Eat Beat

Cholesterol and Kids: A Major Health Problem

by Althea Zanecosky

Most parents think that cholesterol is an adult health issue. They do know that a high blood cholesterol level is known to be a major factor contributing to heart disease and strokes. What many don’t realize is that the latest medical research shows coronary artery disease has its roots in childhood.

Most pediatric health specialists didn’t test for childhood cholesterol levels until recently. Now it’s thought that high cholesterol in kids is a major underreported public health problem. In the past decade, studies have shown a dramatic increase in obesity in children and the problems that result from being overweight. With this weight gain has been a significant increase in the number of children with elevated cholesterol levels.

Because the problems associated with high cholesterol generally don’t show up for years, making the connection between kids’ health and cholesterol is difficult. So it’s important to be aware of your child’s cholesterol levels, even more so if either parent has high cholesterol. Here are the facts about kids and cholesterol.

1. What Is Cholesterol? Cholesterol is a waxy substance produced by the liver. It’s one of the lipids, or fats, your body makes and is used to build cell walls, produce hormones, and form some tissues. If you never ate any food containing cholesterol, your body would have enough of it to run smoothly. That’s because your liver makes enough cholesterol regularly for healthy body function. The rest of the cholesterol in the body comes from food.
Three major factors contribute to high blood cholesterol levels:

Diet — a diet high in fats, particularly saturated and trans fats

Heredity — having parents or a parent with high cholesterol

Obesity — related to both diet and lack of exercise

2. What foods contain cholesterol? Vegetables, fruits, and grains don’t have any cholesterol. Since cholesterol is a substance that only animals can make, the following foods contain it: egg yolks, meat, poultry, seafood, whole-milk dairy products (including milk, cheese, and ice cream).

3. Do any other foods affect cholesterol levels? Research has shown that blood cholesterol levels are more closely related to how much fat you eat rather than how much you eat of foods containing cholesterol. Newer recommendations advise limiting total fat and saturated fat and increasing unsaturated fats.

Unsaturated fats are found in plant foods and fish. They include monounsaturated, found in avocados and olive, peanut, and canola oils; polyunsaturated, found in most vegetable oils; and omega-3 fatty acids, found in oily fish such as albacore tuna and salmon.

Saturated fats are found in meat and other animal products, such as butter, shortening, lard, cheese, and milk (except skim or nonfat). They are also in palm and coconut oils, which are often used in commercial baked goods. Trans fats are found in some margarines, commercial snack foods and baked goods, and some commercially fried foods. An easy guide is that these fats usually are solid at room temperature.

4. To keep cholesterol in check, how much fat is healthy or unhealthy? Currently most Americans get too much fat each day. The National Cholesterol Education Program (NCEP) has established guidelines for how much fat each day is okay based on calorie intake.

The easiest way to figure out a healthy fat level in your children’s diet is to look at their calorie intake. (Remember that these are average daily calories and that individual needs may vary due to body weight, exercise and other health needs.)

5. When should I start keeping an eye on my child’s fat and cholesterol intake? Fat and cholesterol guidelines are only for ages 4 and older. Infants need cholesterol and fat for growth. 2- and 3-year-olds gradually can assume the healthy eating habits of the rest of the family.

6. Should I have my child’s cholesterol level taken? Children should have a cholesterol level less than 175. Those with counts of 175 to 199 are considered “borderline.” and need small diet changes. Children with counts above 200 probably need diet restrictions and may need to be considered for drug treatment.

Children and adolescents should have their cholesterol level tested if:

A parent or grandparent had atherosclerosis (a "hardening" or "furring" of the arteries) before age 56.

A parent or grandparent suffered a heart attack, or showed other signs of artery disease before age 56.

 A parent has a blood cholesterol level higher than 240 milligrams per deciliter.

Experts say about half of the estimated 15 million children who should be tested under these new guidelines probably need further treatment. Most could lower their blood cholesterol level by changing eating habits. A few might need drug treatment if older than age 10.

Althea Zanecosky is a Philadelphia registered dietitian and national spokesperson for the American Dietetic Association.