While pediatricians have been checking cholesterol in children with a family history of heart problems for many years, the American Academy of Pediatrics recommends that all children be screened for high cholesterol between the ages of 9 and 11 and again between 17 and 21.
These recommendations refelect the understanding that too much cholesterol in the blood circulation contributes to the development of plaques that may lead to a blocked artery. A heart attack results when an artery delivering oxygen to the heart is blocked. A stroke results when an artery delivering oxygen to the brain is blocked.
We now understand that the process of an artery becoming blocked by cholesterol begins in childhood and gradually develops over a lifetime.
The diet of the average child contains too much sugar, fat and cholesterol. While some children manage to metabolize these foods without collecting an excess of cholesterol in their blood vessels, other children cannot. This leads to high levels of cholesterol in the circulation and a risk of a future heart attack or stroke.
A blood test is used to screen for cholesterol and is best performed after your child has not eaten for 12 hours. If cholesterol levels are elevated, your physician will first discuss changes in your child’s diet and exercise patterns. For many children, not only will this reduce the cholesterol levels, but it will also minimize other risk factors for early heart disease, such as diabetes, obesity, high blood pressure and inactivity. Healthier diet choses include the following:
|Butter||Light or diet margarine|
|Regular cheese||Low-fat or fat-free cheese|
|Whole or 2% milk||1% or fat-free (skim) milk|
|Cream cheese||Low-fat or fat-free cream cheese|
|Regular ice cream||Fat-free or low-fat frozen yogurt, or sorbet|
|Creamy salad dressings||Oil and vinegar or reduced-fat or fat -free salad dressings|
|Chicken with skin on||Chicken without skin|
|Whole egg||Egg whites or egg substitutes|
|Prime grades of beef||Choice or select grades of beef|
|Ground beef||Ground sirloin, ground round|
|Soda, juices||Water, diet sodas, sugar-free drinks|
If dietary changes are not enough to lower your child’s cholesterol, you may be referred to an expert in childhood cholesterol problems. This will give you an opportunity to discuss all of the available information as well as the potential risks of therapy (or no therapy).
I’ve heard physicians say that a 50-year-old person had “the arteries of an 80-year-old.” That same concept exists in childhood. There are things we can do to keep our children’s blood vessels clean, healthy and young!
While ignorance may be bliss, knowledge is power! and an opportunity to make healthier choices – for our children and ourselves.
Laurie Armsby, M.D.
Associate Professor of Pediatrics, Division of Pediatric Cardiovascular Medicine
OHSU Doernbecher Children’s Hospital