Does your little one have high cholesterol? (Pediatric High Cholesterol) Let's talk about this!

We all often talk about cholesterol in adults, that is, the level of fat in the blood. But did you know that even small children can have this cholesterol problem? In fact, sometimes it can be a little serious. So, don't worry. Today, let's talk about what high cholesterol in small children, or as doctors call it, `(Pediatric High Cholesterol)`, is, why it happens, and what we can do about it.

What does high cholesterol mean in young children?

Simply put, high cholesterol in children means that the amount of cholesterol in your child's blood is higher than normal. This cholesterol is a type of fat in our blood called `(Lipids)`. There is also another type of fat called `(Triglycerides)`, which can also be high in some children. Actually, our body needs some of these fats, because they help in various functions of the body. However, problems arise when these increase too much.

Now you may be wondering, "How do I know for sure if my child has high cholesterol or high triglycerides?" Doctors do a blood test for this. It's called a "Lipid Panel." This test can tell you exactly what these fat levels are. Remember, normal cholesterol levels in young children are slightly different from those in adults.

Here's a look at normal, moderate, and abnormal fat levels in young children.

(Here, it is abnormal if only the good type of cholesterol called HDL cholesterol decreases.)

| Lipid Type | Normal mg/dL | Borderline mg/dL | Abnormal mg/dL |

| :------------------------------------ | :------------------------ | :------------------------- | :-------------------------- |

| Total Cholesterol | < 170 | 170 - 199 | ≥ 200 |

| LDL cholesterol ("bad" cholesterol) | < 110 | 110 - 129 | ≥ 130 |

| HDL cholesterol ("good" cholesterol) | > 45 | 40 - 45 | < 40 |

| Triglycerides (0-9 years) | < 75 | 75 - 99 | ≥ 100 |

| Triglycerides (10-19 years) | < 90 | 90 - 129 | ≥ 130 |

Important: These values ​​may change slightly with age, so it's best to talk to your doctor to find out for sure.

What are the symptoms of high cholesterol in a child?

Most of the time, a child's high cholesterol level doesn't show any obvious symptoms . This is the most dangerous thing. However, if the cholesterol level is very high, especially if it is due to genetic reasons, the child may experience the following:

• Waxy, oily lumps on the skin (Xanthoma)
• A yellow, blister-like formation on or near the eyelid (Xanthelasma)
• Corneal Arcus: A white or gray ring around the cornea of ​​the eye.

If you see symptoms like these, you should definitely see a doctor immediately.

Why does a child's cholesterol level increase?

There are several reasons why a child's cholesterol levels may be high. Let's take a look at what they are:

• Food and Drink: The types of foods the child eats, especially fatty and sweet foods.
• Amount of physical activity: How much the child runs, jumps, plays, and exercises.
• Other diseases: Conditions such as obesity, diabetes mellitus, and kidney disease (Nephrotic Syndrome).
• Medications: Some medications can also cause cholesterol to increase.
• Genetic influence: Genes inherited from parents can also be a major reason for this.

Often, children with high cholesterol have a history of high cholesterol in their mother or father, or may be taking medication to control their cholesterol.

High cholesterol due to genetic causes

Genes play a big role in this problem. Let's see how that works.

Familial Hypercholesterolemia (FH)

This is a genetic condition. What happens is that a child is born with high levels of "bad" cholesterol (LDL Cholesterol). In most cases, this is inherited if only one of the parents has the gene.

A doctor may suspect a child with an unexplained LDL level of 160 mg/dL or higher. An LDL level of 130 mg/dL or higher in a child with parents who have FH is also a cause for concern.

Polygenetic causes

There are other genetic causes besides `(FH)`. A child with polygenic causes of high cholesterol means that the child inherits multiple genes from both parents that raise `LDL` levels. In this case, the `LDL` levels may have been rising gradually over time, and may not become noticeable until they are young. Although these genetic factors increase the risk of heart disease, they do not become as severe as `(FH)`. Children with `(FH)` usually need to start medication earlier than children with polygenic causes.

