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Cholesterol: Treating High Levels

What causes high cholesterol in children?

Cholesterol levels in children are linked to diet, being overweight, or having a parent with high cholesterol.

Why should I treat my child's cholesterol?

If your child's cholesterol level is high or borderline high, start this treatment program. If your child's cholesterol level is normal, it is still a good idea for your whole family to follow these recommendations.

High cholesterol is not the only risk factor for coronary heart disease. Other risk factors are just as harmful: physical inactivity, obesity, and smoking. The more risk factors that you or your child has, the higher the risk of heart disease. Living a long and healthy life requires healthy eating and regular exercise. It is easier to start these habits as a child than to have to adopt them as an adult.

Discuss the following ways to reduce cholesterol levels with your family and try them. If you follow most of these recommendations, you are protecting your child's heart and blood vessels.

How can I help my child?

  • Low-Fat Diet

    The American Heart Association recommends a low-cholesterol, low saturated-fat diet for all adults and children over 1 year of age.

    Eating foods that contain cholesterol raises our blood cholesterol levels. Foods that come from plants, such as fruits, vegetables, and grains, do not contain cholesterol. Foods that come from animals, such as meats, eggs, and milk products, do contain cholesterol.

    Eating saturated fats also raises blood cholesterol levels because fat causes our bodies to make more cholesterol. Even if we don't eat any fat, the liver produces a small amount of cholesterol each day. Therefore, we will always have some cholesterol in our blood.

    Currently, most Americans get 40% of their daily calories from fat. However, in a healthy diet no more than 30% of the total calories should come from fat. The goal is to eat fat in moderation. You do not have to eliminate fat from your child's diet entirely. Lower the amount of fat your child eats so that fat provides no more than 30% of your child's daily calories.

    Serving your family a low-fat diet will help lower everyone's cholesterol levels and is rather easy:

    • Serve more fish, turkey, and chicken because these meats have less fat than red meats. Buy lean ground beef or ground turkey for hamburgers. Use lean ham or turkey for sandwiches. Make sandwiches with whole-grain bread. Low-fat cheese can be added.
    • Trim the fat from meat and remove the skin from poultry before you eat it.
    • Avoid the meats with the highest fat content, such as bacon, sausages, salami, pepperoni, and hot dogs.
    • Limit the number of eggs each person eats to 3 or 4 eggs a week.
    • Limit all meats to moderately sized portions.
    • Use 1% or skim (0.5%) milk instead of 2% milk or whole milk (which is 3.5% fat). (Exception: healthy normal weight 1 year olds should drink whole milk until they are 2 years old).
    • Use a margarine product (vegetable oil spread without trans fats) instead of butter.
    • Avoid any food fried in butter or fat. Bake or grill foods instead of frying them. If you prefer to fry foods, use special margarine or nonstick cooking sprays.
    • Increase the amount of fiber your child eats. Most grains, vegetables, and fruits are good sources of fiber.
    • Help your child choose healthy snacks such as fruits, raw vegetables, and plain unsalted popcorn or pretzels instead of cookies and crackers. Other good snacks are apple slices with peanut butter, orange slices, fruit stirred into nonfat yogurt, juice bars, or low-fat chips.
    • Encourage children to drink water and low-fat milk. Avoid soft drinks that have a lot of calories.
  • Family Exercise Program

    Exercise is the best way to raise the level of HDL (the "good" cholesterol) in your blood. Your goal should be at least 30 minutes of vigorous (aerobic) exercise 3 times each week. For exercise to be vigorous it must involve the large muscles of the legs and cause your heart to beat faster. Vigorous exercise also improves your heart's response to work. A child is much more likely to exercise if you exercise with him.

    Try the following forms of exercise:

    • Walk or bike instead of riding in a car.
    • Use stairs instead of elevators.
    • Take the dog for a walk, jump rope, or play ball if your child appears to be bored.
    • Encourage your child to join a team (for example, soccer) or learn a new sport (for example, roller skating) that requires vigorous exercise. Swimming and jogging are sports that burn lots of calories. Some sports, such as baseball and football, don't exercise the heart.
    • Exercise to a video tape or music on TV.
    • Use an exercise bike, dance, or run in place while you or your child watches TV.

      In addition, limit TV and video game time to 2 hours or less a day. These sitting activities interfere with physical fitness. And support better physical education programs and aerobics classes in your schools.

  • Ideal Body Weight

    Children who are overweight tend to have a low HDL and a high LDL, which is the opposite of what is good for them. Helping your child return to ideal body weight will improve his blood cholesterol levels.

    Fat has twice as much calories as the same amount of protein or carbohydrates. When a person eats less fat each day, he automatically gets less calories from his food each day. A low-fat diet AND exercise are the key ingredients for losing weight.

  • Smoke-Free Home

    If you are a smoker, a good way to raise your own HDL level is to stop smoking. Also avoid exposing your child to smoke.

  • Medicines

    The American Academy of Pediatrics recommends that some children over 10 years of age should take medicine to lower LDL (bad) cholesterol.

    Medicines may be helpful if your child has:

    • Very high LDL (bad) cholesterol levels above 190
    • High risk factors and LDL between 130 and 189

    Other things that affect whether medicine might be needed to control cholesterol are:

    • Smoking
    • Physical activity
    • Blood pressure
    • High HDL (good) cholesterol levels

    Your child’s healthcare provider may refer your child to a heart specialist to help decide if medicine is right for your child.

  • Good Examples

    A child who must lower his cholesterol level needs help from his family. If you put him on a special diet, put the entire family on the special diet. If you put him on a special exercise program, make sure that other family members participate. Eat healthy foods and snacks, so your child will eat healthy food. Play more sports and watch less TV sports, as you would like your child to do.

    If your child's level of cholesterol remains high even though you follow these treatment recommendations, ask for a consultation with a nutritionist about special diets. Also, have your child join an exercise program at a local gym or fitness center. These additional steps will usually help your child. If changes in diet and exercise do not lower cholesterol, your child may need to take medicine.

When should my child's cholesterol be rechecked?

Generally, if your child has high cholesterol (above the 95th percentile), his cholesterol level is checked again 1 to 2 weeks later. If it is still high, a program should be started to try to lower cholesterol. If it stays borderline high (above the 75th percentile), it is usually checked yearly.

Written by Barton D. Schmitt, MD, author of “My Child Is Sick,” American Academy of Pediatrics Books.
Pediatric Advisor 2013.2 published by RelayHealth.
Last modified: 2012-05-21
Last reviewed: 2012-05-14
This content is reviewed periodically and is subject to change as new health information becomes available. The information is intended to inform and educate and is not a replacement for medical evaluation, advice, diagnosis or treatment by a healthcare professional.
© 2013 RelayHealth and/or its affiliates. All rights reserved.
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