High cholesterol is a health problem we often associate with adults, but children can also be affected. High cholesterol levels, along with other factors that put adults at risk for heart problems ( high blood pressure, diabetes, lack of physical activity, being overweight or obese, and smoking), also put children at risk later in life.

For instance, high cholesterol levels play a role in forming fatty plaque build-up in arteries, causing the arteries to harden. This condition, known as atherosclerosis, can start in childhood. If not addressed, it can lead to coronary artery disease in adulthood.

The National Heart, Lung, and Blood Institute (NHLBI) recommends that all children have a cholesterol screening when they are between the ages of nine and 11 years old. However, if high cholesterol levels run in your family or if your child has certain risk factors, he or she may need cholesterol screening before then. Discuss this with your child's doctor. All children should be checked again between the ages of 17-21 years.

There are two types of cholesterol often discussed: “good” cholesterol, also known as HDL cholesterol, and “bad” cholesterol, also called LDL cholesterol. LDL cholesterol is the main culprit of heart problems, so keeping levels low is important. For children, this means making sure that their LDL cholesterol level is less than 110 mg/dL (milligrams per deciliter). Here are cholesterol level guidelines from NHLBI:

Children older than eight years old who have very high LDL cholesterol levels, usually 190 mg/dL or greater, may be given medicines called statins. Statins work by lowering cholesterol levels in the blood. A doctor may prescribe this medicine to your child if she has been diagnosed with familial hypercholesterolemia (an inherited condition in which a person is born with high levels of LDL cholesterol) and diet and exercise have not lowered the cholesterol levels enough.

Regardless of your child’s cholesterol levels, a proper diet and exercise are important to keep cholesterol levels under control, as well as maintain overall health. Here are some ways to incorporate a nutritious diet and physical activity into your child’s life:

• Eat plenty of fruits, vegetables, and whole grains.
• Choose lean meats. Lean cuts of meat (beef, pork, lamb) include round, sirloin, tenderloin, and chuck. For poultry, the leanest choice is skinless, white breast meat. Be sure to include fish, beans (peas, dried beans, lentils), and tofu in meals as healthy alternatives to meat.
• Limit foods that are high in cholesterol.
• Limit foods that are high in saturated or trans fat.
• Consume nonfat or low-fat milk and dairy products.
• When cooking, do not use solid fats. Instead, use vegetable oil. When it comes to buttering bread or corn-on-the-cob, use soft margarine.
• Avoid foods and drinks with a lot of sugar. Encourage your child to drink water.
• Those muffins, donuts, and cupcakes on the grocery store shelf may not be the best snack option for your kids. Opt for healthy snacks, like fresh fruit, vegetables with low-fat dip, popcorn, and low-fat yogurt.
• Get out and play! Encourage your young child to play as much as possible. As your child grows, encourage her to continue to be physically active every day. It's also important that you limit how much time your child spends watching TV, playing video games, and using the computer. Total "screen" time should be less than two hours a day.

Children will often look to adults as lifestyle examples. Therefore, to encourage healthy habits, it is important that the entire family is involved in eating right and exercising. Doing so will ensure that both you and your children can lead healthy lives together.