Clinical Reference Systems: Pediatric Advisor 10.0
Treating High Cholesterol Levels
THE IMPORTANCE OF TREATMENT
If your child's cholesterol level is high or borderline
high, start this treatment program. If your child's
cholesterol level is normal, it is still a good idea for
your whole family to follow these recommendations.
High cholesterol is not the only risk factor for coronary
heart disease. Other risk factors are just as harmful:
physical inactivity, obesity, and smoking. The more risk
factors that you or your child has, the higher the risk of
heart disease. Living a long and healthy life requires
healthy eating and regular exercise. It is easier to start
these habits as a child than to have to adopt them as an
Discuss the following ways to reduce cholesterol levels with
your family and try them. If you follow most of these
recommendations, you are protecting your child's heart and
- Low-Fat Diet
The American Heart Association recommends a
low-cholesterol, low saturated-fat diet for all children
over age 2 years. (None of the following
recommendations apply to children younger than 2).
Eating foods that contain cholesterol raises our blood
cholesterol levels. Foods that come from plants, such
as fruits, vegetables, and grains, do not contain
cholesterol. Foods that come from animals, such as
meats, eggs, and milk products, do contain cholesterol.
Eating saturated fats also raises blood cholesterol
levels because fat causes our bodies to make more
cholesterol. Even if we don't eat any fat, the liver
produces a small amount of cholesterol each day.
Therefore, we will always have some cholesterol in our
Currently, most Americans get 40 percent of their daily
calories from fat. However, in a healthy diet no more
than 30 percent of the total calories should come from
fat. The goal is to eat fat in moderation. You do not
have to eliminate fat from your child's diet entirely.
Lower the amount of fat your child eats so that fat
provides no more than 30 percent of your child's daily
Serving your family a low-fat diet will help lower
everyone's cholesterol levels and is rather easy:
- Serve more fish, turkey, and chicken because these
meats have less fat than red meats. Buy lean ground
beef or ground turkey for hamburgers. Use lean ham
or turkey for sandwiches.
- Trim the fat from meat and remove the skin from
poultry before you eat it.
- Avoid the meats with the highest fat content, such as
bacon, sausages, salami, pepperoni, and hot dogs.
- Limit the number of eggs each person eats to 3 or 4
eggs a week.
- Limit all meats to moderately sized portions.
- Use 1-percent or skim (0.5-percent) milk instead of
whole milk (which is 3.5 percent fat).
- Use soft margarine products and vegetable oils
instead of butter.
- Avoid any food fried in butter or fat. If you prefer
to fry meats, use margarine or nonstick cooking
- Increase the amount of fiber your child eats. Most
grains, vegetables, and fruits are good sources of
- Family Exercise Program
Exercise is the best way to raise the level of HDL (the
"good" cholesterol) in your blood. Your goal should be
20 to 30 minutes of vigorous (aerobic) exercise three
times each week. For exercise to be vigorous it must
involve the large muscles of the legs and cause your
heart to beat faster. Vigorous exercise also improves
your heart's response to work. A child is much more
likely to exercise if you exercise with him.
Try the following forms of exercise:
- Ideal Body Weight
Children who are overweight tend to have a low HDL and a
high LDL, which is the opposite of what is good for
them. Helping your child return to ideal body weight
will improve his blood cholesterol levels.
Fat has twice as much calories as the same amount of
protein or carbohydrates. When a person eats less fat
each day, he automatically gets less calories from his
food each day. A low-fat diet AND exercise are the key
ingredients for losing weight.
If your child is overweight, see also
Overweight: A Weight Reduction Program
- Smoke-Free Home
If you are a smoker, a good way to raise your own HDL
level is to stop smoking. Also avoid exposing your
child to smoke.
If someone in your home is a smoker, see
- Good Examples
A child who must lower his cholesterol level needs help
from his family. If you put him on a special diet, put
the entire family on the special diet. If you put him
on a special exercise program, make sure that other
family members participate. Eat healthy foods and
snacks, so your child will eat healthy food. Play more
sports and watch less TV sports, as you would like your
child to do.
If your child's level of cholesterol remains high even
though you follow these treatment recommendations, ask
for a consultation with a nutritionist about special
diets. Also, have your child join an exercise program
at a local gym or fitness center. These additional
steps will usually help your child. Medications are
sometimes prescribed for adults to help lower their
cholesterol levels. However, they are rarely prescribed
for children unless they have a rare form of high
cholesterol related to disease rather than diet.
RECHECKING YOUR CHILD'S CHOLESTEROL LEVEL
Generally, if your child has high cholesterol (above the
95th percentile), his cholesterol level is checked again
about 2 to 4 months after he starts a program to lower it.
If the cholesterol level is borderline high (above the 75th
percentile), it is usually checked yearly.