Kids and High Cholesterol
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Comment| Wednesday, July 23rd, 2008 | | CWK Producer |
“We need to recognize that our children are at risk at a very young age,”
– Dr. Laurence Sperling, pediatric cardiologist
At age two, Joseph’s cholesterol was 213 – well above the normal range of 170.
“I was scared,” his mother Virginia Idrogo remembers, “He was just a baby. He was just a baby at the time.”
Joseph is nine now, and despite years of diet and exercise, his cholesterol has peaked to 315.
“It could kill me or something,” Joseph worries. “Or else it could make me sick and then kill me.”
Joseph is one of millions of children in the U.S. with high cholesterol. Even more are overweight and at high risk of heart disease.
That’s why the American Academy of Pediatrics is now recommending cholesterol screenings in children as young as two and cholesterol lowering medications in children as young as 8.
“We need to recognize that our children are at risk at a very young age,” explains Dr. Laurence Sperling a pediatric cardiologist with Emory Healthcare of Atlanta. “They aren’t necessarily going to have a heart attack when they are ten years old, but we know through studies of young children that the process of cholesterol build up in the arteries – atherosclerosis – starts at a frightening young age in America.”
For most children, the first line of defense is diet and exercise. But as was the case with Joseph, that doesn’t always work.
“Some children, in my experience, will respond and have as much as a twenty percent decrease in LDL cholesterol by changing their lifestyle habits such as diet and exercise,” explains Dr. John Stevens, a pediatric cardiologist with Children’s Healthcare of Atlanta.” Some have no change whatsoever and when we’re dealing with that we know that there are some genetic factors – genetic abnormalities –that just cannot be overcome through diet.”
Joseph’s problem is genetic, but his mother still wants to save medication as a last resort.
“If I see that’s the only hope that I have, then yes, [I will give him medicine],” she says. “But in the meanwhile, I’m gonna try my best to lower that cholesterol.”
“I think the message to get out is to think about your children and their health and try to set examples and behaviors that will last them for a lifetime,” Stevens says, “because that may be one of the greatest gifts you can give your children.”
Tips for Parents
There is currently a great deal of discussion among parents and physicians about the eating habits of our children. The scientific evidence associated with some of these discussions is not very encouraging. For example, studies show that:
- a significant percentage of U.S. children can be classified as overweight or even obese.
- U.S. children and adolescents have higher blood cholesterol levels and higher intakes of saturated fatty acids than do other children in various parts of the world.
- Individuals with high cholesterol levels as children and adolescents are more likely than the general population to have high cholesterol levels as adults.
- early coronary atherosclerosis or precursors of atherosclerosis often begin in childhood and adolescence and are related to high serum total cholesterol levels, LDL-cholesterol plus very low-density lipoprotein-cholesterol levels, and low high-density lipoprotein levels.
- there is a strong hereditary and familial component associated with developing cholesterol and coronary problems.
While it is important to point out that a substantial number of children with high cholesterol levels transition to adulthood with desirable cholesterol levels without intervention, the American Academy of Pediatrics (AAP) considers the problem serious enough to have issued recommendations to help parents and physicians identify children potentially at risk for problems with high cholesterol. These recommendations are based upon the belief that these children may be at increased risk of having high blood cholesterol levels as adults and increased risk of coronary heart disease. The recommendations target children and adolescents who have a family history of premature cardiovascular disease or have at least one parent with a high blood cholesterol level or those who have other factors for heart disease including obesity, high blood pressure or diabetes. Screening should take place after age two, but no later than age 10.
According to The National Institute of Heart Lung and BUBBA, the following are some guidelines for Total and LDL-Cholesterol Levels in Children and Teenagers From Families With High Blood Cholesterol or Early Heart Disease
| Total Cholesterol | LDL Cholesterol | |
| Acceptable | Less than 170 mg/dL | Less than 110 mg/dL |
| Borderline | 170 to 199 mg/dL | 110-129 mg/dL |
| High | 200 mg/dL | 130 mg/dL or greater |
Note: These blood cholesterol levels apply to children 2 to 19 years old.
There are a number of things that parents can do related to the issue of children and high cholesterol. For example, prior to having a child tested for cholesterol problems, parents can
- Educate themselves about cholesterol. Learn about the different types of cholesterol (i.e. HDL, LDL), their respective functions and negative effects, recommended levels, etc.
- Familiarize themselves with the child’s family medical history, particularly in regard to previous problems with cholesterol or heart diseases
- If possible, have their own cholesterol levels tested.
If a child is found to have high cholesterol, his or her physician will likely recommend treating the problem with a combination of diet and physical activity. From a dietary standpoint, the ideal goal is to reduce the LDL-C levels to the low <110 mg/dL range. To help your child achieve this goal, parents will need to institute what the American Heart Association refers to as a "heart healthy diet," one that is low in cholesterol and saturated fat, high in complex carbohydrates and provides adequate energy for growth.
- no more than 30 percent of calories from total fat
- less than 10 percent of total calories from saturated fats
- 100 mg cholesterol/1000 kcal, not to exceed 300 mg/day
Your child’s pediatrician should be able to provide detailed dietary guideline for your child based upon the severity of his or her cholesterol problem.
From an exercise standpoint, the American Heart Association suggests the following guidelines:
- All children age 5 and older should participate in at least 30 minutes of enjoyable, moderate-intensity activities every day.
- Children should also have the opportunity to perform a total of at least 30 minutes of vigorous physical activities at least 3-4 days each week to achieve and maintain a good level of cardiorespiratory (heart and lung) fitness.
- If a child or children doesn’t get the opportunity to have a full 30-minute activity break each day, parents and other caregivers should try to provide at least two 15-minute periods or three 10-minute activity periods. These periods should allow the child to engage in various activities appropriate to their age, gender and stage of physical and emotional development.
References
- American Academy of Pediatrics
- American Heart Association
- Emory University
