There are several words in medicine that are bad. They are not four letter words but when said are often said in a lowered voice and with concern as they imply a serious problem. Two examples are cancer and cholesterol. Many are surprised to learn that cholesterol is not as fundamentally evil as many think it is. In fact, it is vital to a healthy life. Children of all ages can be at risk of developing dangerous levels of cholesterol. High cholesterol in children can be passed on from parents or can be caused by obesity and diet.
Most cholesterol is locked up in the body’s cells doing useful things. Cholesterol is a fatty substance that plays important structural and functional roles for cell membranes and hormones. Just a small part of the body’s cholesterol, about 7 percent, floats around in the blood stream. Total cholesterol is made up of the following:
1. Low-density lipoproteins (LDL) produced in the liver and then deposited in blood vessels walls.
2. High-density lipoproteins (HDL) removes excess LDL cholesterol from the bloodstream and is sometimes referred to as “good” cholesterol.
3. Very low density lipoproteins (VLDL) produced in the liver and transported in the bloodstream to move cholesterol to the organs.
4. Triglycerides which are fatty acids. Triglycerides come from foods such as butter, oils and other fats. They also come from extra calories as the body changes extra calories into triglycerides and stores them in fat cells.
The key to a healthy cholesterol is to maintain a healthy level, not to eliminate it. Because of the growing epidemic of obesity in children the American Academy of Pediatrics recommends that all children between 9 and 11 years old be screened for high cholesterol levels. They also recommend that children in the following groups be tested after the age of two years and before the age of 10. The first group is children whose parents or grandparents had heart attacks or strokes at age 55 or earlier in men or age 65 or earlier in women. The second group is children whose parents or grandparents have total cholesterol of 249 mg or higher. The third group is children whose family health history is unknown or whose family has heart disease associated with high blood pressure, diabetes, smoking or obesity.
Youth obesity is a leading cause of high cholesterol in children. More than 43 percent of children with obesity have high cholesterol compared to less than 14 percent of children who are not obese. There is very good evidence that children with cholesterol problems become adults with high cholesterol. Cholesterol is an essential part of a child’s health. Making simple lifestyle and dietary choices for you family can help prevent serious health risks in a child’s future.
If you recognize any of the above risk factors in your family, discuss this with your provider, get screened and ask for help in making the lifestyle and dietary changes your entire family needs.
Sally Robinson is a clinical professor of pediatrics at UTMB Children’s Hospital. This column isn’t intended to replace the advice of your child’s physician.
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