High Cholesterol: Is Your Child at Risk?

When Wendy Dean suffered a heart attack, her personal health was not her only concern. Because she was only 35-years-old, she had good reason to worry about her two young daughters.

So one year later, she decided to have the girls' cholesterol levels tested.

“I took them because they were high risk,” said Dean, who lives in Cincinnati, Ohio. “I wondered about their cholesterol immediately.”

The results justified Dean's concern: Her daughter Becca, who was 10, had a total cholesterol level of 213 mg/dL. Her other daughter, Sarah, 7, had a total cholesterol level of 187 mg/dL.

According to the American Heart Association’s Web site, the acceptable total cholesterol level for children ages 2 to 19 is 170 mg/dL or lower.

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Parents don't generally worry about their young children having heart attacks, but high cholesterol in children is actually very common. And if kids with high cholesterol do not change their lifestyles, they could be at risk for a host of problems later in life.

Dean brought her daughters to Dr. Elaine Urbina, director of Preventive Cardiology at Cincinnati Children’s Medical Center, who told them they had to alter their lifestyles immediately. Becca and Sarah had to start watching what they ate and increase their physical activity.

“It’s really common to see abnormalities in cholesterol levels in kids because of the obesity epidemic,” Urbina said. “Because kids are more sedentary, eating more high-fat diets and they are overweight, we are seeing it more and more,” she said.

Urbina, who heads clinical trials for kids with high cholesterol and high blood pressure, said she sees about six new patients every week – and there is a waiting list.

It is proven that unless a strong intervention is made, there is a definite correlation between the risk factors as a child and those as an adult, Urbina said.

“Cholesterol, obesity and high blood pressure is related to the thickness of the carotid artery in young adulthood, and that thickness is a risk for stroke,” Urbina said.

Doctors used to think genetics played the only role in high childhood cholesterol levels, but this fall, when the National Institute of Health issues a new set of guidelines, Urbina said lifestyles will also be listed as a trigger.

“We should promote health in school, stop super-sizing foods and be telling everyone to exercise,” Urbina said. “I’m in favor of universal screening versus selective screening.”

Acceptable HDL levels should be greater than or equal to 35 mg/dL and triglycerides should be less than or equal to 150 mg/dL, according to the Association.

LDL (bad cholesterol) levels are considered acceptable if they are 110 mg/dL or less, according to the Association.

“By definition, 5 percent of kids have high cholesterol, but our entire population’s cholesterol levels are rising,” Urbina said. “Compared to 1980 or 1985, it’d be more than 5 percent because kids are more overweight. It’s a moving target and it’s hard to measure.”

There is compelling evidence that deposits of plaque in artery walls (atherosclerosis) begin in childhood and progress as the child becomes an adult, according to the Association's Web site. This often happens when cholesterol levels are high and can lead to heart disease, the single largest death in the U.S.

For families that are trying to become healthier and lower their cholesterol and/or triglyceride levels, Dean suggested:

— Make exercising a family activity

— Allow yourself and the kids to "splurge" one night a week

— Drink skim milk

— Buy whole wheat or whole grain breads

— Know your family’s heart history

— Limit the amount of red meat you eat; buy leaner cuts when you do eat it

— Use 2 percent or fat-free cheese when cooking

— Eat fish once a week

— Do not eat out as often

— Plan your meals in advance

Fast forward to spring 2008 for the Dean girls.

Becca, 13, has seen her total cholesterol level drop from 213 mg/dL to 176 mg/dL.

In an effort to stay healthy, she plays school sports and modifies her diet. She recently gave up drinking soda.

Sarah, 10, has seen her total cholesterol level rise from 187 mg/dL to 194 mg/dL, but her triglyceride levels are starting to decrease.

Dean said Sarah's LDL levels are also on the rise, but Urbina isn’t worried yet. They continue to motivate Sarah to eat healthy and she recently joined the community pool swim team.

“We still struggle with sweets,” Dean said. “That’s kind of a downfall.

"However, when you are talking about cholesterol, you aren’t looking at that one number,” Dean said. “You have to look at the ratios of all three. My cholesterol was always checked every three to five years and my cardiologist said he wouldn’t have done anything for me – yet, I had a heart attack.”