What Is High Cholesterol in Children?
Cholesterol is a type of fat found in the body. It is not always bad. In fact, cholesterol is essential for life. It helps build cell membranes and is needed to make hormones, bile acids, and vitamins.
Our body gets cholesterol in two ways. Some come from the food we eat, especially foods containing fats. The liver makes the rest. Cholesterol travels in the blood on special carriers called lipoproteins. These include chylomicrons, VLDL (very low-density lipoprotein), LDL (low-density lipoprotein), and HDL (high-density lipoprotein). When cholesterol, triglycerides, or these lipoproteins are present in unhealthy amounts, the condition is called dyslipidemia.
In adults, dyslipidemia is a known risk factor for heart disease, diabetes, high blood pressure, and obesity. Earlier, doctors believed this problem affected only adults. However, research now shows that high cholesterol in children and teenagers can also lead to early artery damage, future heart disease, and other long-term health problems.
What Is a Normal Cholesterol Level in Children?
Cholesterol levels change as a child grows. They also vary based on age, gender, and ethnicity. This is why children have different “normal” cholesterol values than adults.
For children and adolescents aged 19 years or younger, healthy levels are:
Total Cholesterol: Less than 170 mg/dL.
LDL (Bad Cholesterol): Less than 100 mg/dL.
HDL (Good Cholesterol): More than 45 mg/dL.
Values outside these ranges may suggest dyslipidemia and need medical attention.
Why Do Some Children Have High Cholesterol?
There are two main reasons why cholesterol levels may be high in children.
1. Primary (Genetic) Dyslipidemia: Some children are born with genes that affect how their body handles cholesterol. These conditions often run in families and may be linked to early heart disease.
Examples include:
Familial hypercholesterolemia (FH).
Familial defective apolipoprotein B.
Familial hypertriglyceridemia.
There are also conditions caused by several genes acting together, along with lifestyle factors. One common example is familial combined hyperlipidemia, which is often seen in children who are overweight or obese.
2. Secondary Dyslipidemia: This is the most common type seen in children. It develops due to other health problems or lifestyle habits.
Common causes include:
Obesity.
Type 2 diabetes.
Kidney or liver disease.
Certain medicines (like steroids or cancer drugs).
Diets high in saturated and trans fats.
In most children, high cholesterol is related to lifestyle and underlying medical conditions rather than genetics alone.
What Health Problems Are Linked to High Cholesterol in Children?
High cholesterol not only affects the heart. It can influence many systems in the body.
1. Vitamin D and Cholesterol
Vitamin D plays an important role in bone health, immunity, and inflammation control. It also affects how the body handles fats.
Low vitamin D levels may disturb fat metabolism. This can lead to higher triglycerides and lower HDL (good cholesterol). Researches indicate that children whose vitamin D levels are good tend to have normal cholesterol.
The correction of vitamin D deficiency in obese children with dyslipidemia may be useful to correct the cholesterol. Nevertheless, vitamin D supplements must not substitute proper dieting, physical activity, and weight control.
2. Cholesterol and Respiratory Problems
Cholesterol can promote inflammation at the cellular level. When cholesterol balance is disturbed, it may affect airway muscles and worsen inflammation.
Several studies show a strong link between obesity and asthma in children. Dyslipidemia may be one reason why asthma symptoms are more severe in overweight children. This condition is often called “obese asthma.”
Although the relationship is evident, additional studies should be conducted to gain a comprehensive understanding of the influence of diet, fat distribution, and cholesterol on the health of the lungs.
3. Cholesterol and Mental Health
Cholesterol plays a significant role in developing the brain and the nervous system. It aids in the formation of myelin that cushions nerve cells.
When the cholesterol is abnormal, it can influence serotonin, a chemical governing the mood and sleep. Research suggests a link between altered lipid levels and mental health problems such as depression and suicidal thoughts in children and adolescents.
This does not mean cholesterol directly causes these conditions, but it may play a supporting role.
How Is High Cholesterol in a Child Managed?
Treatment of high cholesterol levels in children is similar to that in adults, as it involves lifestyle interventions and pharmacologic therapy (medications). However, lifestyle modification is the primary intervention for high cholesterol in children and adolescents. These include:
Increased Physical Activity: It includes regular exercise and reducing stationary time (in front of a television, computer, or phone).
Healthy Eating: A diet to decrease cholesterol levels includes limiting foods high in saturated fat, sugar, and trans fat. A child must also eat plenty of fresh fruits, vegetables, and whole grains.
Weight Loss: Losing weight is of utmost importance if the child is overweight or has obesity.
However, these lifestyle changes are sometimes not enough to lower the child’s cholesterol level. The clinician may provide medication in some cases, such as:
When the child is 10 years old.
Has an LDL (bad) cholesterol level> 190 mg/dL (after six months of diet modification and exercise).
Has an LDL cholesterol level> 160 mg/dL and is at high risk for CVD.
Has primary dyslipidemia.
The American Heart Association (AHA) recommends the use of Statins (Lovastatin, Simvastatin, Fluvastatin, Atorvastatin, and Rosuvastatin) in children less than ten years old.
Statins are also effective at reducing disease and death rates in CVD patients. These medications result in beneficial cholesterol reductions of about 20 to 50 percent. Due to their efficacy in adults, statins are one of the first-line medications in children with dyslipidemia.
Conclusion
High cholesterol in children often begins quietly and can progress over the years without any apparent symptoms. Most children are perfectly healthy, and thus the condition remains undetected till their adolescence or adulthood, when it begins to cause early heart disease. Since one begins to accumulate cholesterol early in life, it is essential to make sure that the level is controlled in childhood to avoid future heart diseases.
In case the family has high cholesterol or early heart disease in the family, parents need to talk to a specialist. Screening for lipid early in children will allow lifestyle modification and medication to start early when children are at risk. Educating children on the dangers of high cholesterol may reduce the chances of heart attacks and stroke occurring in adulthood.
Key Takeaways
Even though high cholesterol may go undiagnosed in childhood, once it develops, it may silently affect overall health over time, despite the fact that children may appear healthy on the surface.
The main concern is that it often goes unnoticed, as most children have no symptoms despite cholesterol levels rising above healthy limits (total cholesterol above 170 mg/dL or LDL above 100 mg/dL).
Simple steps like healthier eating, regular physical activity, weight control, and timely treatment when needed can lower cholesterol and greatly reduce the risk of heart disease later in life. Approximately 85 million adults in the US who are above 20 years have high levels of total cholesterol and no signs or it. This is paramount because it is important to have your cholesterol levels checked regularly.
