Tackling the problem of high cholesterol in children can be challenging. Registered dietitian Karen Ansel, a spokeswoman for the Academy of Nutrition and Dietetics, offers some meal-planning strategies for managing cholesterol and promoting a healthy lifestyle.
A recent study found some improvement in pediatric cholesterol levels. What are you seeing in your practice?
We’re not sure exactly why but cholesterol levels in children seem to be improving slightly, falling from 11% to 8% in the past 12 years. However, we still have work to do as 22% of kids still have either low “good” HDL cholesterol or high total or “bad” LDL cholesterol.
What is the best dietary strategy for reducing cholesterol levels in children?
Because children of different ages have different requirements for dietary fat, strategies for heart-healthy eating and for reducing cholesterol in children vary slightly by age. To prevent and initially treat high cholesterol, the ideal heart-healthy diet for children ages 2 and older should contain between 25% to 30% of calories from total fat, less than 300 milligrams of cholesterol and between 8% to 10% of calories from saturated fat.
If these measures are not successful, further reductions in saturated fat and cholesterol may be necessary. Because children require fat to support their rapid growth and brain development, the focus should be on healthy fats rather than a low-fat diet. To keep fats heart healthy, parents should offer kids plenty of whole grains, fruits, vegetables and low-fat dairy (for children over age 2) while also limiting fatty cuts of meat and full-fat dairy, as well as choosing healthy fat sources like olive and canola oil.
How should diets vary as children mature?
The biggest difference would be for children between the ages of 1 and 2. Because they require more fat for brain development, their diets should consist of 30% of calories from fat and they should drink 2% milk rather than the fat-free milk recommended for older children.
Do parents need to pay attention to cholesterol type or just shoot for better levels of LDL cholesterol?
Dietary recommendations for lowering total and LDL cholesterol are similar, so parents do not need to get bogged down with the type of cholesterol that needs to be lowered. The best way for parents to lower their child’s total and/or LDL cholesterol is by switching to fats that are plant based, such as avocados, nuts, seeds, canola oil and olive oil, and limiting animal fats such as butter, red meat, cream cheese and full-fat cheese. Parents should also keep in mind that the foods kids do eat can be as helpful as those they don’t. Foods like oatmeal, beans, fruits and vegetables are all rich in soluble fiber, which helps sweep cholesterol out of the body.
Is family buy-in important to cholesterol reduction or is this something that can be targeted just toward the child?
Involving both the child and the parents is the most effective way to help a child lower their cholesterol. Since parents are the gatekeepers of food that comes into the house, they have an enormous impact on what their kids eat. Research reveals they are also a child’s No. 1 role model for healthy eating. One of the most important things parents can do to help reduce their child’s cholesterol is to set a good example and to serve — and eat — lots of healthy foods. If both parents eat a heart-healthy diet, their children will be much more likely to follow their good example.
How will new federal nutrition regulations affect cholesterol levels of school lunches?
New nutrition regulations should help improve American children’s heart health and cholesterol in several ways. The first is that new measures are being taken to help schools reach their goal of limiting saturated fat to no more than 10% of overall calories. Schools will receive assistance procuring more heart-healthy foods that are lower in saturated fat, such as skinless poultry, lean meat and heart-smart vegetable oils. Trans fats will be limited to zero grams per serving. Because milk can also be a substantial source of cholesterol-raising saturated fat, schools will now only be offering 1% or fat-free milk.