Health Library

Hyperlipidemia / Cholesterol Problems in Children

Hyperlipidemia means there are too many fats, like cholesterol, in the blood. These fats can build up over time and increase the risk of heart disease. There are different types of hyperlipidemia, and all of them can affect the heart and blood vessels.

Some things that raise cholesterol, such as family history or certain medical conditions, are out of our control. But others, like eating habits and physical activity, are things we can change. Helping children make healthy choices early can help protect their hearts as they grow.

Too much cholesterol in the blood can stick to the walls of the arteries and form a buildup called plaque. This buildup can start in childhood and slowly narrow the arteries, making it harder for blood to flow. Over time, these blockages can become serious enough to cause heart attacks or strokes—even in young adults.

What Is Cholesterol?

Cholesterol is a type of fat found in animal foods like meat, eggs and dairy, and our bodies make it too. We need some cholesterol to build cells and hormones, but too much can raise the risk of heart disease.

Doctors check cholesterol levels in kids between ages 9 and 11. If levels are high, a blood test called a lipid profile looks at different types of cholesterol and fats, including LDL (bad), HDL (good), and triglycerides.

Another type, Lipoprotein(a) or Lp(a), is mostly inherited and doesn’t change with diet or exercise. If a child has very high LDL or a strong family history of heart disease, doctors may test Lp(a) to better understand their risk.

Cholesterol Guidelines for Children 2-19

Your provider may recommend checking with a specialist if your child’s LDL is 130 mg/dL or higher or a triglycerides are 200 mg/dL or higher. If there’s a history of heart problems or very low HDL, your doctor may suggest earlier or more detailed evaluation.

How is High Cholesterol in Children Treated?

Evidence suggests that children with high cholesterol are likely to have high cholesterol when they are adults. The chances of developing heart disease are greater if there is a family history of heart disease, since the evidence is strong that heart disease runs in families.

Researchers studied young people who died in accidents and found damage in their arteries. This damage was linked to high cholesterol. Behavior is learned. Even though we can’t change the genes we’re born with, we can still make healthy choices—like not smoking, staying active, and eating foods that are low in unhealthy fats, cholesterol and added sugar. Now is a great time to help your child build healthy habits that can last a lifetime.

The first step in managing high cholesterol is setting realistic goals for your child and family. Making small changes to your family’s eating habits can help you reach those goals and support heart health over time.

Current guidelines from the National Heart, Lung, and Blood Institute (NHLBI), the American Heart Association (AHA), and the American Academy of Pediatrics (AAP) recommend making changes to the diet as the first step in treating high cholesterol. The dietary tips below can help lower cholesterol and improve heart health.

Healthy Eating Tips for Cholesterol

1. Choose Healthy Fats
• Use olive oil, canola oil, nuts, seeds and avocados.
• Avoid fried foods and fatty meats.
2. Watch Saturated Fat
• Found in butter, whole milk, cheese and desserts.
• Found in coconut and palm oils.
• Keep it lower than 7% of your daily calories.
3. Limit Cholesterol
• It comes only from animal foods like meat and eggs.
• Aim for less than 200–300 mg per day.
4. Eat More Fiber
• Fiber helps soak up fat before it gets into your blood.
• Good sources: oats, beans, lentils, fruits, veggies and whole grains.
• Try to get 25–30 grams a day.
5. Cut Back on Sugar
• Too much sugar can raise triglycerides (a type of fat).
• Avoid soda, juice and sugary snacks.
• Choose water and whole grains instead.
6. Read Food Labels
• “Cholesterol-free” doesn’t mean healthy.
• Check for added sugars and unhealthy fats.
7. Don’t Use Food as a Reward
• Try stickers, books or small toys instead.

Diet

You do not need special "diet" foods to help your child eat healthier. A balanced diet that’s low in saturated and trans fats is safe for children over age 2 years and can be achieved with everyday foods.

Choosing a variety of foods may sound too simple, but it really works. There are no magical "good" foods or "bad" foods. The key is helping your child pick options that are lower in saturated fat and added sugars. Fewer processed foods and more fruits and vegetables are a great place to start.

It’s not just about swapping out high-fat "junk" food for fat-free versions, which can still have extra sugar and fewer nutrients. Instead, focus on foods that are rich in nutrients, like whole grains, lean proteins, and healthy fats from nuts, seeds, avocado, olive and canola oil.

The goal isn’t to cut out all fat, but to limit unhealthy fats and sugars while making sure your child gets the right amount of calories to grow and stay healthy. Obesity is a growing concern among children, and healthy eating combined with regular activity can help maintain a healthy weight. You can track your child’s growth using BMI charts available at www.cdc.gov/growthcharts.

Tips

Make it a family effort.

Kids do better when everyone at home eats healthy. Avoid bringing processed foods into the house that might tempt them.

Cook and eat together.

Home-cooked meals and sitting down as a family help build healthy habits. Planning meals, buying seasonal produce, and trying meatless options can save money and support success.

Be smart when eating out.

Choose grilled or baked foods, watch portion sizes, and skip sugary drinks. Condiments can add extra calories, fat, and salt—use them lightly.

Lead by example.

Kids copy what they see. If parents eat well and stay active, kids are more likely to do the same.

Use positive language.

Avoid calling foods “diet” or “special.” Focus on lasting healthy changes, not temporary fixes.

Make food fun.

Use colorful fruits and veggies. Cut foods into fun shapes to make them more appealing.

Get kids involved.

Let them help plan meals, prep food, and learn to read nutrition labels.

Support a healthy weight.

Encourage active play and limit screen time. Offer tasty, low-fat, nutrient-rich foods and avoid “empty calorie” snacks.

Don’t ban favorite foods.

Let kids enjoy treats occasionally, in small amounts. Pair this with regular exercise to help lower cholesterol and protect heart health.

Favorite foods are not off limits to children, but limiting quantity and frequency of high-fat and high-sugar foods along with implementing regular exercise can help kids lower their cholesterol levels and decrease their risk for developing coronary artery disease later in life.

What if diet doesn't work?

If you and your child have worked hard to improve cholesterol levels through healthy eating and lifestyle changes for a while, often up to a year, and levels are still high, your doctor may talk with you about adding medication to help.