At first blush, the new guidelines on cholesterol control in children were shocking. Statins, one of the most frequently prescribed drugs for adults worldwide, could be prescribed for some children as young as 8, according to recommendations released last week by the American Academy of Pediatrics.
But the vast majority of children will never in their pre-pubescence or teens pop a pill to lower cholesterol. Nor will their parents want them to. "I hear it every time I see parents," says Dr. Alan Lewis, a pediatric cardiologist and director of the lipid clinic at Childrens Hospital Los Angeles. " 'I don't want my kid taking a pill.' "
For most children, the new guidelines will simply serve to alert parents that their kids could be accumulating plaque in their arteries that will set them on a road to early heart attacks or strokes. "My own practice and the new guidelines emphasize the importance of lifestyle as the approach to lowering the risk of cardiovascular disease," Lewis says.
Whether you're a kid or a grown-up, here's how to adopt that lifestyle.
Diet and exercise
Children ages 2 to 10 who test in the acceptable range (total cholesterol less than 170 milligrams per deciliter of blood) should simply keep up the good work. Those who test in the borderline range (total cholesterol 170 to 199) need to make some changes in what they eat and how much they exercise. (For adults, total cholesterol of less than 200 is desirable; 200 to 239 is borderline high; above 240 is high, carrying with it twice the risk of heart disease as a level below 200.)
It's children who test at elevated levels, above 200, who bump into the controversial recommendation of taking a statin as part of their preventive therapy. Even then, "you should always start with lifestyle modifications," says Dr. Stephen R. Daniels, chairman of the department of pediatrics at the University of Colorado School of Medicine in Denver and lead author of the guidelines.
For starters, dietary fat intake should be lowered to less than 30% of calories, with saturated fat, found in meat and whole-milk dairy products, less than 10% of calories and no more than 200 milligrams of cholesterol a day.
