All children should be screened for high cholesterol between ages 9 and 11

Chances are the next time you bring your child in for a wellness check, your pediatrician will talk to you about cholesterol.

While pediatricians have been checking cholesterol in children with a family history of heart problems for many years, the American Academy of Pediatrics recommends that all children be screened for high cholesterol between the ages of 9 and 11 and again between 17 and 21.

These recommendations refelect the understanding that too much cholesterol in the blood circulation contributes to the development of plaques that may lead to a blocked artery. A heart attack results when an artery delivering oxygen to the heart is blocked. A stroke results when an artery delivering oxygen to the brain is blocked.

We now understand that the process of an artery becoming blocked by cholesterol begins in childhood and gradually develops over a lifetime.

The diet of the average child contains too much sugar, fat and cholesterol. While some children manage to metabolize these foods without collecting an excess of cholesterol in their blood vessels, other children cannot. This leads to high levels of cholesterol in the circulation and a risk of a future heart attack or stroke.

A blood test is used to screen for cholesterol and is best performed after your child has not eaten for 12 hours. If cholesterol levels are elevated, your physician will first discuss changes in your child’s diet and exercise patterns. For many children, not only will this reduce the cholesterol levels, but it will also minimize other risk factors for early heart disease, such as diabetes, obesity, high blood pressure and inactivity. Healthier diet choses include the following:

Instead of: Choose:
Butter Light or diet margarine
Regular cheese Low-fat or fat-free cheese
Whole or 2% milk 1% or fat-free (skim) milk
Cream cheese Low-fat or fat-free cream cheese
Regular ice cream Fat-free or low-fat frozen yogurt, or sorbet
Creamy salad dressings Oil and vinegar or reduced-fat or fat -free salad dressings
Chicken with skin on Chicken without skin
Whole egg Egg whites or egg substitutes
Prime grades of beef Choice or select grades of beef
Ground beef Ground sirloin, ground round
Soda, juices Water, diet sodas, sugar-free drinks


If dietary changes are not enough to lower your child’s cholesterol, you may be referred to an expert in childhood cholesterol problems. This will give you an opportunity to discuss all of the available information as well as the potential risks of therapy (or no therapy).

I’ve heard physicians say that a 50-year-old person had “the arteries of an 80-year-old.” That same concept exists in childhood. There are things we can do to keep our children’s blood vessels clean, healthy and young!

While ignorance may be bliss, knowledge is power! and an opportunity to make healthier choices – for our children and ourselves.

Laurie Armsby, M.D.
Associate Professor of Pediatrics, Division of Pediatric Cardiovascular Medicine
OHSU Doernbecher Children’s Hospital

One response to “All children should be screened for high cholesterol between ages 9 and 11

  1. It’s frightening to see children at this age already having to be screened for cholesterol problems, but no surprise. I’ve seen many parents giving children as young as 3 years old soft drinks and platefuls of cookies to consume every day. It’s sad that people don’t realize how irresponsible that is and the damage it can do to the child.

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