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High Cholesterol in Children and Teens
Reviewed by Medicinsk Expert•Last updated: 2026-10-22•Blood Heart Circulation

High Cholesterol in Children and Teens

High cholesterol in children and teens is often managed through lifestyle changes, as it can lead to long-term risks like coronary artery disease.

What is cholesterol?

Cholesterol is a waxy, fat-like substance found in all the cells in the body. While the body needs some cholesterol to work properly, high cholesterol can stick to the walls of arteries, narrowing or blocking them, which puts children and teens at risk of coronary artery disease and other heart diseases.

What causes high cholesterol in children and teens?

Three main factors contribute to high cholesterol in children and teens:

  • An unhealthy diet, especially one high in saturated fats
  • A family history of high cholesterol
  • Having obesity

Some diseases, such as diabetes, kidney disease, and certain thyroid diseases, can also cause high cholesterol.

Symptoms

There are usually no signs or symptoms that your child or teen has high cholesterol.

Diagnosis

A blood test measures total cholesterol, LDL (bad) cholesterol, HDL (good) cholesterol, non-HDL, and triglycerides. Healthy levels for those aged 19 or younger are:

  • Total Cholesterol: Less than 170 mg/dL
  • Non-HDL: Less than 120 mg/dL
  • LDL: Less than 110 mg/dL
  • HDL: More than 45 mg/dL

General testing recommendations include a first test between ages 9 and 11, with follow-ups every 5 years. Children with a family history of high cholesterol, heart attack, or stroke may start testing at age 2.

Treatment & Management

Lifestyle changes are the main treatment:

  • Being more active: Get regular physical activity and reduce sedentary time.
  • Healthy eating: Limit foods high in saturated fat, sugar, and cholesterol; eat plenty of fresh fruits, vegetables, and whole grains.
  • Losing weight: If your child or teen is overweight or has obesity.

If lifestyle changes are insufficient, a health care provider may consider cholesterol medicines if the child is at least 10 years old and meets specific high-risk criteria, such as having an LDL level higher than 190 mg/dL, an LDL higher than 160 mg/dL with high heart disease risk, or familial hypercholesterolemia (FH).

Frequently Asked Questions

If cholesterol levels remain high despite consistent lifestyle changes, your child's doctor may consider further evaluation or, in some cases, medication. This decision is made carefully, considering the child's age, specific cholesterol levels, and family history of heart disease. Statins, for example, are sometimes prescribed for children over a certain age with very high cholesterol and significant risk factors, but this is typically a last resort.
The most significant risk factors are a family history of high cholesterol, early heart attack (before age 55 in men or 65 in women), or stroke. Additionally, if your child has obesity, diabetes, kidney disease, or certain thyroid conditions, early testing starting at age 2 may be recommended. Otherwise, routine screening typically begins between ages 9 and 11.
Children and teens should aim for at least 60 minutes or more of moderate-to-vigorous physical activity every day. This can include active play, sports, biking, swimming, or brisk walking. Reducing sedentary time, such as excessive screen time, is equally important to promote overall heart health and help manage cholesterol levels.
Focus on reducing saturated and trans fats found in processed foods, fried items, fatty meats, and full-fat dairy. Encourage a diet rich in fruits, vegetables, whole grains, lean proteins (like fish and poultry), and healthy fats (avocado, nuts, olive oil). Limiting sugary drinks and excessive sweets is also important, as these can contribute to unhealthy cholesterol levels.
Source: MedlinePlus, National Library of Medicine

MedlinePlus brings together authoritative health information from the National Library of Medicine (NLM), the National Institutes of Health (NIH), and other government agencies and health-related organizations.

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