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Cholesterol Screening or Testing

What is cholesterol?

Cholesterol is a type of fat in the blood. It is needed for building hormones and cells. Everyone needs to have some cholesterol in their blood. What you eat affects the level of cholesterol in our blood. Cholesterol comes from animal products such as meat, eggs, and dairy products. If you eat less cholesterol and saturated fat, you will have less cholesterol in your blood.

Cholesterol has several parts: high-density lipoproteins (HDL), low-density lipoproteins (LDL), and triglycerides. HDL is called the "good" cholesterol because it carries cholesterol away from the arteries to the liver. The liver helps the body get rid of cholesterol. The LDL is called "bad" cholesterol. If you have too much LDL, cholesterol builds up in the arteries. As a result your arteries become clogged. The HDL, LDL, and triglycerides together are called "total cholesterol."

Why is having low cholesterol important?

People who have higher-than-normal levels of cholesterol have a higher risk of developing clogged or narrowed blood vessels that carry blood to the heart muscle. Lower cholesterol levels can reduce the risk of heart disease.

Reducing children's cholesterol levels with proper diet and exercise is believed to give children a better chance of having low cholesterol when they are adults.

What are normal and high cholesterol levels?

Cholesterol levels for children are as follows:


             Total            LDL              HDL
             Cholesterol      Cholesterol      Cholesterol
Normal       less than 170    less than 120    above 60
Borderline   170-199          120-144          40-60
Abnormal     200 or higher    145 or higher    less than 40

Should children have their cholesterol checked?

New Recommendation (American Academy of Pediatrics 2011): Do cholesterol tests for all children between ages 9 and 11. Repeat the cholesterol tests between ages 17 and 21. The reason for this change is the increasing rate of obesity in our society.

Old Recommendation: Only children who are at high risk for heart disease needed to be screened. Heart disease includes heart attack, chest pain, stroke, or bypass surgery. Your child is at high risk if he or she:

  • Is overweight or obese
  • Has high blood pressure
  • Smokes cigarettes
  • Has diabetes
  • Has a father or grandfather who had heart disease before the age of 55, or a mother or grandmother who had heart disease before the age of 65
  • Has a relative with high cholesterol or a lipid disorder
  • Does not know family health history, for example, because your child is adopted

How often should my child's cholesterol be checked?

If your child is at high risk, and the test results show the cholesterol level is normal, your child should be checked every 3 to 5 years.

If your child’s total cholesterol level is borderline high (between 171 and 200), your child will start a program that includes a low-fat diet and exercise. Your child’s total cholesterol will probably be rechecked every year

Children with total cholesterol greater than 200 will have a lipid panel test. This test measures the levels of LDL, HDL, and triglycerides, as well as total cholesterol. These levels will be checked again after 2 to 4 months of treatment. Usually the test is done the first thing in the morning, before your child eats or drinks anything except water. Your child must be fasting for the test to be accurate.

Your child may need to take medicine to lower cholesterol if:

  • One or two tests show your child has high levels of cholesterol
  • Your child is at high risk for heart disease
  • Diet and exercise do not lower cholesterol enough

Talk with your healthcare provider about what is best for your child.

Should my whole family be checked?

If your child has very high cholesterol, everyone in your family should have their total cholesterol checked. It is helpful to start the whole family on a healthier diet and exercise program.

Written by Barton D. Schmitt, MD, author of “My Child Is Sick,” American Academy of Pediatrics Books, and by Robert Brayden, MD, Professor of Pediatrics, University of Colorado School of Medicine.
Pediatric Advisor 2013.2 published by RelayHealth.
Last modified: 2012-05-21
Last reviewed: 2012-05-14
This content is reviewed periodically and is subject to change as new health information becomes available. The information is intended to inform and educate and is not a replacement for medical evaluation, advice, diagnosis or treatment by a healthcare professional.
© 2013 RelayHealth and/or its affiliates. All rights reserved.
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