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.
"If children can be introduced to these more healthful lifestyle features -- healthy diet, exercise, weight control -- then we have a chance that this becomes natural for them," Lewis says. Making the changes is labor intensive, often involving a nutritionist, an exercise physiologist and a physician advising the entire family. "The children and the family share the same food at the table, the same gene pool," Lewis says. "It's really important to get the whole family involved."
And often, lifestyle changes work. "Adoption of a nutritional approach can usually reduce the serum cholesterol," Lewis says.
"And if it's mild to moderately elevated can often lower it to within the normal range. For the majority of children, the nutritional approach is really all that they need."
For an article about using red yeast rice and fish oil, visit latimes.com/statins.