Cholesterol and Lipid Problems

What are cholesterol and triglycerides?

Cholesterol is a soft, waxy substance found in the bloodstream and in all your body's cells. Triglycerides are the most common type of fat in your body, and provide a major energy source.  Both cholesterol and triglycerides are essential for the normal function of your body. They are both produced by the body, as well as found in the food that we eat.  Unfortunately, high levels of cholesterol and triglycerides in the bloodstream can cause damage over long periods of time. They do this by depositing in the walls of the arteries causing plaque build-up.  This process can start in childhood.  However, it takes many, many years for it to get to the point that it can cause problems.  Significant plaque build-up in the arteries feeding the heart muscle with blood can lead to a heart attack. Plaque build-up in the arteries in the brain can result in a stroke.  The risk of a heart attack or stroke in a child is basically zero.  However, if left uncorrected, high levels of cholesterol and triglycerides may cause problems for someone as early as in their late 30s or early 40s.

What causes high levels of cholesterol and triglycerides?

Cholesterol and triglycerides come from two sources: your body and food. Your liver and other cells in your body make about 75 percent of blood cholesterol. The other 25 percent comes from the foods you eat. There are two main types of cholesterol particles in the bloodstream. LDL cholesterol is the “bad” cholesterol - it directly contributes to plaque build-up. HDL cholesterol is the “good” cholesterol - high levels appear to protect against plaque build-up. Usually a high level of cholesterol in the bloodstream is caused by eating too much cholesterol and saturated fat, which stimulates the production of cholesterol and triglycerides in the liver.  However, some individuals have a genetic defect that causes them to manufacture an excess amount of LDL cholesterol.

What are the current guidelines for lowering cholesterol and triglycerides in children/teenagers?

The current guidelines for cholesterol/triglyceride management were updated by the American Academy of Pediatrics in early 2008.  In nearly all cases, dietary management is the first step. Medication is typically reserved only for severe cases that have not responded to dietary changes.  It is important to point out that the guidelines for children and teenagers are much less strict than those for adults.  To qualify for medication, a child should be over the age of 8 and have failed a trial of dietary therapy.  In addition, the LDL should be above 190, or above 160 if there is a family history of early heart problems or other risk factors such as high blood pressure or obesity. Dietary changes include the following: Limiting cholesterol to less than 200 mg per day, and limiting saturated fat to less than 7% of total calories.  Other products that can help lower cholesterol include soluble fiber and plant sterols/stanols.