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SUBJECT: NUTRITION

CHOLESTEROL IN CHILDREN: HEALTHY EATING IS A FAMILY AFFAIR
CHOLESTEROL IS A FAMILY AFFAIR

Do you know your blood cholesterol level? Is it high?

Your child's blood cholesterol level can be related to your level. If you have high blood cholesterol or heart disease, there is a greater chance that your child has high blood cholesterol. Children whose blood cholesterol levels are high, in general, tend to have higher levels as adults and be at greater risk for heart disease. That is why controlling blood cholesterol levels is a family affair.

All healthy Americans, 2 years of age or older, should eat in a way that is low in saturated fat and cholesterol. We now know that eating this way lowers blood cholesterol levels and reduces the risk of heart disease.

Heart disease is still the number one killer of both men and women in the United States. More than 6 million Americans have symptoms of heart disease. High blood pressure, smoking, and obesity, as well as high blood cholesterol increase your risk of getting heart disease. The good news is that you can change these risk factors and reduce your family's risk of heart disease.

How DOES BLOOD CHOLESTEROL AFFECT HEART DISEASE?

Heart Disease Has Its Start Early in Life

Atherosclerosis may start very early in life, yet not produce symptoms for many years. Over the years, cholesterol and fat build up in the arteries. This narrows the arteries and can slow or block the flow of blood to the heart. This process is known as "atherosclerosis." Most heart attacks are caused by a clot forming at a narrow part of an artery which cuts off the blood and oxygen supply to the heart muscle. Most coronary heart disease is due to blockages in these same arteries.

We know that lowering blood cholesterol in adults slows the fatty buildup in the walls of the arteries and reduces the risk of heart disease and heart attack. Lowering blood cholesterol levels in children is likely also to help reduce their risk of heart disease when they become adults.

Cholesterol: Your Body Needs It And Makes Its Own

Cholesterol is a soft, waxy substance. Your body needs cholesterol to function normally. Cholesterol is present in all parts of the body, including the brain, nerves, muscle, skin, liver, intestines, and heart. It is a part of cell membranes. And it is important for the production of hormones, vitamin D, and bile acids-which help to absorb fat.

Your blood cholesterol level is affected not only by the saturated fat and cholesterol in your diet, but also by the cholesterol made in your liver. In fact, your body makes all the cholesterol it needs. The saturated fat and cholesterol in your diet only help to increase your blood cholesterol level.

Lipoproteins Carry Cholesterol in Your Blood

Cholesterol travels in your blood in packages called lipoproteins. They are often referred to as LDLs and HDLS.

LDLs-Low density lipoproteins (LDLS) carry most of the cholesterol. If your LDL level is high, cholesterol and fat can build up in your arteries and cause atherosclerosis. This is why LDL cholesterol is often called "bad cholesterol."

HDLs-Cholesterol is also packaged in high density lipoproteins (HDLs). HDLs carry cholesterol back to your liver. Here it is processed or removed from your body. Removal helps prevent cholesterol from building up in your arteries. So, HDLs are often referred to as "good cholesterol."

WHAT AFFECTS BLOOD CHOLESTEROL LEVELS?

Many Factors Influence Blood Cholesterol Levels

Diet. Among the factors you and your family can do something about, diet has the greatest effect on blood cholesterol levels. Saturated fat raises blood cholesterol levels more than anything else you eat. Dietary cholesterol also increases blood cholesterol levels.

Changing your family's way of eating will be a very important step to control or lower blood cholesterol.

Weight. In children, as in adults, obesity is related to increased total blood cholesterol levels. Losing weight has been shown to lower these levels. Children who are obese are more likely than other children to become obese adults. Obesity, by itself, also increases the risk of heart disease.

Physical activity. Regular exercise throughout life is associated with a lower risk of heart disease. We also know that regular exercise may help control weight and increase HDL-cholesterol. Aerobic exercise helps strengthen the heart and improve the circulatory system as well.

Smoking. Cigarette smoking is related to lower HDL-cholesterol levels, and also increases the risk of heart disease.

Genetic factors. Genes, i.e., heredity, play a major role in determining blood cholesterol levels and how well your child will be able to lower the level by diet. Because of their genes, a very small number of people have a high blood cholesterol level even if they eat a cholesterol-lowering diet.

Sex and age. In the United States, the average total cholesterol level in children is about 160 mg/dL. At birth, total cholesterol levels are about 70 mg/dL and rise to between 100 to 150 mg/dL during the first few weeks of life. At 2 years of age, these levels increase to about 160 mg/dL in boys and to 165 mg/dL in girls. They stay at about these levels until puberty. Between 12 and 18 years, total cholesterol in boys declines slightly to about 150 mg/dL. Levels in girls also decline slightly. At age 20, blood cholesterol levels in both men and women start to rise.

Alcohol. You may have heard that modest amounts of alcohol can improve HDL-cholesterol levels. However, it is not known whether this protects against heart disease. Because drinking alcohol can have serious harmful effects, it is not recommended as a way to prevent heart disease.

Shared Habits and Genes

Families share similar habits including eating, exercise, smoking, and drinking. Families also share similar genes. The shared habits and genes influence cholesterol levels in families. Clearly, as a family you can do something about your shared habits. See the box below.

Eat foods lower in saturated fat and cholesterol. This will help to lower blood cholesterol levels and maintain a healthy weight. In fact, most people are able to control or lower their blood cholesterol levels by eating this way.

Exercise regularly.

If you smoke, STOP. As your child's role model, help him or her avoid taking up the habit.

Be aware that friends, fads, and advertising also influence eating, exercise, smoking, and other habits.

SOURCE: National Institutes of Health, National Heart, Lung, and Blood Institute - NIH Publication No. 92-3099

OTHER RESOURCES: HMO's, Sporting Goods, Health & Diet Products



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