Most parents probably don't think about what
cholesterol means for their kids. But high levels of cholesterol
are a major factor contributing to heart disease and stroke, and
medical research shows that cardiovascular disease has its roots in
childhood. And with the dramatic increase in childhood obesity,
more and more kids are at risk.
Problems associated with high cholesterol generally don't
show up for years, so making the connection between kids'
health and cholesterol can be difficult. But it's
important to know your child's cholesterol levels, especially
if there's a family history of high cholesterol or premature
Identifying high cholesterol now will let you and your doctor
work together to make changes that will lower your child's risk
of developing heart disease later.
Cholesterol is a waxy substance produced by the liver. It's
one of the
, the body makes and is used to form cell membranes and some
If you never ate another bowl of ice cream or another
cheeseburger, your body would have enough cholesterol to run
smoothly. That's because the liver makes enough for healthy
body function. In fact, the liver produces about 1,000 milligrams
of cholesterol a day. The rest comes from the foods we eat.
Although vegetables, fruits, and grains don't have any
cholesterol, the following foods from animals do:
- egg yolks
- dairy products (including milk, cheese, and ice cream)
Good vs. Bad Cholesterol
Cholesterol doesn't move through the body on its own. It has
to combine with proteins to travel through the bloodstream to where
it's needed. Cholesterol and protein traveling together are
Two kinds - low-density lipoprotein (LDL) and high-density
lipoprotein (HDL) - are the two most people have heard about.
, or "bad cholesterol," are the primary cholesterol
carriers. If there's too much LDL in the bloodstream, it can
build up on the walls of the arteries that lead to the heart and
the brain. This buildup forms plaque - a thick, hard substance that
can cause blood vessels to become stiffer, narrower, or blocked.
is the name for hardening of the arteries. If a blood clot forms
and blocks a narrowed artery, the result can be a heart attack
Atherosclerosis can also diminish blood flow to other vital
organs, including the intestines or kidneys.
- the "good cholesterol" - carry cholesterol away from
the arteries and back to the liver, where it's processed and
sent out of the body, and might even help remove cholesterol from
already formed plaques.
High levels of LDL increase the risk for heart disease and
stroke. But high levels of HDL can help protect the circulatory
Three major factors contribute to high cholesterol levels:
- diet: a
high in fats, particularly saturated and trans fats
- heredity: having parents or a parent with high cholesterol
- obesity: related to both diet
Kids who are physically active, eat healthy foods,
don't have a family history of high cholesterol, and aren't
overweight probably aren't at risk for high cholesterol.
Your doctor will help decide whether you should have your
child's cholesterol level checked.
Monitoring and Treating High Cholesterol
Current guidelines recommend screening in kids who are at risk
for high cholesterol starting at age 2 but no later than age 10.
Screening is recommended for kids who:
- have a parent with a total cholesterol higher than 240
- have a family history of cardiovascular disease prior to the
age of 55 in men and 65 in women
- have an unknown family history
- are overweight or obese
- have additional risk factors, such as diabetes, high blood
pressure, or cigarette smoking
Your doctor can order a simple blood test, usually done fasting
(nothing to eat or drink, except water, for 12 hours), to tell you
if your child's cholesterol is too high.
According to the National Cholesterol Education Program (NCEP)
guidelines for children and adolescents, the ranges of total and
LDL cholesterol for kids 2 years to 18 years old are:
||Total cholesterol (mg/dL)
||LDL cholesterol, (mg/dL)
||Less than 170
||Less than 110
||200 or greater
||130 or greater
mg/dL = milligrams per deciliter
Children with LDL cholesterol levels 170 mg/dL or greater should
receive individual nutritional counseling that focuses on reducing
dietary fat and cholesterol and increasing physical activity.
Kids whose results are acceptable should be screened every
3 to 5 years. Those with borderline cholesterol levels should be
rechecked in 1 year.
Kids with high cholesterol levels should be rechecked after 3 to
6 months of lifestyle intervention.
Medication may be considered for kids over 8 years old with LDL
cholesterol levels of 190 or higher if changes in diet and
exercise haven't worked. For kids with additional risk factors,
treatment may be considered at even lower levels.
10 Ways to Lower Cholesterol
Here are 10 ways to help keep your family's cholesterol
at healthy levels:
- Know your own cholesterol level and if it's high,
ask to have your kids checked.
- Serve a diet rich in fruit, vegetables, and whole grains.
- Choose lean meats and vegetable alternatives, including fish,
legumes (dried beans, peas, and lentils), and tofu or other soy
- Read nutrition facts labels so that you can limit cholesterol
and saturated and trans fat intake. The 2005 Dietary Guidelines
and the American Heart Association (AHA) recommend keeping
dietary fat intake between 30%-35% for kids 2-3 years old and
between 25%-35% for kids 4 and older, with most fats coming from
sources of unsaturated fats, such as fish, nuts, and vegetable
For kids older than 2 years and teens, the AHA recommends
- cholesterol to less than 300 milligrams a day
- saturated fats to less than 7% of calories
- trans fats to less than 1% of calories
- Choose nonfat or low-fat milk and dairy products.
- Stay away from solid fats. Use vegetable oil for cooking and
soft margarine for table use.
- Limit beverages and foods with added sugars.
- Limit commercially prepared baked goods and serve healthy
snacks such as fresh fruit, vegetables with low-fat dip, lite
popcorn, and low-fat yogurt.
- Get plenty of exercise. Exercise helps boost HDL levels in
the blood - and that's a good thing! Kids 2 years of
age and older and teens should be physically active at least
60 minutes a day.
- Make living healthier a family affair. Kids usually
aren't the only ones at risk, so it's important to make
this a family effort. The strides you take to improve your
family's lifestyle can have a positive effect on your
family's health not only now, but far into the future.
Mary L. Gavin, MD
Date reviewed: March 2009
Note: All information is for educational purposes only. For specific medical advice,
diagnoses, and treatment, consult your doctor.
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