Yep, Kids Can Have High Cholesterol, Too

Brought to you by Nemours CareConnect

If your child has a cold or strep throat, it’s pretty obvious to see and diagnose. But what happens if there’s something going on in their little bodies that we can’t see, something like high cholesterol?

You hear the word “cholesterol” and a child doesn’t exactly come to mind — more like one of us grown-ups fighting the urge to scarf down that double cheeseburger. But now, in the wake of the ongoing childhood obesity epidemic, the American Academy of Pediatrics (AAP) says tracking youngsters’ cholesterol levels at an early age may help fend off future heart disease, the No. 1 killer of both men and women.

And research shows that the stage for adult heart disease (also known as “cardiovascular disease”) is set early on. That’s why the AAP now recommends cholesterol screening for:

• all children between 9 and 11 years old
• at-risk kids after age 2 and no later than 10. That means those who are overweight or obese, or have diabetes, high blood pressure, a family history of cholesterol problems or heart attacks at a young age, or an unknown family medical history.

To tell you if your child’s cholesterol is too high, your doctor can order a simple blood test. Kids who are at risk will need to fast (that means nothing to eat or drink except water for 12 hours). Healthy kids without risk factors can get a non-fasting blood test.

What, Exactly, Are “Good” and “Bad” Cholesterol?

A lipid (or fat) made by the liver, cholesterol is one thing we actually don’t need to get from any foods at all. That’s because the liver produces enough of the waxy substance on its own for the body to function just fine — to build cell walls and form some hormones and tissues. All other added cholesterol comes from the foods we eat like egg yolks, animal fats, hydrogenated oils and whole-milk dairy products.

But cholesterol doesn’t move through the body by itself. In order to travel through the bloodstream to where it’s needed, it has to combine with proteins. Cholesterol and protein traveling together are called “lipoproteins.” The two kinds of lipoproteins that are the most important are:

• high-density lipoproteins (HDL), sometimes called “good cholesterol” — think high-density for “happy, healthy or hard-working.” These move the rest of the cholesterol away from the arteries and back to the liver, where it’s processed and sent out of the body.
• low-density lipoproteins (LDL), sometimes called “bad cholesterol” — think low-density for “lousy.” These 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 brain, forming plaque (a thick, hard substance that can cause blood vessels to become stiffer, narrower, or blocked). If a blood clot forms and gets jammed in a clogged artery, a heart attack or a stroke could follow.

Here’s where understanding cholesterol levels gets a little tricky, though: High levels of LDL (the “bad” cholesterol) increase the risk for heart disease and stroke. But high levels of HDL (the “good” cholesterol) can offset that risk and actually help protect your circulatory system. In most kids and adults with a high level of total cholesterol in the blood (known as “hypercholesterolemia”), it’s high levels of “bad” cholesterol (LDL) that are usually the reason for the high cholesterol level — which can lead to health problems.

Soooooo … What Can You Do About It?

Adults with high cholesterol levels can benefit from fasting, obtaining good prolonged fasting results can help reduce high cholesterol levels over time. But for children, they still need a steady supply of food and energy for continuous growth and development. The primary treatment that needs to be immediately implemented for children and adults alike is weight management. It could be achieved through enhanced diet, nutritional counseling, and regular physical exercise.

Kids might not commiserate over their cholesterol levels on the playground like coworkers chatting about weight at a water cooler. Still, moms and dads do need to be aware of how their children’s cholesterol today may affect them much later.

On top of heredity, obesity and a diet high in fats — the three major factors that contribute to high cholesterol levels — high blood pressure, smoking and diabetes up kids’ risk for heart disease, too. So, if your child is active, eats healthy foods, isn’t overweight, and doesn’t have a family history of obesity or potential heart problems, you probably don’t have to worry much.

But, whether your child is at risk or not, it’s still wise to:

• Have both your and your child’s cholesterol levels checked.
• Read nutrition labels so you can limit cholesterol, as well as saturated and trans fat intake.
• Avoid foods that are high in saturated fats (all animal fats and some tropical oils) and/or trans fats (fats formed when vegetable oils are hardened). That means doing things like choosing low-fat dairy products, steering clear of solid fats (instead, cooking with vegetable oils and trans-fat-free margarine), and choosing a variety of protein sources (e.g., lean meats and poultry without the skin, fish, nuts, beans, peas, lentils, tofu and soy products).
• Pack healthy school lunches and teach children to forego the junk food (fatty, fried, sugary fare) in the school cafeteria and choose healthier items instead.
• Limit commercially prepared baked goods and treats.
• Serve snacks like fruit, raw veggies and low-fat dips, plain popcorn or pretzels, low-fat cheese and whole-grain crackers, or low-fat yogurt.
• Scale back on or totally skip soda and sugary fruit drinks — all of that excess sugar will just be transformed into fats. When kids do drink juice, make sure it’s 100 percent fruit juice and only about one serving a day.

And, by all means, make exercise a part of your kid’s — and your family’s — everyday routine. Make fitness time together time — walking, hiking, biking, shooting some hoops, playing tennis, participating in classes (karate, dance, yoga, pilates). Whatever you do, just keep moving and motivating your kids to do the same. Physical activity helps boost the good cholesterol levels in the blood, which means you and your kids will be far less likely to become a heart disease statistic down the road.