Cholesterol and Teens

Cholesterol and Teens
By CWK Network Producer

“We have been putting children on lipid-lowering medications for some years now. We’ve been putting more children on them recently.”
Jack Stevens, M.D., Pediatric Cardiologist

A new survey by the Centers for Disease Control finds that 20 percent of American teenagers have unhealthy levels of cholesterol, which is a major component of heart disease. It’s common for adults to take cholesterol lowering drugs, but doctors say, in some cases, teens may need this medicine as well.

How do you know if the drugs are right for your child?

Seventeen-year-old Josh Lewis and his sister Abbey, for example, are thin and athletic, yet they both have high cholesterol.

“You can’t tell by looking at a kid how healthy or unhealthy they are on the inside,” says their mom, Sydney Ruben-Lewis.

“I wasn’t eating a lot of like greasy foods or anything,” says Josh. “I was like, ‘I have high cholesterol? What does that mean?’”

“I was told that you can have heart disease,” says 15-year-old Abbey, “heart attacks, you could die early. And that’s kind of a scary thought.”

New research finds that 20 percent of U.S. teens have high cholesterol. Poor diet is one reason: another is genetics.

“Those with very high cholesterol tend to be children who are born into families where there is an abnormality in metabolism of cholesterol,” says pediatric cardiologist Dr. Jack Stevens. “And the people with really the higher cholesterols tend to have genetic or metabolic defects that lead to elevated cholesterol.”

Over time, cholesterol can lead to clogged arteries.

“What we are talking about with elevated cholesterol is the likelihood that we have coronary artery disease,” says Dr. Stevens, “hardening of the arteries, deposition of the fat in the arteries, some of the things we refer to, occurring starting in childhood, continuing in the teenage years.”

That means teens with high cholesterol could have heart attacks much earlier- in their 20’s and 30’s, instead of later in life.

“The first treatment that has been recommended for all people with hypercholesterolemia,” says Dr. Stevens, “and has been recommended for really all Americans, is to try to cut saturated fats in the diet.”

But if that doesn’t work, cholesterol-lowering drugs may be an option – especially for teens with a family history.

“If there is a family history of early coronary artery disease in the parents, grandparents, or the aunts and uncles, than the child should undergo a lipid profile,” says Dr. Stevens.

Abbey and Josh both take the drugs: their cholesterol levels have dropped.

“I’m very glad I’m taking it,” says Abbey, “because I know in the long run, even though I can’t tell now, it’ll help me a lot.”

Managing Cholesterol in Kids
By CWK Network, Inc

There is currently a great deal of discussion among parents and physicians about the eating habits of our children. The scientific evidence associated with some of these discussions is not very encouraging. For example, studies show that:

• A significant percentage of U.S. children can be classified as overweight or even obese.
• U.S. children and adolescents have higher blood cholesterol levels and higher intakes of saturated fatty acids than do other children in various parts of the world.
• Individuals with high cholesterol levels as children and adolescents are more likely than the general population to have high cholesterol levels as adults.
• Early coronary atherosclerosis or precursors of atherosclerosis often begin in childhood and adolescence and are related to high serum total cholesterol levels, LDL-cholesterol plus very low-density lipoprotein-cholesterol levels, and low high-density lipoprotein levels.
• There is a strong hereditary and familial component associated with developing cholesterol and coronary problems.

While it is important to point out that a substantial number of children with high cholesterol levels transition to adulthood with desirable cholesterol levels without intervention, the American Academy of Pediatrics (AAP) considers the problem serious enough to have issued recommendations to help parents and physicians identify children potentially at risk for problems with high cholesterol. These recommendations are based upon the belief that these children may be at increased risk of having high blood cholesterol levels as adults and increased risk of coronary heart disease. The recommendations target children and adolescents who have a family history of premature cardiovascular disease or have at least one parent with a high blood cholesterol level or those who have other factors for heart disease including obesity, high blood pressure or diabetes. Screening should take place after age two, but no later than age 10.

According to The National Institute of Heart Lung and BUBBA, the following are some guidelines for total and LDL-cholesterol levels in children and teenagers from families with high blood cholesterol or early heart disease:

• Total Cholesterol
• LDL Cholesterol

• Acceptable
• Less than 170 mg/dL
• Less than 110 mg/dL

• Borderline
• 170 to 199 mg/dL
• 110-129 mg/dL

• High
• 200 mg/dL
• 130 mg/dL or greater

Note: These blood cholesterol levels apply to children 2 to 19 years old.

What We Need to Know

There are a number of things that parents can do related to the issue of children and high cholesterol. For example, prior to having a child tested for cholesterol problems, parents can

• Educate themselves about cholesterol. Learn about the different types of cholesterol (i.e. HDL, LDL), their respective functions and negative effects, recommended levels, etc.
• Familiarize themselves with the child’s family medical history, particularly in regard to previous problems with cholesterol or heart diseases
• If possible, have their own cholesterol levels tested.

If a child is found to have high cholesterol, his or her physician will likely recommend treating the problem with a combination of diet and physical activity. From a dietary standpoint, the ideal goal is to reduce the LDL-C levels to the low <110 mg/dL range. To help your child achieve this goal, parents will need to institute what the American Heart Association refers to as a “heart healthy diet,” one that is low in cholesterol and saturated fat, high in complex carbohydrates and provides adequate energy for growth.

• no more than 30 percent of calories from total fat
• less than 10 percent of total calories from saturated fats
• 100 mg cholesterol/1000 kcal, not to exceed 300 mg/day

Your child’s pediatrician should be able to provide detailed dietary guideline for your child based upon the severity of his or her cholesterol problem.

From an exercise standpoint, the American Heart Association suggests the following guidelines:

• All children age 5 and older should participate in at least 30 minutes of enjoyable, moderate-intensity activities every day.
• Children should also have the opportunity to perform a total of at least 30 minutes of vigorous physical activities at least 3-4 days each week to achieve and maintain a good level of cardio-respiratory (heart and lung) fitness.
• If a child or children doesn’t get the opportunity to have a full 30-minute activity break each day, parents and other caregivers should try to provide at least two 15-minute periods or three 10-minute activity periods. These periods should allow the child to engage in various activities appropriate to their age, gender and stage of physical and emotional development.