Ask the Dietitian
By Althea Zanecosky, MS, RD, LDN
Mid-Atlantic Dairy Association
September 2008
Q: I just heard that the American Academy of Pediatrics said it’s OK to give adult cholesterol medication to children. Isn’t diet and exercise the best way to promote heart health?
A: The American Academy of Pediatrics (AAP) recently updated its cholesterol guidelines and, when first released, many parents found them shocking. That was because the media spotlighted the new guideline stating that children as young as 8 can be given cholesterol-lowering drugs to prevent future heart problems. But the major change from the AAP 1992 guidelines is that this time, the Academy is not just recommending screening for children who have a family history of cardiovascular disease or other similar risk factors – it is also recommending screening for children who are overweight. Here are a few questions parents may need to ask to better understand how to keep their children’s heart healthy:
Isn’t heart disease just in adults?
With 10 years of new data about risk factors for cardiovascular disease, the American Academy of Pediatrics guidelines point out that atherosclerosis - the hardening of the arteries that leads to heart disease - begins in childhood. That’s why it’s important to know your child’s cholesterol level. Cholesterol levels in childhood are lower than in adulthood. A cholesterol level greater than 200 mg/dL is considered to be too high in a child 2 to 18 years of age. But a full lipid panel test with LDL ("bad") and HDL ("good") cholesterol is recommended since LDL clogs the arteries, whereas HDL prevents the clogging.
Will children now take cholesterol medication like adults do?
The real center of attention is on the need to monitor overweight children’s cholesterol levels. The updated AAP strategy directs interest to the importance of diet and exercise, with only a small number of children having cholesterol levels high enough to warrant cholesterol-lowering medication. The vast majority of children will never pop a pill to lower cholesterol. Losing excess weight, which requires lowering calories and fat consumption, and increasing exercise is the most successful strategy for lowering cholesterol.
If weight can be a risk factor for heart disease, how do I know if my child is overweight?
Overweight children have a Body Mass Index (BMI) that falls within the 85th to 95th percentiles. BMI is a statistical measure of a person’s weight scaled according to height. Unlike adults, whose BMI is classified in relation to specific cut-off points, children are classified using pediatric growth charts that compare their BMI with that of other kids of the same sex and age. This type of measurement takes into consideration that children are still growing and developing.
What is a heart healthy diet for kids?
The AAP report reemphasized that all children older than 2 years should be following the Dietary Guidelines for Americans. This includes lowfat (1%) and fat-free milk and dairy products, whole grains, lean meats, and ample fruits and vegetables. Kids as young as 1 year – according to the new guidelines and with their pediatrician’s recommendation – can stop drinking whole milk and start drinking reduced fat (2%) milk.
National Dairy Council (NDC) is working in partnership with the American Academy of Pediatrics to educate parents with children of different ages and health circumstances how to choose the milk products best for them. Visit NDC here.
For more information:
American Heart Association’s dietary recommendations for infants, children and adolescents to promote cardiovascular health:
American Academy of Pediatrics’ report “Lipid Screening and Cardiovascular Health in Childhood”Do you have a dairy-related question for “Ask the Dietitian?”
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