Lipoprotein (a)

`(Lipoprotein (a))` (pronounced "lipoprotein little A") is a special type of cholesterol that can be inherited from parents to children. People with high levels of `(Lipoprotein (a))` are at a higher risk of developing coronary artery disease. It can also contribute to the rare occurrence of strokes in children.

If your child has one or more of the following risk factors, a doctor may order a blood test to check their `(Lipoprotein (a))` levels:

• Being diagnosed with ``Familial Hypercholesterolemia``.
• Having previously had an ischemic stroke of unknown cause.
• Having high levels of `(Lipoprotein (a))` in either the mother or the father.
• Having a sibling or parent who has had a heart attack at a young age.

Why do a child's triglyceride levels increase?

The main reasons for high triglyceride levels in children are:

• Obesity
• Diabetes
• Some medications

High triglycerides can also have genetic causes, but they are not as common as FH. If a child's fasting (12-hour fast) blood test shows triglycerides of 500 mg/dL or higher for no other reason, doctors may suspect a genetic cause.

What complications can occur due to high cholesterol in children?

Children with high cholesterol (`LDL` cholesterol) can develop health problems as they grow older. These are mainly caused by fatty deposits (atheroma) inside the blood vessels, which can block blood flow. This can reduce blood flow to the heart, brain, or legs. You may have heard of these conditions:

• Heart Attack
• Stroke
• Peripheral Artery Disease

Just think, if these problems are controlled at a young age, how much it will help you avoid such serious illnesses when you grow up!

What are the complications that can occur due to increased triglycerides in children?

If the level of `(Triglycerides)` is too high, the child may develop `(Pancreatitis).` If the level of `(Triglycerides)` is high for a long time, it can also contribute to the deposition of fat in the arteries to some extent. However, it does not have as great an effect as `(LDL)` cholesterol.

How do doctors diagnose high cholesterol in children?

School-age children can have their cholesterol levels checked with a simple blood test. In some cases, you may need to fast for at least 12 hours before the blood test. Ask your doctor if this is necessary.

It is especially important to get this test done if someone in the family has heart disease, or if the parents have high cholesterol levels. The results of the blood test can tell if the child's cholesterol or triglycerides are high.

How to treat high cholesterol in children?

The first step in controlling high cholesterol is to make changes to your child's diet and increase the amount of physical activity they do . Your doctor will advise you on this. If these changes alone do not bring your child's cholesterol levels down to a safe level, your doctor may recommend medication (for children over 8 years of age).

Does my child need medicine?

It may be necessary. Doctors recommend medications based on expert advice from organizations like the National Heart, Lung and Blood Institute and the American Heart Association. Here are some situations where a doctor might give your child medication:

• If the LDL level is greater than 190 mg/dL:
• If the child has no other risk factors for cardiovascular disease.
• If your LDL level is 160 mg/dL or higher, and you have any of the following:
• The child has risk factors for cardiovascular disease.
• One of the parents had a heart attack at a young age, or there is fatty deposits in the arteries of the heart (coronary artery plaque).
• If your cholesterol levels have not reached the target level after six months of making changes to your diet and exercise.
• If your LDL level is greater than 130 mg/dL, you have any of the following:
• One of the parents has been diagnosed with `(FH)`.
• The child has cardiovascular disease risk factors such as obesity, high blood pressure, smoking (child or people around them), low HDL levels, history of Kawasaki Disease, kidney disease, having an organ transplant, Juvenile Rheumatoid Arthritis, Lupus, or HIV.
• If your LDL level is greater than 100 mg/dL, you have any of the following:
• The child has Type I or Type II Diabetes.
• The child has Kawasaki Disease, which causes coronary artery aneurysms.

What medications are given to children for cholesterol?

Statins are the first choice for children with high LDL levels. For example:

• Atorvastatin (Lipitor®)
• Rosuvastatin (Crestor®)
• Simvastatin (Zocor®)

This is how statin drugs lower a child's LDL levels:

• Stops the liver from making cholesterol.
• It removes excess cholesterol from the blood and helps the body use it properly.

