context: Adults are not the only people affected by high cholesterol. Children also may have high levels of cholesterol, which can cause health problems, especially problems with heart disease, when the child gets older. Too much cholesterol leads to the build-up of plaque on the walls of the arteries, which supply blood to the heart and other organs. Plaque can narrow the arteries and block the blood flow to the heart, causing heart problems and stroke. Cholesterol levels in children are mostly linked to three risk factors: Heredity (passed on from parent to child) Diet Obesity In most cases, kids with high cholesterol have a parent who also has elevated cholesterol. Health care professionals can check cholesterol in school-age children with a simple blood test. Conducting such a test is especially important if there is a strong family history of heart disease or if a parent of the child has high cholesterol. The blood test results will reveal whether a child's cholesterol is too high. The National Heart, Lung, and Blood Institute ( NHLBI) the American Academy of Pediatrics recommend that all children should be screened once between ages 9 and 11 and again between ages 17 and 21. Selective screening is recommended for kids with a family history of high cholesterol or blood fats or a family history of premature heart disease (age 55 or younger for men, age 65 or younger for women). Screening is also recommended for kids who have a body mass index ( BMI) greater than the 95th percentile in children ages ages 2-8 or in older children (ages 12 to 16) with a BMI greater than the 85th percentile and who have other risk factors such as exposure to tobacco smoke, diabetes, or high blood pressure. First screening is recommended after age 2, but no later than age 10. Children under age 2 should not be screened. If the fastinglipid profile is normal, a child should be screened again in three to five years. For kids who are overweight or obese and who have a high blood-fat level or low level of "good" HDL cholesterol, weight management is the primary treatment. This means improved diet with nutritional counseling and increased physical exercise. For kids aged 10 years and older with extremely high cholesterol levels (or high levels with a family history of early heart disease), drug treatment should be considered. The best way to treat cholesterol in children is with a diet and exercise program that involves the entire family. Here are some tips. Eat foods low in total fat, saturated fat, trans fat, and cholesterol. The amount of total fat a child consumes should be 30% or less of daily total calories. This suggestion does NOT apply to children under the age of two. Saturated fat should be kept to less than 10% of daily total calories while trans fat should be avoided. For children in the high-risk group, saturated fat should be restricted to 7% of total calories and dietary cholesterol to 200 milligrams a day. Select a variety of foods so your child can get all the nutrients he or she needs. Exercise regularly. Regular aerobic exercise, such as biking, running, walking, and swimming, can help raise HDL levels (the "good" cholesterol) and lower your child's risk for cardiovascular disease. Here are some examples of healthy foods to give your child. For breakfast: Fruit, non-sugary cereal, oatmeal, and low-fat yogurt are among the good choices for breakfast foods. Use skim or 1% milk rather than whole or 2% milk (after age 2, or as recommended by your doctor). For lunch and dinner: Bake or grill foods instead of frying them. Use whole-grain breads and rolls to make a healthier sandwich. Also, give your child whole-grain crackers with soups, chili, and stew. Prepare pasta, beans, rice, fish, skinless poultry, or other dishes. Always serve fresh fruit (with the skin) with meals. For snacks: Fruits, vegetables, breads, and cereals make great snacks for children. Children should avoid soda, juice and fruit drinks. If diet and exercise alone doesn't improve your child's cholesterol level, your child may need to take medication such as cholesterol-lowering statin drugs. A child's cholesterol level should be retested and monitored after dietary changes are made or medication started as recommended by your child's health care provider.