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Are cholesterol levels a childhood concern?

Research suggests that high cholesterol in childhood may play a role in the development of heart disease later in life. Fortunately, there's much parents can do to help keep their children's cholesterol levels in a healthy range.

Chickenpox. Measles. Mumps. Those are problems associated with childhood.

High cholesterol. Heart disease. Atherosclerosis. Those are problems adults face—right?

Years of research suggests that the answer isn't quite that simple. Medical experts now say it's clear that atherosclerosis—the narrowing and hardening of the arteries that cause heart disease—is a process that begins in childhood. And one of the biggest contributors to the beginning of that process is high cholesterol.

For some parents, this news is "kind of an awakening," says Stephen R. Daniels, MD, the lead author of the American Academy of Pediatrics' (AAP) guidelines on testing and treating kids with high cholesterol.

But if you know your child's road to a healthy heart starts now, you can take steps to steer it in a good direction.

Cholesterol and heart disease

Atherosclerosis results from fat and cholesterol building up within the arteries.

"It starts out as a thin, fatty streak inside the artery," says Dr. Daniels, who also co-authored an American Heart Association (AHA) scientific statement on kids and cholesterol.

Over time these streaks grow into fibrous plaques and atherosclerotic lesions, he says, which ultimately can thicken and block arteries.

Research has shown that atherosclerosis can begin early in life. Studies have also linked elevated cholesterol in childhood and atherosclerotic lesions in young adults.

The evidence that high cholesterol in kids increases their risk for cardiovascular disease in adulthood is convincing, according to the AHA. The AAP and the National Heart, Lung, and Blood Institute (NHLBI) agree.

All three of those organizations also agree that family history—genetics—plays a big role.

But environmental factors may be just as important, and that's where parents come in.

"They can focus the family on a healthier lifestyle," says Dr. Daniels, "which boils down to a healthier diet and increased levels of physical activity."

What parents can do

To help steer kids on the path to healthy cholesterol levels, parents have to push back against an often unhealthy world of fast food and inactivity.

A heart-healthy diet, for example, emphasizes foods from plant sources and reduces foods from animal sources and those high in saturated fat, both of which can raise cholesterol levels.

For many families this can be a challenge, acknowledges Dr. Daniels.

"There's no question it is easier to do this if you focus on foods you prepare yourself," he says, and he encourages families to seek the advice of a dietitian if they think it would be helpful.

Physical activity is also important. For kids, a healthy level of activity is 60 minutes of heart-pumping, lung-working exercise most days of the week, according to the AHA and AAP.

Of course, parents should also discourage smoking, which is another risk factor for abnormal cholesterol levels and heart disease.

Probably the best way for parents to encourage healthy behaviors in their children is to serve as role models by engaging in the behaviors themselves.

Kids are more likely to eat healthy foods and exercise if their parents do the same.

Talk to your doctor

Parents also can help their kids by finding out what their own cholesterol levels are, says Dr. Daniels.

"You can't take a look inside a child's arteries to see if there are any fatty streaks or lesions," says Dr. Daniels. "But family history is one clue that the process may have begun."

Children with parents or grandparents at high risk for heart disease should have their cholesterol tested after age 2 but no later than age 10, according to the AAP. Even parents who know their cholesterol levels are healthy should let their child's doctor know of any family history of heart disease, stroke or abnormal cholesterol.

At the very least, you can begin a discussion on how to stop an adult disease in your child before it starts.

reviewed 9/5/2019

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