The American Academy of Pediatrics and NHLBI (National Heart, Lung, and Blood Institute) recommend that cholesterol screening begin at age 2. Recent studies have shown that children and adolescents who have high cholesterol are at an increased risk for coronary heart disease as adults. Keeping blood cholesterol levels in the normal range throughout one’s lifetime may be of great benefit in reducing the likelihood of developing coronary heart disease and high blood pressure.

Cholesterol is a soft, fat-like, waxy substance found in the bloodstream and in all your body's cells. It's normal to have cholesterol. Cholesterol is an important part of a healthy body because it's used for producing cell membranes and some hormones, and serves other needed bodily functions. But too much cholesterol in the blood is a major risk for coronary heart and for stroke.

LDL cholesterol is more commonly called “bad” cholesterol. It contributes to the formation of plaque in the arteries called atherosclerosis. LDL should be as low as possible. Avoiding foods high in saturated fat and dietary cholesterol, increasing exercise, and maintaining a healthy weight will help lower your child’s LDL.

HDL cholesterol is more commonly called “good” cholesterol. It helps remove cholesterol from the blood and prevents buildup of plaque in the arteries. You can increase HDL by exercising for at least 20-30 minutes 3 times per week, avoiding foods high in saturated fat, and decreasing body weight.

Triglycerides are another form of fat found in the blood. Elevated triglycerides can be due to overweight/obesity, physical inactivity, and a diet high in carbohydrates (60 percent of total calories or more). People with high triglycerides often have a high total cholesterol level, including a high LDL (bad) level and a low HDL (good) level.

Children and adolescents are increasingly at risk for having elevated blood cholesterol levels due to one or more of the following:

• Being overweight or obese
• Sedentary lifestyles (video games/TV instead of participating in exercise)
• High-fat junk food and fast food diets
• Family history of high cholesterol

The AAP recommends checking blood cholesterol levels in children and adolescents if there is a family history of high cholesterol, early heart disease in a parent or grandparent, or if there are additional risk factors such as obesity (a BMI > 85%.) A fasting lipid profile may be obtained to check your child’s cholesterol levels.

Blood cholesterol levels are specific to each individual. In general, healthy levels are an LDL less than 130 mg, an HDL greater than 35 mg, and Triglycerides less than 150 mg. The NHLBI (National Heart, Lung, and Blood Institute) recommends the following levels for children and adolescents from families with high cholesterol and early heart disease: