How to lower cholesterol in a child

Cholesterol (for Parents) - Nemours KidsHealth

What Is Cholesterol?

Cholesterol is a waxy, fat-like substance made by the liver. Cholesterol (kuh-LES-tuh-rawl) helps build cell membranes and is used to make hormones, like estrogen and testosterone, and vitamin D.

Most parents probably don't think about what cholesterol means for their kids. But heart disease has its roots in childhood. So high levels of cholesterol in children can increase their chances of heart disease and strokes as adults.

Where Does Cholesterol Come From?

The liver makes all the cholesterol that the body needs. But cholesterol also comes from some of the foods we eat. Foods that are high in saturated fat and trans fat also can increase the liver's production of cholesterol.

These foods from animals contain cholesterol:

• egg yolks
• meat
• poultry
• seafood
• dairy products (including milk, cheese, and ice cream)

Foods from plants, like vegetables, fruits, and grains, don't have any cholesterol.

What Are the Types of Cholesterol?

Cholesterol in the blood doesn't move through the body on its own. It combines with proteins to travel through the bloodstream. Cholesterol and protein traveling together are called lipoproteins (lie-poh-PRO-teenz).

Low-density lipoprotein (LDL) and high-density lipoprotein (HDL) are the lipoproteines that most of us have heard about.

Low-density lipoproteins, or "bad cholesterol," can build up on the walls of the arteries. Cholesterol and other substances in the blood form plaque. Plaque buildup can make blood vessels become stiffer, narrower, or blocked. Plaque makes it easier for blood clots to form. A blood clot can block a narrowed artery and cause a heart attack or stroke.

Atherosclerosis (ah-theh-roe-skleh-ROE-siss), or hardening of the arteries, also leads to decreased blood flow to vital organs, including the brain, intestines, and kidneys.

High-density lipoproteins, or "good cholesterol," carry cholesterol away from the arteries and back to the liver. In the liver, cholesterol is broken down and removed from the body.

High levels of LDL and low levels of HDL increase a person's risk of heart disease. 

What Causes High Cholesterol?

Three major things contribute to high cholesterol levels:

1. diet: eating a diet high in fats, particularly saturated fat and trans fat
2. heredity: having a parent or close family member with high cholesterol
3. obesity: having a poor diet and not exercising

People who are physically active, eat healthy foods, don't have a family history of high cholesterol or heart disease, and aren't overweight are less likely to have high cholesterol.

How Is High Cholesterol Diagnosed?

All kids should have their cholesterol checked when they're between 9 and 11 years old and again when they're between 17 and 21.

Kids over 2 years old should be tested if they:

• have a parent or other close relative with a total cholesterol higher than 240 mg/dL
• have a family history of cardiovascular disease before age 55 in men and age 65 in women
• have some kinds of medical conditions (such as kidney disease, Kawasaki disease, or juvenile idiopathic arthritis)
• are overweight or obese
• have diabetes, high blood pressure, or smoke cigarettes

Your doctor can order a blood test to check your child's cholesterol. Your child may have to fast (nothing to eat or drink, except water, for 12 hours) before the test.

According to the National Cholesterol Education Program (NCEP) guidelines, the ranges of total and LDL cholesterol for kids and teens 2–18 years old are:

mg/dL = milligrams per deciliter

How Is High Cholesterol Treated?

If your child has an LDL cholesterol level of 130 mg/dL or higher, your doctor will talk to you about lifestyle changes or refer you to a dietitian. The goals are to:

• reduce fat (especially saturated fat and trans fat) and cholesterol in the diet
• increase exercise
• lose weight, if needed

Your doctor will probably do a cholesterol check again after 3–6 months of lifestyle changes.

Medicine might be considered for kids 10 and older whose LDL cholesterol is 190 mg/dL or higher if changes in diet and exercise haven't worked. Kids with risk factors, such as diabetes or high blood pressure or a family history of high cholesterol or heart disease, may need treatment at lower LDL levels.

5 Ways to Lower Cholesterol

First, check your own cholesterol level — and if it's high, ask to have your kids' levels checked.

Here are 5 ways to help keep your family's cholesterol in control:

1. Serve a heart-healthy diet, including:
   - vegetables, fruit, and whole grains
   - lean meats and poultry, fish, nuts, beans, and soy products
   - nonfat or low-fat milk and dairy products
   - healthy fats, like those found in fish, nuts, and vegetable oils
2. Limit drinks and foods with added sugars.
3. Read nutrition facts labels so that you can limit cholesterol and saturated fat and trans fat.
4. Encourage plenty of exercise. Exercise helps boost HDL levels in the blood — and that's a good thing! Kids and teens should be physically active at least 60 minutes a day.
5. Help your kids keep a healthy weight.

Make healthy living a family effort. Improving your lifestyle now will benefit everyone's health now and far into the future.

Reviewed by: Mary L. Gavin, MD

Date reviewed: May 2022

Diet Tips for Children with High Blood Cholesterol

What is high blood cholesterol?

High blood cholesterol, also called hypercholesterolemia, is an unhealthy level of cholesterol in the blood. Having high levels of blood cholesterol can cause your child to have heart problems when he or she gets older. But there are changes you can make in your child's diet now to lower the blood cholesterol.

How can I help my child eat right?

The first step to reducing cholesterol levels is to follow the “step 1” diet of the American Heart Association. This diet is low in cholesterol and saturated fat and high in complex carbohydrates. It provides energy and protein for normal activity and growth.

What are some examples of good foods?

Breakfast:

The first meal of the day is a good time to give your child foods that are high in fiber, such as cereals and whole-grain breads. Fruits, juices, cheeses and yogurt are also good. Use skim or low-fat milk rather than whole or 2% milk.

Lunch:

Use whole-grain breads and rolls to make a better sandwich. Whole grains increase the total fiber in your child's diet. Give your child whole-grain crackers with soups, chili and stew, and always serve fresh fruit (with the skin) with meals.

Here are some ways to make healthier sandwiches:

• Use low-fat or fat-free lunch meats. They are good in sandwiches or cut into strips on top of a salad.

• Put leftover chicken or turkey strips in a tortilla to make a cold fajita (add strips of raw red and green peppers and onions). Use fat-free sour cream as a dressing.

• Stuff a pita-bread “pocket” with vegetables, fat-free cheese and bits of leftover grilled chicken.

• Cut up vegetables such as onion, carrot, celery and green peppers to add to tuna salad. Mix vegetables and water-packed tuna with fat-free mayonnaise or, for a different taste, mix with a fat-free salad dressing.

• Chunky bits of leftover chicken mixed with fat-free mayonnaise, raisins, shredded carrots and sliced almonds is a great chicken salad. Serve it in a pita-bread pocket. Top it with salsa for a Southwestern flavor.

• Mix cranberry sauce and fat-free mayonnaise to add to a turkey sandwich.

• Put natural peanut butter together with an all-fruit jelly for an old favorite.

• Sliced ham and low-fat or fat-free cheese with honey mustard is great on rye bread.

• Low-fat cheese makes a good sandwich with tomato slices and mustard or fat-free mayonnaise on a roll.

• Slice leftover pork tenderloin and top with barbecue sauce for a hot or cold sandwich.

• Make grilled-cheese sandwiches with low-fat or fat-free cheese and serve them with raw carrot and celery sticks.

What snacks are good for my child?

Fruits, vegetables, breads and cereals also make great snacks for children. Here are some ideas for ways to serve these foods to your kids:

Fruits (Bite-size pieces of fruit look good to kids):

• Fruit bits stirred into nonfat yogurt

• Strawberries

• Raisins

• Grapes

• Pineapple chunks

• Orange or grapefruit sections

• Bananas cooked lightly in apple juice

• Apple slices with natural peanut butter

• Dried fruit mixes

Vegetables:

• Baked potato with low-fat cheese sprinkled on top

• Carrot sticks

• Celery sticks with natural peanut butter

• Raw broccoli and cauliflower florets with a low-fat dip or salsa

Protein:

• Cheese: use 1% fat or fat-free cottage cheese or ricotta cheese

• Water-packed tuna mixed with fat-free mayonnaise on top of celery sticks or low-fat crackers

• Yogurts: use fat-free yogurt. Try topping it with sunflower seeds, chopped dried fruit or a spoonful of oat bran

Cereals:

Sweets and desserts:

Other snacks:

• Popcorn: use “lite” or nonfat versions (try sprinkling popped corn with a little garlic, onion or chili powder)

• Rice cakes

• Low-fat pretzels

• Roasted peanuts in the shell

• Sunflower seeds, pumpkin seeds

• Fat-free or baked potato chips

• Bagels and low-fat bagel chips

• Low-fat breadsticks

• Low-fat pita chips

Miscellaneous:

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Elevated cholesterol levels eventually lead to vascular atherosclerosis, which means coronary heart disease (complication - heart attack), acute vascular disorders of the brain (stroke), is a strong pathological link in diabetes mellitus 2 type, with glaucoma (ischemic type) and age-related macular degeneration of the retina.

First, the liver and a number of cells produce approximately 75% of cholesterol. The remaining 25% comes from food (from animal products). nine0003

Dietary cholesterol is found in food

Dietary cholesterol is what is found in food and ultimately in the food we eat. It is mainly of animal origin. In one egg, for example, 275 mg; it's not in the apple.

