Can Kids Have High Cholesterol? Yes, Here’s What to Know

High cholesterol, or hyperlipidemia, is a common problem in adults. But children can have high cholesterol too. The American Academy of Pediatrics (AAP) recommends that all kids have their cholesterol checked at least twice during childhood. 

But why would you want to test your child for high cholesterol if they seem healthy? 

Let’s take a look at why experts recommend checking all kids for high cholesterol — and how high cholesterol can affect their health now and in the future. 

Why is high cholesterol a problem for kids?

You might be surprised to learn that even kids can develop artery disease from having high cholesterol. This can put them at risk for things like heart attacks or stroke when they reach adulthood.

Studies show that about 1 in 5 kids between the ages of 6 and 19 have an elevated level on their lipid panel, like high cholesterol or high triglycerides. Researchers suggests that high cholesterol or triglycerides levels can put kids at risk for developing medical problems like:

• Hardening of the arteries (atherosclerosis)

• Heart attack

• Stroke

• Peripheral artery disease

• Chronic kidney disease

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These risks are true — even if children don’t have any other medical problems.

By finding high cholesterol early, you can work together to bring your child’s level down. High cholesterol won’t just “go away” in most children. Studies have found that at least 1 in 2 children with high cholesterol will still have it as adults.

You can also work with your child’s healthcare team to teach your child skills to keep their heart healthy throughout their lives. Experts recommend that children with high cholesterol build long-term habits to improve their heart health — like avoiding tobacco, maintaining a weight that is considered to be in a healthy range, and staying active. 

What causes high cholesterol in children?

There are three main reasons why kids can develop high cholesterol: diet, certain medical conditions, and genetics. Let’s take a closer look at each one.

1. Diet

Children who eat foods with more saturated and trans fats — like fried foods and processed baked goods — tend to have higher cholesterol and triglyceride levels. 

2. Medical conditions

Certain medical conditions make it more likely for children and teens to have high cholesterol levels. These conditions include:

• Being considered overweight or obese

• Diabetes (Type 1 and 2)

• Nephrotic syndrome

• Chronic kidney disease or liver disease

• Hypothyroidism

• Polycystic ovary syndrome (PCOS)

• Lupus

• Juvenile rheumatoid arthritis

Children who use certain medications can also be at risk for high cholesterol. If your child has ever taken these medications, they could develop high cholesterol before adulthood:

• Corticosteroids

• Isotretinoin

• Certain types of chemotherapy

• Certain types of antiretrovirals

3. Genetics

Some people don’t process cholesterol normally because of genetic mutations — this includes conditions called familial hypercholesterolemia or familial hypertriglyceridemia. In these situations, many people in the same family have a history of high cholesterol or early heart disease. Early heart disease is usually considered a heart attack or stroke in males younger than 55 years old or females younger than 65 years old. 

What are the symptoms of high cholesterol in children?

Most children with high cholesterol don’t have any symptoms. That’s why it’s important to check their levels during childhood. 

Children with a genetic cause of high cholesterol, called homozygous familial hypercholesterolemia, may develop visible signs. These can include:

• Xanthomas: Yellow, waxy lesions, often near the elbows, knees, fingers, or ankles

• Xanthelasmas: Yellow, waxy lesions near the eyes

If you notice any of these skin changes, contact your child’s healthcare team. 

When to get your child’s cholesterol checked

The National Heart, Lung, and Blood Institute (NHLBI) and the AAP recommend that all children have their cholesterol checked once between 9 and 11 years old and again between 17 and 21 years old. 

Experts advise against checking kids when they’re 12 to 16 years old because changes happening during puberty can make results less accurate. 

Your child may need earlier or more frequent cholesterol checks if:

• High cholesterol runs in your family

• Your child has relatives with familial hypercholesterolemia

• Early heart disease runs in your family

• Your child has a medical condition that puts them at risk for high cholesterol 

What kind of cholesterol test does my child need?

Your child will have a blood test called a lipid panel. This checks four things: 

1. Total cholesterol: The total amount of all the cholesterol in their blood.

2. Low-density lipoproteins (LDL): Also called “bad” cholesterol, LDL can deposit on artery walls and cause clogged arteries.

3. High-density lipoproteins (HDL): Also called “good” cholesterol, HDL clears extra cholesterol from your blood.

4. Triglycerides (TG): High levels can increase the risk for heart attack, stroke, and pancreatitis.

Your child may need a “fasting” lipid panel, which is done in the morning when your child hasn’t eaten for 10 to 12 hours. Some offices can do a finger prick and take some blood from your kid’s finger and run a random, or “non-fasting,” cholesterol screen. This kind of test is helpful because it’s:

• Quick: You can get the results at the doctor’s office.

• Convenient: Your child doesn’t need to fast or go to a lab first thing in the morning.

• Accurate: Studies show fasting and non-fasting studies are equally accurate.

Normal cholesterol levels for kids

Once your child has their cholesterol checked, what do you do with the results? First, look to see if their numbers are in healthy ranges. Cholesterol levels can change with age. But here are general guidelines for healthy, borderline, and unhealthy lipid levels:

Your healthcare team will review the results with you. In general, the next steps depend on your child’s results. 

Safe and healthy ways to lower your child’s cholesterol

If your child has high cholesterol, there are many things you can do to help lower it — like making changes to your family’s nutrition and exercise routines. These tips will also help prevent high cholesterol later in life, even if your child’s results are currently in the healthy range.

Healthy eating

Good nutrition is important for your child’s growth and development. When kids learn healthy eating habits early, they’ll last a lifetime. A diet low in saturated and trans fats — and high in fresh fruits and vegetables — has many health benefits, like lowering cholesterol levels. Consider meeting with a nutritionist or dietitian to come up with a nutrition plan for your whole family. 

Exercise

Studies show that exercise improves cholesterol levels. Increased activity seems to help improve HDL (the good cholesterol) and lower triglycerides and LDL (the bad cholesterol). Try getting more active as a family or sign your child up for sports or other activities that increase movement. 

Medication 

Children with familial hypercholesterolemia may need to take medications, like statins, to manage their high cholesterol levels. Your family will work with a specialist to make sure medications are right for your child. Recent studies show that these medications are safe and effective for children with high cholesterol levels.

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Written by:

Brian Clista, MD

Dr. Clista is a board-certified pediatrician who works in private practice in Pittsburgh, Pennsylvania. He previously served as a National Health Service Corporation Scholar in the inner city of Pittsburgh for 11 years.

Edited by:

Patricia Pinto-Garcia, MD, MPH

Patricia Pinto-Garcia, MD, MPH, is a medical editor at GoodRx. She is a licensed, board-certified pediatrician with more than a decade of experience in academic medicine.

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