We commonly think of high cholesterol and heart disease as an adults-only issue. Unfortunately, it can be a problem for kids as well.

Even though heart disease is rare for children, high cholesterol levels at an early age can lead to increased risks of developing heart disease in adulthood. There is good news, however: the National Health and Nutrition Examination survey for 1999 to 2016, released last month, showed that trends in children’s cholesterol levels are improving in the U.S.

What steps can be taken to continue this favorable trend and help children prevent early heart disease?

Kids need cholesterol screening

Since 2011, universal cholesterol screening has been recommended for all children ages 9 to 11 to identify those at highest risk for heart disease. It is important to measure cholesterol before puberty, since levels can be lowered during rapid periods of growth.

Prior to 2011, lipid screening only focused on measuring total cholesterol (TC), Low Density Lipoprotein Cholesterol (LDL-C), High Density Lipoprotein Cholesterol (HDL-C), and Triglycerides (TG). More recently, Non-HDL-C is considered a more useful screening tool to predict early heart disease and can be tested without fasting, which is always a favorable approach for children. In addition, screening for apolipoprotein B (ApoB) is also often recommended for children with a family history of early heart disease.

If your child has already had cholesterol screening, the expert panel has established these cholesterol level goals for children without chronic disease:

  • Total Cholesterol: Less than 170 mg/dL
  • LDL-C: Less than 110 mg/dL
  • HDL-C: Greater than 45 mg/dL
  • Non-HDL-C: Less than 120 mg/dL
  • Apolipoprotein B (ApoB): Less than 90 mg/dL
  • Triglyceride (TG): In children from infancy up to 9 years old, less than 75 mg/dL; in children 10 to 19 years old, less than 90 mg/dL ()

Mixed messages in cholesterol trends for kids

From 2009 to 2016, cholesterol levels in children decreased by 3 percent, despite the fact that obesity rates remain high. Even though ideal lipid levels including TG, LDL-C and ApoB, were found in about half of all U.S. children, still a quarter had at least one abnormal level.

Researchers speculate one reason for lower cholesterol levels may be related to children eating fewer foods containing trans fats (which were banned in 2018). Regardless of the reason, messages about eating healthier, increasing physical activity, avoiding smoking, and maintaining a healthy weight are all important to children achieving normal cholesterol levels.

Cholesterol tips for parents

Early screening can not only detect lipid abnormalities but also help children learn about preventing and treating high cholesterol. This is especially important if your family has a history of high cholesterol, early heart disease, heart attack, or stroke before age 55.

Teaching young children how to eat “heart healthy” is one way you can help prevent high cholesterol. Preparing meals high in dietary fiber and low in saturated fat as well as reducing processed snack foods, desserts, and sugary beverages are great steps toward getting your children on track to reducing their risk of early heart disease.

Megan Robinson, MS, RD, CDE, LDN, is a registered dietitian at the Children’s Hospital of Philadelphia.