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Cholesterol, LDL, HDL, and Triglycerides in Adolescents

Facts about cholesterol

Cholesterol is a fat-like, waxy substance that can be found in all parts of your adolescent's body. It aids in the production of cell membranes, some hormones, and vitamin D. The cholesterol in blood comes from two sources: the foods your adolescent eats and his/her liver. However, your child's liver makes all of the cholesterol your adolescent's body needs.

Cholesterol and other fats are transported through the blood stream in the form of round particles called lipoproteins. The two most commonly known lipoproteins are low-density lipoproteins (LDL) and high-density lipoproteins (HDL).

What is LDL (low-density lipoprotein) cholesterol?

What is HDL (high-density lipoprotein) cholesterol?

This type of cholesterol is commonly called "bad" cholesterol. It can contribute to the formation of plaque build up in the arteries, known as atherosclerosis.

LDL levels should be low. To help lower LDL levels, help your adolescent:

  • Avoid foods high in saturated fat, dietary cholesterol, and excess calories

  • Increase exercise

  • Maintain a healthy weight

This type of cholesterol is known as "good" cholesterol, and is a type of fat in the blood that helps to remove cholesterol from the blood, preventing the fatty build up and formation of plaque.

HDL should be as high as possible. It is often possible to raise HDL by:

  • Exercising for at least 20 minutes three times a week

  • Avoiding saturated fat intake

  • Decreasing body weight

For some adolescents, medication may be needed. Because raising HDL can be complicated, you should work with your child's physician on developing a therapeutic plan.

Checking blood cholesterol levels

A cholesterol screening is an overall look at, or profile of, the fats in the blood. Physicians in the past felt that children and adolescents were at little risk for developing high cholesterol levels and other risk factors for heart diseases affecting the coronary arteries and blood vessels until later in life. However, many physicians now realize that children and adolescents are increasingly at risk for having high blood cholesterol levels as a result of one, or more of the following:

  • Sedentary lifestyles (playing video games, watching TV instead of participating in vigorous exercise)

  • High-fat junk food and fast food diets

  • Obesity

  • Family history of high cholesterol levels

Children and adolescents with high cholesterol are at higher risk for developing heart disease as adults. Many physicians are recognizing that keeping blood cholesterol levels in normal ranges throughout one's lifetime may be of great benefit in reducing the likelihood of developing coronary artery disease and high blood pressure.

Cholesterol testing for children

The National Heart, Lung, and Blood Institute (NHLBI), a division of the National Institutes of Health, recommends that cholesterol testing begin at age 2 for any child who has the following:

  • At least one parent who has been found to have high blood cholesterol (240 mg/dL or greater)

  • A family history of early heart disease (before age 55 in a male parent or grandparent and before age 65 in a female parent or grandparent)

The NHLBI also recommends that children and adolescents who have demonstrated risk factors, such as obesity, should have cholesterol and other lipids tested periodically by their physicians.

In 2008, the American Academy of Pediatrics (AAP) published updated guidelines that added more specific recommendations to those above, including testing of children older than 2 years whose family history is unknown. The AAP also recommends that physicians should consider giving cholesterol-lowering medications (statins) for children older than 8 years who have high LDL blood levels.

A full lipid profile shows the actual levels of each type of fat in the blood: LDL, HDL, triglycerides, and others. Consult your adolescent's physician regarding the timeliness of this test.

What is a healthy blood cholesterol level?

Blood cholesterol is very specific to each individual. A full lipid profile can be an important part of your adolescent's medical history and important information for your adolescent's physician to have. In general, healthy levels are as follows:

  • LDL of less than 130 mg/dL

  • HDL of greater than 35 mg/dL (less than 35 mg/dL puts your adolescent at higher risk for heart disease)

The NHLBI recommends the following guidelines for cholesterol levels in children and teenagers (ages 2 to 19) from families with high blood cholesterol or early heart disease:


Total cholesterol



Less than 170 mg/dL

Less than 110 mg/dL


170 to 199 mg/dL

110 to 129 mg/dL


200 mg/dL or greater

130 mg/dL or greater

Statistics about cholesterol

Elevated cholesterol is a risk for many Americans. Consider the following information from the CDC:

  • 16.3 percent of U.S. adults -- or one in every six -- have high cholesterol.

  • People with high cholesterol carry almost twice the risk for heart disease as people with healthy cholesterol levels. A cholesterol level less than 200 mg/dL is considered optimal.

  • The average cholesterol level for U.S. adults is 200 mg/dL, which is considered borderline high risk.

  • In the U.S., more women have high cholesterol than men.

What are triglycerides?

Triglycerides are another class of fat found in the bloodstream. The bulk of your adolescent's body fat tissue is in the form of triglycerides.

The link between triglycerides and heart disease is under clinical investigation. However, many children and adolescents with high triglyceride levels also have other risk factors such as high LDL levels or low HDL levels.

What causes elevated triglyceride levels?

Elevated triglyceride levels may be caused by medical conditions such as diabetes, hypothyroidism, kidney disease, or liver disease. Dietary causes of elevated triglyceride levels may include obesity and high intakes of fat, alcohol, and concentrated sweets.

For adults, the CDC says that a healthy triglyceride level is less than 150 mg/dL.