Serum cholesterol is found in the blood

Serum cholesterol circulates in the blood, and doctors measure it with a special test.

There are two main types of cholesterol in the blood:

• HDL-cholesterol (high-density lipoprotein) - good cholesterol, is a type of serum cholesterol that is considered "good" because of its ability to clean the arteries: the higher its level, the better.
• LDL-cholesterol (low-density lipoprotein) - bad cholesterol, it is the "evil twin" of HDL that clogs the arteries. The lower its level, the better.

CNN blood cholesterol

Reduce dietary fat intake. Saturated fats, by far, have the most significant effect on cholesterol levels. So, it would be wise to cut down on sources of saturated fat such as fatty meats, butter, cheese, and refined oils. Whenever possible, replace these foods with fish, poultry, or low-fat dairy products.

Switch to olive oil. Olive oil and some other foods such as nuts and avocados are high in a completely different fat, monounsaturated fat. It was found that monounsaturated fats reduce only LDL-cholesterol ("bad") and HDL-cholesterol ("good") are left untouched. So stick to a lean diet, then add 2-3 tablespoons of olive oil daily. Be careful to replace other fats with monounsaturated fats, and not just add to them.

Do not eat too many eggs. But this does not mean that you should completely eliminate them from your diet. Although eggs contain a huge amount of cholesterol (275 mg each), Dr. McNamara estimates that approximately 2/3 of the population can handle the extra dietary cholesterol without experiencing an increase in serum cholesterol levels. This is because the body adjusts to high levels of consumption by reducing its production of cholesterol and excreting the excess. In one of his studies, 50 patients ate up to 3 large eggs daily for 6 weeks. Less than a third of them had high cholesterol levels afterwards. If you want to eat an egg and still avoid the risk, limit your consumption to 3 eggs per week. nine0003

Load up on beans. Nutritious and inexpensive, beans and other legumes contain a water-soluble fiber called pectin, which surrounds cholesterol and flushes it out of the body before it can cause trouble.

Watch your body weight. The fatter you are, the more cholesterol your body produces. A twenty-year study in the Netherlands concluded that body weight is the single most important determinant of serum cholesterol. Each 0.5 kg increase in body weight raises cholesterol levels by 2 levels. And the famous Framingham Heart Study found a clear link between blood cholesterol and body weight. nine0003

Eat more fruit. Fruits also have the ability to lower cholesterol due to the presence of pectin in them. Gastroenterologist James Cerda at the University of Florida Health Sciences Center found that grapefruit pectin, found in the pulp and skin, lowered cholesterol by an average of 7.6% in 8 weeks. Eat lots of other fruits. If you, for example, eat half a grapefruit for breakfast, an apple for lunch, a few orange slices for lunch, you may be able to significantly reduce your cholesterol. nine0003

Oats and barley remove cholesterol and fats. Beta glucan is a soluble fiber found in oats and barley. It lowers cholesterol levels and the risk of heart disease.

The compound beta glucan just reduces the concentration of bad cholesterol without affecting the good one. It dissolves in the gastrointestinal tract, resulting in a dense gel. This gel binds to excess cholesterol and saturated fat.

Thus, they are not absorbed by the body, but are excreted naturally. Experts believe that the optimal amount of beta glucan intake is at least 3 grams per day. The effect can be observed after six weeks. nine0003

Call a carrot for help. "Carrots also lower cholesterol because they contain pectin," says Peter D. Hoagland, Ph.D., USDA Eastern Research Center in Philadelphia, Pennsylvania. “In fact, for people with high cholesterol, eating 2 carrots a day is enough to reduce it by 10-20%.”

Exercise . Rhode Island cardiologist Paul D. Thompson, associate professor of medicine at Brown University, thinks it's possible that exercise reduces the cholesterol blockage that has accumulated in the arteries. “One of the best ways to raise protective HDL levels,” he says, “is intense exercise, which also lowers unwanted LDL levels a little. ” nine0003

Do not smoke. Here's another reason to quit smoking. In a study by New Orleans researcher David S. Friedmon, M.D., teenage boys who smoked as little as 20 cigarettes a week experienced significant increases in blood cholesterol levels. In addition, research has shown that smokers have low levels of beneficial HDL cholesterol. However, when a group of heavy smokers quit smoking, all of them rapidly and significantly increased their HDL levels. nine0003

How to manage high cholesterol without medication?

Cholesterol is a waxy, fat-like substance found in all body cells. The body needs cholesterol to produce hormones, vitamin D, and substances that help digest food. However, an excessive accumulation of cholesterol in the blood, in other words high cholesterol , can lead to serious illness. We talk more about this in the article. nine0089