High levels of fats and cholesterol in the blood can collect in the arteries and form a plaque or raised lesion on the inside of the arteries. This can clog blood flow and lead to heart attacks and stroke. Some of these changes have been seen on autopsies of young adults and teenagers, proving that the changes begin at a very young age. Medicines are used to lower cholesterol in adults, but for children with high cholesterol, dietary changes are the recommended therapy.
Definitions
Cholesterol is a fat or lipid found in all foods derived from animals, but is not present in foods derived from plants. It is an important building block of hormones and cell membranes. The human liver also makes cholesterol. In fact, according to the Nemours Center for Children's Health Media, if you never ate another cheeseburger or fatty food, your body would make enough cholesterol for the rest of your life. When testing for cholesterol, your doctor orders a lipid panel, which reports the level of total cholesterol, HDL, LDL and triglycerides. Cholesterol travels in the blood attached to a protein and is commonly called a lipoprotein. Total cholesterol is made up of HDL and LDL. HDL is high-density lipoprotein, or "good cholesterol," which carries cholesterol away from the arteries and back to the liver, where it's sent out of the body. LDL is low-density lipoprotein, or "bad cholesterol," which can cause the plaques in arteries that leads to heart attacks and stroke. Trigylcerides are fats circulating free in your bloodstream, unattached to proteins. The goal for children 2 to 19 years old is to have total cholesterol less than 170 and LDL less than 100.
Evidence
Results of the seven-year Dietary Intervention Study in Children published by the DISC Collaborative Research Group in "Pediatrics" in 2001 showed that a low-fat diet in children significantly reduced LDL levels without any adverse effects. A systematic evidence review of multiple studies by the U.S. Preventive Task Force in 2007 also showed that a low-fat diet reduces LDL levels in children.
Fats
The American Heart Association recommends that a low-fat diet be given to all children over the age of 2 years, but not for those younger than the age of 2. Fats should be limited to 30 percent to 35 percent of total calories for children age 2 to 3 years, but only 25 to 35 percent for children 4 to 18 years. Children should reduce their intake of saturated fats, which are found in meat, poultry and anything that comes from an animal, such as dairy products. Plant oils with saturated fat include coconut, palm and palm kernel oils. Saturated fats should be limited to less than 10 percent of the child's calories. Cholesterol should be no more than 200 to 300 mg per day. Trans fats should be reduced to less than 1 percent of calories. Eat nonfat or low-fat milk and dairy products. Use vegetable oil for cooking.
Fiber
Fiber can act like a sponge by absorbing some fat and eliminating it from the body. Children need 25 to 30 g of fiber each day. Serve whole-grain and high-fiber grains and cereals rather than refined grain products.
Fruits And Vegetables
Serve a variety of fruits and vegetables daily, and limit juice intake. Each meal should have at least 1 fruit or vegetable.
Fish
Fish are an important source of omega-3 fatty acids, which have been shown to lower LDL and promote heart health in general. The American Heart Association recommends at least two servings of fish weekly, but avoid the commercially fried and breaded fish, as these are lower in omega-3 fatty acids. Young children should avoid shark, swordfish, king mackerel and tilefish because they contain high levels of mercury. Most of the commonly eaten varieties of fish are low in mercury: shrimp, canned light tuna, salmon, pollack and catfish.
Helpful Tips
When making dietary changes, the whole family should participate; parents need to set good examples. Never refer to dietary modifications as a "diet," as this implies a temporary solution. Get your children involved in meal planning and preparation, and teach them to read labels. Regular exercise can also help children lower their cholesterol, and families should try to exercise together. Children should limit their intake of simple sugars, as sugars can contribute to higher trigyceride levels. Children should especially avoid regular soft drinks and other sugar sweetened beverages.
References
- Cincinnati Children's Hospital: Heart Diseases: Hyperlipidemia/Cholesterol Problems in Children
- KidsHealth from Nemours: Cholesterol and Your Child
- "Pediatrics": Long-Term Safety and Efficacy of a Cholesterol-Lowering Diet in Children With Elevated Low-Density Lipoprotein Cholesterol: Seven-Year Results of the Dietary Intervention Study in Children (DISC); Eva Obarzanek et al, 2001
- "Pediatrics": Screening and Treatment for Lipid Disorders in Children and Adolescents: Systemic Evidence Review for the US Preventive Services Task Force; Elizabeth Haney, et al, 2007
- "Circulation": Dietary Recommendation for Children and Adolescents: A Guide for Practitioners: Consensus Statement from the American Heart Association; Samuel Gidding et al; 2005
