Are the Optimal Levels of Cholesterol for Children Any Different?

Cholesterol levels are obtained through a routine blood test taken after a starvation period, ingesting only water, for 9 to 12 hours prior to the test; this same test is used to ascertain cholesterol levels in children. Generally, children under 2 years old are not subjected to cholesterol testing, but if a family history of high cholesterol exists and the child is seriously overweight or obese, then a cholesterol level test may be in order.

Because doctors believe that a propensity toward heart disease and stroke may develop in early childhood, there is no harm, and possible benefit, in monitoring a child’s cholesterol levels. The one caveat that divides doctors is this: if they find high LDL cholesterol levels in a child’s blood, should it be treated with prescription drugs; many pediatricians feel the drugs pose a greater threat to a youngster than high cholesterol itself.

Young, growing bodies have different composition than adults, and children do not react well to niacin, an element in many of the drugs used to lower cholesterol. No studies have, to date, been done on the long-term effects of cholesterol medications on the constitutions of children. Most doctors suggest that children’s cholesterol levels are seldom if ever high enough to warrant the use of prescription medications.


What are the Acceptable Levels of Cholesterol in Children?

Compared to adults, children’s general cholesterol levels are targeted a bit lower. This takes into account many factors, such as the likelihood of greater physical activity and energy needs, the growth of children, and the different nutritional requirements they have.

In the United Sates, unlike Canada and Europe (they are on the metric system), cholesterol is measured in milligrams (mg) of cholesterol per deciliter (dL) of blood; that shows as “mg/dL” when measurements are reported. Here is a comparison of total cholesterol levels as required by children and adults:

  • The “Desirable” level for normal adults is less than 200 mg/dL; in children it is less than 172 mg/dL.
  • The “Borderline High” level for adults sits at 200-239 mg/dL; for children it is 175-199 mg/dL.
  • The “High” designation for adults is over 240mg/dL; that translates as over 200 mg/dL for children.

Clearly, what is desirable for adults is high for children. It should be emphasized that these figures represent total cholesterol levels and not only LDL cholesterol levels.


How Do I know if My Child has Borderline High or High Cholesterol Levels?

The only way to know for sure is to enlist them for a cholesterol blood test, but there are ways you can ascertain if they are at high risk for high cholesterol:

  1. If they are significantly overweight or obese.
  2. If you have a family history of heart disease, stroke or just high cholesterol levels, especially if a parent or grandparent suffered a heart attack before the age of 55, or if one parent has chronic cholesterol levels above 240 mg/dL.
  3. If the child spends too much time in front of the television or computer and isn’t getting enough exercise.


What Can I Do if My Child has High Cholesterol Levels?

As a rule of thumb, cholesterol-lowering prescription drugs are not administered to children less than 10 years of age. The exception, of course, is a child at high risk for coronary heart disease, which is uncommon. Children’s bodies tend to be more flexible and are more naturally open to adjustments, so for children with borderline high cholesterol levels, modest diet alterations and a little more physical play time should do the trick, aiming for a less than 175 mg/dL total cholesterol level. If they fall into the high category, then serious diet alterations are required, plus ample exercise.