Pediatric Associates of the NW Blogs

Keeping Tabs on Kids’ Cholesterol

Connie Liakos, MS, RDN, CSSD, LD
April 19, 2017 08:30AM

Because heart disease is rare in children, parents often wonder why we check cholesterol levels in kids. Read on to learn why it’s important to monitor lipid levels during childhood.

As the registered dietitian nutritionist at Pediatric Associates of the Northwest, I often see children and teens with elevated blood fat (lipid) levels. In the vast majority of the cases, the kids I see are well, active and thriving. So why the worry?

Prevention is the Best Medicine

Kids with elevated cholesterol or triglycerides are not ill or impaired in any way. But they may be at risk for future heart disease, especially if they have a strong family history of cardiovascular disease. By identifying elevated lipid levels in childhood, changes can be made to reduce the risk of later cardiovascular disease. Eating, exercise and other lifestyle habits begin in childhood. Forming good habits early on is much easier than breaking bad habits later in life.

At Pediatric Associates of the Northwest, our patients receive a cholesterol screen at age 10 and again at age 17. If the cholesterol level is elevated, parents are asked to bring their child back in for a fasting lipid panel. 
If the values in the fasting lipid panel are abnormal, we routinely provide education and counseling. In rare instances, children with extremely elevated lipid levels will receive outside referral and specialized care. 

Lifestyle Approach

If your child’s levels are considered abnormal, there are a number of changes in diet and activity that can make a positive impact and bring those levels within an acceptable range. Most of the changes are in line with established good family health behaviors and I often hear reports of parents and siblings making positive changes as well!

The following lifestyle factors have been shown to improve abnormal blood lipid levels.

  • Move to a Mediterranean style of eating.  The Mediterranean diet has been shown to improve lipid levels and contribute to overall health. This pattern of eating relies heavily on vegetables, fruits, legumes, nuts, seeds, olive oil, whole grains and seafood with more moderate amounts of low-fat dairy, eggs and poultry. Meats and sweets are consumed less often.
  • If triglyceride levels are elevated, it is important to reduce the amount of refined or “white” carbohydrates and sugar sweetened foods and beverages.
  • Increase soluble fiber intake. Foods high in soluble fiber naturally lower cholesterol levels. Good sources include oatmeal, nuts, beans, barley, apples, pears, apricots, blueberries, Brussels sprouts, sweet potatoes, asparagus, oranges and flaxseeds. 
  • Select seafood with healthy omega-3 fats. Fish with higher omega-3 content include salmon, lake trout, albacore tuna, and sardines.
  • Use healthy fats. Examples include olive oil, canola oil, avocado oil, walnut oil and grapeseed oil. Foods naturally high in healthy fats include nuts and seeds, olives, fatty fish and avocados.
  • Nix the trans fats by avoiding foods that contain Partially Hydrogenated Vegetable Oils in the list of ingredients. Originally developed to keep foods more shelf stable, these chemically altered fats are the most harmful fats in the food supply. The Food and Drug Administration (FDA) is currently in the process of banning artificial trans fat from the food supply. 
  • Limit saturated fats. No more than 10% of total calories should come from saturated fats, found predominantly in full fat dairy products, fatty meats, coconut oil and palm oil. For most children, the range is 17-24 total daily grams of saturated fat. 
  • Clearing up Cholesterol Confusion.  While it seems contradictory, foods that are high in cholesterol such as egg yolks and shrimp have little effect on blood cholesterol when eaten in reasonable amounts. 
  • Exercise! Participating regularly in moderate to vigorous activity increases HDL, known as the “good cholesterol.” The goal for children is to accumulate 60 minutes of movement each day through active play, organized activities, or active transportation. In addition to improving cholesterol levels, kids and teens will also experience higher levels of fitness, more energy, enhanced sleep and better overall health!

Good Results

Just by making a few positive changes, I often see kids return with big improvements in their lipid levels. To learn more about cholesterol, lipids and guidelines for kids, you can download our educational handout from our website at's%20Cholesterol.pdf