Ezetimibe is a second-line drug that lowers LDL levels. It works by blocking the absorption of cholesterol from the intestines into the blood.

Treatment of high Lipoprotein (a)

Lifestyle changes do not have as much of an impact on `(Lipoprotein (a))` levels as `(LDL)` levels. Currently, there are no specific medications to treat high `(Lipoprotein (a))` levels. However, drug trials are underway. If your child's `(Lipoprotein (a)` levels are high, a doctor may recommend that they focus on reducing other risk factors for coronary artery disease. These include:

• Eating heart-healthy foods.
• Getting enough exercise.
• Treating other cholesterol levels with medication.
• Avoid smoking.

Treating high triglycerides

Your child's doctor may recommend things like:

• Making changes to your child's diet and exercise.
• Fish oil supplements (up to 4000 mg per day).
• Other medications (in special cases where children's triglyceride levels are very high).

Can high cholesterol in children be reversed?

Yes, it can! Treatment can help lower your child's cholesterol levels to a safe level. This can also reduce the risk of serious complications in the future. Your doctor can help you find out exactly what your child's target cholesterol levels are and how to get there.

How can I help lower my child's cholesterol?

You can help lower your child's cholesterol levels by encouraging them to:

• Feed foods that are low in total fat. Fat should make up 30% or less of your child's total daily calories. A dietitian can help you calculate this amount and create meal plans.
• Avoid trans fats and limit saturated fats. Saturated fats are fats that are usually solid at room temperature, such as animal oils, coconut oil, and palm oil. Saturated fats should account for less than 10% of your total daily calories. Instead, choose unsaturated fats, such as olive oil, avocado oil, and flaxseed oil.
• Limit dietary cholesterol intake. Children should consume less than 300 mg of cholesterol per day.
• Avoid full-fat dairy products. Give 2% fat milk to children between 12-24 months. Give fat-free milk to children over 2 years of age.
• Provide foods with enough fiber. Encourage your child to eat foods high in fiber, such as vegetables, fruits, nuts, legumes, and whole grains.
• Encourage regular physical activity. Aerobic activities such as cycling, running, walking, and swimming can help increase HDL ("good") cholesterol levels and reduce the risk of cardiovascular disease.
• Help your child maintain a healthy weight. Your doctor can help you determine what that weight range is.

What are the best foods to feed my child?

Choose a variety of foods to ensure your child gets all the nutrients they need. Here are some nutritious foods that can help control cholesterol levels:

For breakfast:

• Fruit
• Whole grain cereal
• Oatmeal
• Greek yogurt

For lunch and dinner:

Fill your child's plate with the USDA MyPlate model:

• Lean protein like chicken, fish, beans (1/4 of the plate)
• Whole grains (1/4 of a plate)
• Fruits and vegetables (1/2 of the plate)
• Low-fat dairy product diet

Healthy cooking methods include baking, grilling, and air frying. Avoid deep frying.

Snacks:

• Fruit
• Vegetables
• Types of nuts and seeds
• Whole grain crackers
• Low-fat dairy products

Drinks:

Choose water and low-fat milk. Avoid soda, sweetened milk, fruit drinks, and sports drinks.

When should I take my child to see a doctor?

Your doctor will tell you how often you should bring your child to the doctor. Your child's cholesterol levels will also need to be monitored regularly. You should also have your child's cholesterol levels checked six months after making any dietary changes or two months after starting any new medication.

Finally, something to consider.

Because we’re so used to hearing about cholesterol in adults, it’s easy to forget that even young children can have this problem – until it happens to our own child. And then it’s hard to stop thinking about it. Don’t worry, your child’s doctors understand your concerns, and they’re here to help your whole family. Ask your questions, learn as much as you can. Work together to create a heart-healthy lifestyle.

Treating cholesterol at an early age can give your child the best chance for a healthy future.

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