Studies of adults have shown that bad cholesterol can be lowered by 5% to as much as 20% by lifestyle changes, including quitting smoking.
Losing excess weight, which requires lowering calories and fat consumption and increasing exercise, is the most successful strategy for lowering cholesterol. "Before starting a statin, try losing 20 pounds," says Dr. David Becker, cardiologist at the University of Pennsylvania Health System.
"In most kids, you'd want to work on this for three to six months before you go to a more aggressive treatment," Daniels says. If during that time physicians see evidence of improvement in lower cholesterol numbers and lost weight, the lifestyle treatment could continue without adding a drug.
Leading by example
For adults and children alike, it's clear that increasing physical activity while changing eating habits to include more fruits, vegetables, fiber, whole grains and fish and less saturated fat and sugar is easier said than done. But children have an advantage. Their bad habits are relatively new, not ingrained for decades, and might be easier to overcome.