AAP Takes Aim at Cholesterol in Kids

You think of high cholesterol and a young child doesn't come to mind — more like a grown-up fighting the urge to eat that double cheeseburger. But now, in the wake of the ongoing childhood obesity epidemic and rising diabetes rates among kids, the American Academy of Pediatrics (AAP) says tracking youngsters' cholesterol levels at an early age — and treating those that are unhealthy — may help fend off future heart disease, the No. 1 killer of both men and women.

According to the AAP, current research shows that the stage for adult heart disease (also known as cardiovascular disease) is set early on. So, the organization is changing its 10-year-old policy on cholesterol and urging:

• cholesterol-reducing drugs for children as young as 8 with unhealthy cholesterol levels, high blood pressure, or excess weight. Before, the AAP had advised cholesterol-combating drugs for kids 10 and up who hadn't responded to weight-loss attempts.
• cholesterol screening at routine checkups after age 2 and no later than 10 for at-risk kids; that is, only those who are overweight or obese, or have diabetes, high blood pressure, a family history of cholesterol problems or heart attacks at a young age, or an unknown family medical history.
• low-fat milk, instead of whole, starting at 12 months old for tots who are at risk for weight or cholesterol issues (previously, the AAP didn't recommend low-fat or skim milk for these kids until after 24 months of age). Whole milk was considered the go-to beverage for kids come their first birthday, since it provides toddlers with the fat they need for brain growth and development. But now, many toddlers are getting enough extra fat from plenty of other sources, which means kids don't require — and won't be negatively affected if they don't get — the high fat and cholesterol content of whole milk.

Clarifying Cholesterol

A lipid (or fat) made by the liver, cholesterol is one thing we actually don't need to get from any foods at all.That's because the liver produces enough of the waxy substance on its own for the body to function just fine — to build cell walls and form some hormones and tissues. All other added cholesterol comes from the foods we eat like animal fats, hydrogenated oils, egg yolks, and whole-milk dairy products.

But cholesterol doesn't move through the body by itself. It has to combine with proteins to travel through the bloodstream to where it's needed. Cholesterol and protein traveling together are called lipoproteins. The two kinds that are the most important are:

• low-density lipoproteins (LDL), sometimes called "bad cholesterol" — think low-density for "lousy." These are the primary cholesterol carriers. If there's too much LDL in the bloodstream, it can build up on the walls of the arteries that lead to the heart and the brain, forming plaque (a thick, hard substance that can cause blood vessels to become stiffer, narrower, or blocked). If a blood clot forms and gets jammed in a clogged artery, a heart attack or a stroke could follow.
• high-density lipoproteins (HDL), sometimes called "good cholesterol" — think high-density for "happy, healthy, or hard-working." These move cholesterol away from the arteries and back to the liver, where it's processed and sent out of the body.

Here's where understanding cholesterol levels gets a little tricky, though: High levels of LDL (the "bad" cholesterol) increase the risk for heart disease and stroke. But high levels of HDL (the "good" cholesterol) can offset that risk and actually help protect your circulatory system.