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 your 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 “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 cholesterol levels with proper diet and exercise gives teens a better chance of having low cholesterol when they are adults.

What are normal and abnormal cholesterol levels?

Normal levels of total cholesterol in teens are between 120 and 170 mg/dl. After age 18, the levels considered to be normal rise about 1 point per year of age. Levels between 171 and 200 mg/dl are considered to be borderline high. Levels higher than 200 mg/dl in teens are high.

Levels of HDL, or “good” cholesterol, should be over 60 mg/dl in teens. A borderline value is between 40 and 60 mg/dl. A low or abnormal value is less than 40 mg/dl in teens.

Should I have my cholesterol level checked?

The American Academy of Pediatrics (2011) recommends cholesterol tests for all children between ages 9 and 11. Repeat the cholesterol tests between ages 17 and 21. Teens who are at high risk for heart disease may be screened earlier. Heart disease includes heart attack, chest pain, stroke, or bypass surgery. You are at higher risk if you:

• Are overweight or obese
• Have high blood pressure
• Smoke cigarettes
• Have diabetes
• Have 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
• Have a relative with high cholesterol or a lipid disorder
• Do not know your family health history, for example, because you are adopted

How often do I need my cholesterol level checked?

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

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

Teens 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 you eat or drink anything except water. You must be fasting for the test to be accurate.

You may need to take medicine to lower cholesterol if:

• One or two tests show you have high levels of cholesterol
• You are at high risk for heart disease
• Diet and exercise do not lower cholesterol enough

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

Should my whole family be checked?

If you have high cholesterol, everyone in your family should have their total cholesterol checked. Very often the close relatives of teenagers with high cholesterol also have high cholesterol. It is often helpful to start the whole family on a healthier diet and exercise program.