LDL Cholesterol in Children

A common misperception is that high cholesterol only happens to adults. However, research has shown that high cholesterol can begin to present as early as childhood. The reasons for cholesterol issues that stem from the "bad" or low-density lipoprotein (LDL) cholesterol can be linked to obesity, being too sedentary, poor food choices and genetics. However, there are ways to prevent the "bad" cholesterol from leading to an even worse health-related scenario down the road.

The Facts

• Cholesterol, created by the liver, is a lipid (fat) the body generates to develop hormones and cell membranes. A healthy body can survive on the amount of cholesterol the body creates, which is typically 1,000 milligrams daily. Other cholesterol comes from consumable foods that are byproducts of animals.

  All cholesterol, as it courses through our bloodstream and blends with proteins, the mixture of which is called lipoproteins. There are low-density lipoproteins and high-density lipoproteins, the former of which is the focus of discussion. LDLs are the major cholesterol transporters. Too many LDLs in the blood lead to accumulation in the arteries that link to the brain and heart. The LDL deposits in the arteries develop plaque, which can lead to blocked or restricted blood vessels.

  Presently, the acceptable LDL cholesterol range for children age 2 to 18 years is less than 110 mg/dL, according to the National Cholesterol Education Program. The "borderline" range is 110 to 129 mg/dL, and anything more than 130 mg/dL is considered high.

Significance

• Targeting high LDL cholesterol levels in children may prevent a future stroke, atherosclerosis (artery hardening) or onset of heart disease. Because of children's possible ongoing exposure to smoking, their minimal exercise and the issue of childhood obesity, their LDL levels cannot be ignored.

Identification

• Obese children are at greater risk of high LDL cholesterol, especially if those children are also sedentary and not regularly exercising Genetics also can play a role in determining which children would be more likely to have cholesterol issues related to high LDL. For instance, children with family history of cardiovascular disease before age 55 in men and 65 in women are at increased risk.
  In addition, having parents with total cholesterol of 240 mg/dL or higher puts the child at greater risk. Risk factors that have an impact on the parents include diabetes, high blood pressure and cigarette smoking, all of which can lead to cholesterol-related obstacles.

Considerations

• When children have problematic cholesterol levels, it is important for parents and physicians to collaborate together to determine solutions to lowering the children's risk of heart disease down the road.

  Specifically, for children who are at risk for high cholesterol, recommendations call for screening as early as age 2 and no later than age 10. If children have LDL cholesterol of 170 mg/dL or higher, dietary counseling is highly recommended to find ways to trim extra fat and cholesterol in the diet, while adding more activity to the child's life.

  If LDL levels exceed 190 mg/dL, a physician may prescribe medication to children who are 8 years and older, especially if diet and exercise have not delivered significant change. The medication of choice is often a statin, or cholesterol-lowering drug.

  Overall, parents are advised to stay on top of their children's cholesterol levels. Monitor those levels by having children checked at least yearly. This becomes even more significant if there is an existing family history of cholesterol or heart disease.

Prevention

• The proper diet to control LDL levels in children includes a heavy concentration of fruit, whole grains and vegetables. Meats should be lean cut. Fish is highly recommended. Opt for low-fat dairy choices. Try to limit beverages with sugar.