A: Jerry, as you know, cholesterol is a fatty substance found in animal food products such as meat, poultry, eggs and dairy products. Cholesterol plays a helpful role in making body tissues and certain important chemicals in the bloodstream. However, too high levels of cholesterol in the blood for extended periods of time can lead to fatty deposits in the arteries and the development of high blood pressure, heart disease and stroke.

Although we tend to think about high cholesterol as an adult problem, it's important to recognize it in children, too. In fact, the early signs of high cholesterol and damage to the blood vessels can begin during childhood. Some children have high cholesterol resulting from a genetically inherited condition that runs in the family. In addition, children who eat high-fat diets and are overweight are more likely to have high cholesterol.

Cholesterol screening isn't recommended for all young children, but it is recommended, beginning at 2 years of age, for children considered to be at risk for high cholesterol and heart disease. This group includes children:

• With a parent who has a cholesterol level of 240 mg/dl or higher or other blood lipid abnormalities
• With a parent or grandparent with heart disease before age 55
• With medical conditions that predispose them to heart disease, such as overweight, diabetes or high blood pressure

Talk with your children's doctor about your family history of high cholesterol and heart disease, and ask about cholesterol screening for your children. The blood cholesterol levels considered normal for children are lower than in adults. Acceptable cholesterol levels for your children would be under 170 mg/dl. If your children's cholesterol levels are 170-199, they would be considered borderline, and levels over 200 would be considered high. The doctor may also check your children's levels of other blood lipids, such as lipoproteins LDL and HDL, and triglycerides.

If your children are found to have borderline or high cholesterol, or other high blood lipids, the doctor might recommend a low-fat diet and plenty of physical activity. These recommendations are good for the whole family. In general, it's recommended to reduce fat by drinking low-fat or nonfat milk, and eating more fish, skinless poultry, lean meat, soy products, beans, whole-grain products, fruit and vegetables.

Also, plan family activities that involve exercise such as walking, swimming and playing sports. Work closely with your doctor to do follow-up testing of your children's cholesterol. Medications are usually only considered for children over 10 years old, if the changes in diet and exercise have not adequately reduced their cholesterol levels.

For more information, visit the American Heart Association website at www.americanheart.org.