Cholesterol is found in the body from two sources:  cholesterol we eat, and cholesterol our liver makes.  Dietary cholesterol comes from meat, fish, poultry, and dairy products.  Plants contain no cholesterol. 

LDL (low density lipoprotein) is called "bad" cholesterol because high LDL levels are associated with an increased risk of coronary heart disease.  Deposits of LDL form on artery walls, causing plaques, which thicken the artery walls and lead to atherosclerosis.

HDL (high density lipoprotein) is called "good cholesterol" because HDL prevents atherosclerosis by extracting cholesterol from the artery walls and putting them in the liver. 

Total cholesterol is LDL + HDL + VLDL (very low density lipoprotein), and IDL (intermediate density cholesterol). 

Triglycerides are composed of three fatty acids.  It is debated whether triglycerides are involved directly in atherosclerosis, but elevated triglycerides are associated with obesity, low HDL, insulin resistance and diabetes mellitus.

The American Heart Association suggests the following cholesterol level guidelines in children and adolescents 2-19 years old:

Total cholesterol

• Acceptable - less than 170
• Borderline -170-199
• High - 200 or greater

LDL cholesterol

• Acceptable - less than 110
• Borderline - 110-129
• High - 130 or greater

Eating habits, exercise habits, cigarette smoke exposure, and genetics can each lead to risks of elevated cholesterol and heart disease.  The atherosclerotic process (the buildup of plaques in the arteries) begins in childhood.  High cholesterol can lead to early coronary heart disease if left untreated. 

The primary treatment involves lowering LDL cholesterol by losing excess weight, exercising regularly, and following a diet low in saturated fat and cholesterol. 

Weight loss should be monitored by a physician and/or dietician closely in children.  Growing children often should not lose weight, but maintain the same weight as they gain height.  Working with a nutritionist or dietician for caloric needs is especially beneficial in children, and although often not covered by insurance, working with a nutritionist can be well worth the cost.  Consider the lifetime medical costs associated with obesity:  diabetes, heart disease, joint problems, increased loss of work, and more.  Not to mention the psychological impact of being overweight...

Diets rich in omega-3 fatty acids have been shown to decrease levels of triglycerides and cholesterol. 

• Nuts (especially walnuts) are high in omega-3 fatty acids, as well as protein, fiber, healthy monounsaturated fats, vitamins, and antioxidants.  One to one and a half ounces of nuts per day is recommended, unless there is a nut allergy.  Too many nuts do increase the fat and calories in the diet, so should be avoided.
• Fatty fish (salmon, tuna, trout, herring, sardines, and mackerel) are also high in omega-3 fatty acids.  Two 4-ounce servings of fish per week are recommended, unless allergic to fish.
• Flaxseed, canola oil, and omega-3 enriched eggs are other sources of omega-3 fatty acids. 
• For people who are not able to eat fish or nuts, fish oil supplements can be taken (unless allergy to fish is present).  They are available in capsule form as well as gummy vitamins and liquid preparations.  Health food stores will often allow children to sample a variety of flavors before purchasing. 
• Click here for more information on omega-3 fatty acids.

If exercise and dietary changes fail to lower cholesterol, some children require medication.  These medications are approved in children, but do have side effects, which should be discussed with your doctor if they are being considered.  Medicine is sometimes seen as a "quick fix", but it must be used in conjunction with healthy habits. 

There are familial forms of high cholesterol.  These are also called genetic high cholesterol ... you have high cholesterol no matter how healthy you eat and how much you exercise.  These often require medication beginning at an early age.

More information about healthy eating and weight loss tips are available on our "Feeding and Nutrition" page.