Having uncontrolled high cholesterol levels during childhood means an increased risk of heart disease, including heart attacks and stroke, during early adulthood. — Filepic
In this column, I want to emphasise an important, yet often overlooked, health issue: high cholesterol in children.
Many parents might not realise that cholesterol is not just a concern for adults.
It can occur in children too, and similar to adults, elevated levels of cholesterol in children can lead to serious health issues, including heart disease and stroke, later in life.
What Is cholesterol?
Cholesterol is a waxy fat-like substance in the blood and is a type of lipid.
It is needed for building cell membranes and producing hormones.
However, while cholesterol is essential for our health, too much of it (hypercholesterolaemia or hyperlipidaemia) can be harmful and is a major risk factor for heart attack and stroke.
Cholesterol travels through the bloodstream in two primary forms known as lipoproteins:
- Low-density lipoproteins (LDLs)
Commonly referred to as “bad cholesterol”, these sticky particles accumulate in the walls of arteries, leading to the formation of plaque – a hardened substance that narrows and blocks these blood vessels.
When the blood vessels are severely obstructed, blood flow to the heart or brain is compromised, leading to a heart attack or stroke.
- High-density lipoproteins (HDLs)
Some people call this the “good” cholesterol.
That’s because people with high HDL levels tend to have a lower risk of heart attack, stroke and other health problems.
Another important type of lipid are the triglycerides.
These are not cholesterol, but they are often measured alongside cholesterol levels, as having high triglycerides increases your risk of heart disease, stroke and other health problems.
Causes of high cholesterol
High cholesterol in children is a significant health issue that can set the stage for serious conditions later in life such as heart diseases, heart attacks and strokes.
Research has established a link between high cholesterol levels and premature heart attacks, underscoring the importance of addressing this issue early on.
Below are the common causes of high cholesterol in children:
- Genetics
A family history of high cholesterol often puts children at risk.
Familial hypercholesterolaemia is a genetic condition that causes very high levels of cholesterol in the blood.
In severe forms, high cholesterol can occur in children as young as two to five years old.
This predisposes to early heart disease in young adulthood.
Early diagnosis and intervention are crucial to manage the condition effectively and reduce the risks.
- Diet
Consumption of high-fat and processed foods will increase one’s cholesterol levels.
- Obesity
Being overweight is a significant risk factor for elevated cholesterol levels.
- Diabetes mellitus types 1 and 2
- Hypothyroidism (low thyroid hormones)
- Liver disease
- Chronic kidney disease
- Nephrotic syndrome.
The risk of developing heart disease is compounded when children also have conditions like diabetes, hypertension (high blood pressure) or thyroid disorders.
Unfortunately, high cholesterol usually does not present any symptoms until a serious health event, like a heart attack or stroke, occurs, hence the need for awareness.
If there’s a family history of high cholesterol or early-onset heart disease, it’s crucial for parents to monitor their child’s cholesterol levels proactively.
Diagnosis and management
Cholesterol levels can be checked with a simple blood test.
Screening is typically recommended for children aged nine to 11 years old, and again at 17 to 21 years old.
Some children are tested younger if there is a parent with high levels of cholesterol.
Screening is especially important in those with risk factors such as obesity or diabetes.
The best initial approach to managing high cholesterol in children is through dietary changes and increased physical activity – ideally, as a family effort.
If lifestyle changes are not effective, and particularly for those with additional risk factors such as in familial hypercholesterolaemia or diabetes, medications known as statins may be considered.
These are typically for those aged above eight to 10 years old.
Here are some ways to help lower your child’s cholesterol levels:
If your cholesterol levels are high or if there is a family history of early heart attack, consider having your child’s levels checked as well.
Include plenty of fruits, vegetables, whole grains and lean proteins, while minimising added sugars and unhealthy fats.
The amount of fat a child (above two years old) consumes should be 30% or less of daily total calories (45 to 65 grammes of fat or less per day).
Choose low-fat dairy options and healthier fat options.
The different types of fat are saturated, unsaturated and trans fats.
Saturated fat is usually solid at room temperature.
Examples are red meat, butter, cheese and some oils (like coconut oil).
Eating too much saturated fat can raise bad cholesterol levels and increase heart disease risk.
Unsaturated fat is liquid at room temperature and is considered to be healthier.
Sources include olive oil, nuts, avocados and fish.
Trans fats are found in processed foods and fried foods.
They are harmful and best to be avoided altogether.
Promote at least 60 minutes of daily exercise for your child.
Encourage water and healthy snacks, while steering clear of carbonated drinks, juices, sweet treats and processed foods.
Adopting healthy habits together fosters a supportive environment for lasting change.
High cholesterol in children is a significant health concern that requires attention.
By focusing on early detection, healthy lifestyle choices and appropriate medical care, we can support our children’s heart health for their future years.
Regular check-ups are essential, especially for kids with obesity, diabetes or a family history of cholesterol issues.
Dr Jeanne Wong Sze Lyn is a consultant paediatrician and paediatric endocrinologist. For more information, email starhealth@thestar.com.my. The information provided is for educational purposes only and should not be considered as medical advice. The Star does not give any warranty on accuracy, completeness, functionality, usefulness or other assurances as to the content appearing in this column. The Star disclaims all responsibility for any losses, damage to property or personal injury suffered directly or indirectly from reliance on such information.
