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Does your child have high cholesterol?

Without lifestyle changes now, your child could face a lifetime of health problems

In the past, pediatricians and parents didn’t have reason to be concerned about high cholesterol in children. But over the past 10 years the rate of child obesity has jumped to epidemic proportions, laying the groundwork for high cholesterol, heart and cardiovascular disease and a host of health problems as adults.

Many adults aren’t even aware of their own cholesterol levels, let alone those of their children. Because the problems associated with high cholesterol generally don’t show up for years, parents need to take action now, while their children are young, to prevent long-term damage to children’s health. Some experts think that high cholesterol in kids is a major underreported health problem.

According to the American Heart Association, there is sound research that cholesterol buildup in the arteries begins in childhood. Cholesterol is a soft, waxy substance produced by the liver. It’s one of the lipids, or fats, the body makes and is used to build cell walls and form some hormones and tissues. However, a high level of cholesterol in the blood is a major risk factor for heart problems and strokes in the future.

“The number of overweight children I see now is definitely greater than those of normal weight,” says Rona Heublum, MD, a pediatrician affiliated with Vassar Brothers Medical Center in Poughkeepsie. “These children usually spend their free time playing on the computer or using handheld computer games and less time engaging in physical activities. They are also less likely to have healthy snacks and have poor eating habits.”

According to Dr. Heublum, many of these children also have overweight parents. “Obesity as well as family history and poor diet are linked to high cholesterol,” says Dr. Heublum.

Family history plays a big role in a child’s likelihood of having high cholesterol, which is why parents need to get their own weight and cholesterol issues in check for their children’s sake. Cholesterol levels in children are linked to three major risk factors:

1. heredity – having one or both parents with high cholesterol

2. diet – a diet high in fats, particularly saturated and trans fats, common in baked treats and commercial snack products

3. obesity – related to both diet and lack of exercise

Current recommendations encourage cholesterol screening in children, starting at 2 years old, who are at risk for having high cholesterol. A cholesterol screening is necessary if your child:

  • has a parent with a total cholesterol higher than 240 mg/dl
  • has a parent or grandparent with a history of heart disease prior to age 55
  • has an unknown family history (such as an adopted child)
  • is overweight or obese

“Family history is very important,” says pediatrician Ann Nunez, M.D. of Mid-Hudson Medical Group in Fishkill. “I will have a fasting total cholesterol blood test done on a child if there is a strong family history of high cholesterol.

“I will also have that child seen by a cardiologist as well as a nutritionist,” she continues. “I try to counsel the parents as well. I find that the parent is the role model the child follows, in diet, exercise, and all health choices.”

According to the American Heart Association, the ranges of total cholesterol for children 2 years to 19 years old are acceptable if less than 170 mg/dl. (Mg/dl means milligrams per deciliter). If the results are considered acceptable, then your child should be screened every five years.

If your child’s total cholesterol is 170 or higher, then your child’s doctor will most likely have your child fast for 12 hours and then repeat it with a fasting cholesterol test. If your child’s initial cholesterol level is greater than 200, both fasting cholesterol and a lipoprotein analysis will be ordered. This will identify your child’s HDL (good cholesterol) and LDL (bad cholesterol) levels.

According to Dr. Nunez, the American Academy of Pediatrics has specific guidelines for giving medication to children with high cholesterol. “Children under the age of 10 years generally do not take medication,” said Dr. Nunez. “Close monitoring is vital, however. All growing children need annual physicals to observe their growth and development as well as head off any problems before they begin,” she adds.

Dr. Nunez asserts that parents need to put a bigger emphasis on exercise and good health in general. “This has to start at an early age,” she explains. “You can’t expect a child at 12 or 13 who has had a background of bad eating habits and no exercise to change over-night. It all starts with the parents.”

Children and adolescents with high cholesterol levels are more likely to continue to have high levels as adults. “Recent studies indicate that the up and coming generation of children will not be as heart healthy as the baby boomer generation,” says Gretchen Scalpi, a registered dietician with a private practice in New Windsor. “Many of these children are overweight, they eat unhealthy snacks, fast food, and do too much sitting around. These habits could potentially shorten their life span by causing high cholesterol levels, diabetes, and heart disease when they are adults.”

A good place to start would be school lunches. “I encourage parents to send healthy lunches from home,” says Scalpi. “Whole wheat bread, snack-size pieces of fruits and vegetables, low-fat cheese, and low-fat yogurt and yogurt smoothies can be appealing to the child as well as healthy.”

Exposing children to healthier food choices at a young age is crucial. “Parents need to set the example of healthy eating,” says Scalpi.

Saturated fat, cholesterol, and trans fats all raise cholesterol levels. Saturated fats and cholesterol are usually found in foods such as dairy products, meat, and eggs. You can limit these in your child’s diet by switching to low or non-fat dairy products, serving lean meats, removing the skin from poultry, eating fish one to two times per week, and by using beans, tofu, or lentils as a protein source two to three times per week.

Trans fats are found in foods made with hydrogenated or partially-hydrogenated oils such as stick margarines, microwave popcorn, crackers, cookies, chips, and fast food French fries, fried chicken, and breaded chicken patties. To eliminate trans fats from the diet, check ingredient lists and avoid any products made with these. Switch your child’s snacks from cookies, crackers, and chips to fresh fruits, vegetables, and whole-grain snacks.

Fast food restaurants are both tempting and easy at the end of a busy day. They are fine occasionally, but try to limit when possible.

Lowering cholesterol levels in children requires a change in lifestyle. Because 90 percent of parents whose children have high cholesterol have high levels themselves, and because diet and exercise monitored by a parent are so important in lowering cholesterol levels, treatment is a family affair.

Make healthier food choices and get moving together as a family. Limit TV and computer time to no more than one to two hours per day. Start a family game night instead! Encourage daily physical activity such as:

  • soccer, basketball, swimming
  • walking the dog together
  • taking a hike as a family
  • biking together

Parents who don’t know their own cholesterol levels should get them checked. Also, keep these heart-healthy lifestyle tips in mind:

  • Don’t use food as a reward or punishment.
  • Send your child with lunch from home at least twice a week.
  • Look over the school lunch menu together to make healthier choices.

The measures you take to improve your family’s lifestyle can have a huge impact on the health of your entire family, not only now, but far into the future.

Patricia Palmer Hurd is a freelance writer specializing in health issues.