Cholesterol and Children

If you’re a parent, it’s never too early to start thinking about your child’s cholesterol levels. High cholesterol may seem like “middle-aged” disease, but it can be a problem for children, too, leading to high blood pressure, clogged arteries and heart disease. But when should you get your child’s cholesterol checked, and what should you do if it’s too high?
 
Background
Cholesterol is a fatty, wax-like substance found in the bloodstream and in your body’s cells. It’s used for producing cell membranes and some hormones.
 
There are two main types of cholesterol: high-density lipoprotein (HDL), known as “good” cholesterol, and low-density lipoprotein (LDL), known as “bad” cholesterol.
 
Everyone needs some cholesterol in order for the body to function properly, but if you have too much LDL, it can build up on the artery walls, form plaque and cause hardening of the arteries, or atherosclerosis. This can lead to heart attack or stroke and diminish blood flow to vital organs like kidneys and intestines.
 
Screening
It’s important to know your child’s cholesterol levels, especially if you have a family history of heart disease or high cholesterol.  Early detection is the key to making diet and exercise changes that could prevent heart disease later. Current guidelines recommend screening in children who are at risk for high cholesterol as early as age 2 and no later than age 10. Screening is recommended for kids who:

• Have a parent whose total cholesterol is above 240 mg/dL.  About 90 percent of children with high cholesterol have a parent with high cholesterol, as well.
• Have a family history of cardiovascular disease before age 55 in men and age 65 in women.
• Are overweight or obese.
• Have diabetes or high blood pressure.

If your child has any of these risk factors, your pediatrician may order a simple blood test, usually done after the child has fasted for 12 hours. If your child’s total cholesterol is above 170 mg/dL, you should see a dietitian to get nutritional counseling.
 
Children with acceptable cholesterol levels should be retested every three to five years. Medication may be recommended for children whose cholesterol exceeds 190 mg/dL if changes in diet and exercise haven’t worked.
 
Lowering Cholesterol
Diet and exercise are the keys to lowering cholesterol. Encourage your child to get at least one hour of physical activity every day and make sure your child is eating a healthy diet, which includes:

• Fruits
• Vegetables
• Whole grains
• Lean meats and proteins, such as fish, legumes and soy products

Read food labels to limit how much cholesterol, trans fat and saturated fat your child eats.  Current guidelines recommend dietary fat intake of between 30 percent and 35 percent for kids 2-3 years old and between 25 percent and 35 percent for kids 4 and older, with most fats coming from sources of plant-based fats.
Choose non-fat and low-fat dairy products, and stay away from solid fats. Instead, use vegetable oil and soft margarine. Also, limit sugary beverages and prepared baked goods. Instead, serve snacks like raw vegetables and dip, popcorn and low-fat yogurt.

Finally, lead by example. Commit the entire family to a lifestyle of healthy eating and regular exercise, including family hikes, games and organized sports.
For more information or to schedule an appointment with a physician in the section of Cardiology at St. Christopher's Hospital for Children, call (215) 427-4820.