High Cholesterol in Children and Adolescents: Causes and What to Do

Discover everything you need to know about high cholesterol in children and adolescents.
High Cholesterol in Children and Adolescents: Causes and What to Do

Last update: 16 January, 2023

It’s often thought that high cholesterol and triglyceride levels can only occur in adults. However, children and teens can also develop this imbalance, and the consequences are the same as in adults. In the following article, we’ll look at the causes of high cholesterol in children and adolescents and what specialists do to treat it.

High blood cholesterol levels can lead to plaque buildup in the arteries. This buildup narrows the space where the blood circulates, which means there’s an increased chance of developing heart disease and strokes. Discover everything you need to know about high cholesterol in children and adolescents.

Causes of high cholesterol in children and adolescents

Cholesterol is a waxy substance much like fat that the body needs during metabolism. Most of this is secreted in the liver, although it’s also obtained from food.

The body uses cholesterol to produce certain hormones, digest food and synthesize certain vitamins. The body makes all the cholesterol it needs on its own, at least it does most of the time.

Increased levels of cholesterol and triglycerides in the bloodstream are known as dyslipidemia. According to the World Health Organization (WHO), up to a third of ischemic heart disease is attributable to high cholesterol. As experts point out, arteriosclerosis begins in childhood and goes through a process that can take decades.

If nothing is done to reverse it, it can lead to a myocardial infarction, stroke, or even death. Lifestyle is to blame for high cholesterol in children and adolescents to a large extent, and the records of the last decades keep on warning us of a problem that’s already considered a priority in public health. Let’s look at three of the main causes of high cholesterol in young people.

1. Unhealthy diet

High cholesterol in children is related to diet.
On many occasions, high cholesterol (and also triglycerides) is related to eating problems.

A diet with high concentrations of trans fats and saturated fats can cause an increase in blood cholesterol levels. Both types of fats play a leading role in unbalanced or healthy diets, and, unfortunately, they’re the ones that receive the greatest interest from children and adolescents. Here are some examples:

  • Frozen pizza
  • Sweet cookies and cakes
  • Commercial baked goods
  • Microwave popcorn
  • Donuts
  • Fried chicken and French fries
  • Bread rolls
  • Margarine

This is just a selection of foods that contain trans fat and saturated fat. Both these types of fat raise bad cholesterol (low-density lipoprotein cholesterol) and lower good cholesterol (high-density lipoprotein cholesterol). Manufacturers include this type of fat in their products because it’s more economically profitable and because it extends the useful life of their products.

Cholesterol levels are also likely to rise if you drink large amounts of whole milk, eat a lot of high-fat cheese, and very fatty meats. Ice cream, palm oil, and coconut oil can also have the same effect. In general, cholesterol won’t increase if these products are consumed in moderation; the problem is when they are the main items in the young person’s diet.

2. Genetic predisposition

Familial hypercholesterolemia (FH) is a genetic disorder of lipoprotein metabolism that results in elevated levels of LDL cholesterol. According to experts, maximum lipid levels are reached between 9 and 11 years of age, which is when it’s usually detected.

It’s estimated that 1 in 200 or 1 in 300 people worldwide have this disorder. It is, therefore, a very common occurrence, one that is independent of the patient’s lifestyle habits. If there are records of high cholesterol levels in the grandparents and parents of children and adolescents, then it’s likely that the cause is genetic predisposition.

3. Obesity and overweight

High cholesterol in children and overweight.
This problem is usually associated with weight problems with blood lipid disorders.

According to the WHO, the prevalence of overweight and obesity among children and adolescents aged 5 to 19 years has increased dramatically. It went from just 4% in 1975 to just over 18% in 2016. It has more than quadrupled the number of overweight and obese youth worldwide, and it has done so in just four decades.

As the experts indicate, the increase in adipose tissue in the body interferes with the metabolism of cholesterol in the liver. It does so because it absorbs a greater amount of free fatty acids.

This is especially true when fatty tissue accumulates around the waist (visceral fat). Obesity can also cause insulin resistance and inflammatory processes, two conditions that affect said metabolism.

Treatment of high cholesterol in children and adolescents

Reports from the American College of Cardiology and the American Heart Association recommend lifestyle change as the main therapy for high cholesterol. The most important changes that must be made are to opt for a balanced diet and an increase in physical activity. As a general rule, an average of 300 minutes a week of moderate physical activity should be prioritized.

At the same time, time spent in front of television, mobile phones, and video game consoles should be minimized. Children and adolescents should be aware of the consequences of continuing with their current lifestyle, as well as the benefits they receive from exercising and maintaining a balanced diet. As has already become clear, foods with high concentrations of trans fats and saturated fats should be avoided.

Researchers don’t recommend limiting protein intake, but you should limit simple carbohydrates. If the values are very high initially, the evolution will be monitored every 3 or 4 weeks, until the levels return to normal. If a genetic predisposition is suspected (or when no improvement is seen in 12 months), pharmacological treatment for high cholesterol in children and adolescents may be chosen.

This is only recommended for young people over 10 years old. The groups most used in these contexts are cholesterol absorption inhibitors, bile acid sequestrants, 3-hydroxy-3-methyl-glutaryl-coenzyme A reductase inhibitors, fibric acid derivatives, omega-3 fatty acids, and niacin. The options are chosen by the specialist based on each particular case.

Lifestyle changes are the most effective and safe method of treating high cholesterol in young people. These must be permanent, and they’re easier to assimilate when those around them accept responsibility. Indeed, if the family follows a balanced diet and exercises regularly, it’s much more likely that the habit will be consolidated in them.

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