bile acids.  Cholesterol is found in basically all animal food products such as meats, eggs, and milk.  If eaten in excess, cholesterol may collect in the blood vessel walls and lead to heart disease or other vascular problems (i.e., strokes, peripheral artery disease, etc.).  Even though cholesterol is an important substance for the body, you don't need to eat any.  Your body has the ability to create all the cholesterol it needs.  Certain things in the diet can cause your body to make too much cholesterol (such as trans fats, saturated fats, and dietary cholesterol). 

Which kids should have blood cholesterol levels checked?

You and your doctor should consider the following risk factors for cardiovascular disease.  The more risk factors that are present, the more important it is to check a blood lipid panel (which include a blood cholesterol level). 

• Family history of cardiovascular disease (especially if it is diagnosed in young adults or children)
• Family history of a blood lipid disorder (such as hyperlipidemia)
• Overweight or obesity
• Diabetes
• High blood pressure
• Some chronic diseases
• Smoking or passive smoke exposure
• Pancreatitis

What does a cholesterol (or lipid) panel include?

• Total cholesterol
  • More than 170 mg/dL is borderline
  • More than 200 mg/dL is elevated
• Triglycerides
  • More than 150 mg/dL (fasting) is elevated
• HDL cholesterol
  • Less than 35 mg/dL is too low (high values are good)
• LDL cholesterol
  • More than 110 mg/dL is borderline
  • More than 130 mg/dL is high

How are high cholesterol levels (or a low HDL level) treated?

• Weight management with diet and exercise
• Management of high blood pressure or diabetes (if present)
• Stop tobacco smoke exposure
• Medications for severe cases

Which kids should be treated with medications?

This should be discussed with your doctor, but drugs are often considered for kids with the following risk factors (according to the American Heart Association).

• Children over 10 years old if a 6-12 month trial of diet and exercise is not successful
• LDL levels remain over 190 mg/dL
• LDL levels over 160 mg/dL and there is a family history of early cardiovascular disease
• LDL levels over 160 mg/dL and there are at least 2 other major risk factors

What are the goals of treatment?

• Exercise and diet should be continued to achieve a healthy Body Mass Index
• Ideally the LDL level should remain less than 110 mg/dL
• HDL should be kept as high as possible (this number can go up with exercise)

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