HomeHealthArchivesDec 2005

 

Cholesterol and Children

Most people equate cholesterol problems and heart attacks with those of us from middle age and up. While the effects of eating fat and cholesterol will most likely manifest themselves in that age group, the eating patterns causing the problem start much earlier. It has been estimated that eighty percent of children eat more fat than that recommended by the American Heart Association, and that by the age of twenty 70% of us have some coronary heart disease.

Children need some fat in their diet and their metabolism is usually able to handle a slight overload. But unfortunately they are learning habits that make them the next generation of heart attack victims. A good diet and excellent health in the early years is critical to preventing major medical problems later in life. After all, the body is too complicated as it is, with so many cells, tissues, and organs that can become diseased. It needs all the help it can get.

You probably feel you're taking every steps necessary to protect your children. But you could be falling short of real long term protection. Let's face it, many heart attacks aren't from problems developed just a week before. 

Even the American Academy of Pediatrics recommends that cholesterol levels be checked in children over two years old, if your family has a history of heart attacks. In fact, the recommended levels of serum cholesterol for children are lower than those for adults.

Could this be a typical meal for the active teenager on the go:

     Breakfast: Breakfast sandwich and soda
                   Calories    355
                   Fat             24
                   Cholesterol 249

     Lunch:  Vanilla Shake, Large Hamburger, Fries
                   Calories    1255
                   Fat                66
                   Cholesterol  123

     Dinner:  Chocolate Shake, Fries, Roast Beef Sandwich
                   Calories    1078
                   Fat                43
                   Cholesterol   95 

     Daily Totals:

                   Calories    2688
                   Fat              133
                   Cholesterol  467

                  45% of the calories derived from fat

This doesn't even include any snacks, such as sharing a bag of potato chips or cookies with a friend or sibling.

Less than two ounces of chocolate coated peanuts, as you'd find in a single-serving package, contains 13 grams of fat, 44% of calories. A Baby Ruth candy bar has 6 grams of fat (41%); one ounce of cheese balls, 11 grams (62%); and six sandwich cookies, 14 grams (40%). Nine Hershey kisses have 13 grams of fat (53%), or two chocolate and peanut butters snacks, 17 grams (55%).

Okay, so they don't eat out. But since they're finicky, and you're busy, you don't serve them the same low-fat, low-cholesterol food you eat.

Well, one serving of prepared instant mashed potatoes may contain up to 7 grams of fat -- 45% of calories, more than the average fast food serving. That slice of prepared cake mix may contain 14 grams of fat (47%), or that quick microwave cake with icing, 17 grams (51%).

Have just enough time to open up that can of "chunky-type" soup? Depending on the brand and variety, one serve can have up to 26 grams of fat, 73% of calories!

The fried foods, cookies, and junk food that children consume are developing their tastes -- for fat, cholesterol, sugar, and salt. While they might not be in any immediate danger, how many of these active children will continue eating the same way as more sedentary adults? Will puberty automatically change their tastes from hamburger to tofu, from fries to fruit?

Our children eat too much fat, sugar, salt. (We knew a young lady who ate pickles and BBQ chips for breakfast every morning through high school, and by her senior year was on medication for dangerously high blood pressure.) They don't exercise enough to burn their calories and control their weight. They are asking for heart problems and high blood pressure. And some parents are doing nothing to help.

Don't expect must help from outsiders. In the last decade, hamburger franchises nearly doubled (a new McDonald's opened every 17 hours), and pizza stores multiplied almost 6 times. Childhood obesity have increased by 40%.

What alternatives can you offer your children? Can there really be a more important issue?

Providing low-fat low-cholesterol food at home is only half the answer. As children get older, they'll eat more of their meals away from home; first at school, then at friend's homes, then at restaurants. So our strategy must attack each of these areas.

At least they're eating nutritious school lunches. Right? Better think again. Many of our school lunch programs use government supplied surplus food -- such as fat-rich cheese, whole milk, and high-fat meat. Many more pander to the student's taste for fried food and hamburgers, selling candy and ice cream to help support other school activities. In some schools, few students eat the meal that was carefully designed by the nutritionist.

This is where you have to take an active role. Talk to the school nutritionist, nurse, and health education teacher. In the younger grades, ask the teacher to include nutrition in the curriculum, or suggest speakers be invited -- for lower grades, traveling puppet shows are often available. Work with the parent's association, such as the PTA, in making nutrition education a part of the school's overall goals.

How about the school's physical education program? Are there exercise classes? Do thesports activities provide enough and well varied exercises? Playing baseball could be doing nothing if your child just stands out in left field.

Have the same conversation at your child's religious school or summer camp.

But there is only so much others can do for your child. You have the ultimate responsibility for their welfare.

When you leave your children with babysitters, or when older by themselves, what food do you leave in the house? Is it high fat prepared food or extra servings of something nutritious that you made yourself? Letting them eat high-fat foods when you're not at home sends mixed signals. Why not make extra and freeze portions of meals and desserts. If you have a microwave, leave the babysitter instructions for preparing it, or teach your older children.

But since you can't watch them all the time, then you have to transfer some of this responsibility directly to them.

First, consider the forces working against you. Chances are, not every parent in the neighborhood is concerned about fat and cholesterol. So your child will be subject to peer pressure when  playing with friends or on dates. But perhaps the greatest pressure imposed on children in through television and television advertising.

How many teenager-oriented shows depict the local hamburger shop as the hang-out? Shakes, fries, and burgers are portrayed as the ideal diet. Shows aimed at younger children, however, are even worse because of the high concentration of junk food advertising. Most, if not all, of the food products advertised are high in sugar and fat. Just look at the major non-toy advertisers: cereal and snack companies, and fast food chains.

Let's face it, sugar and chocolate-coated cereals in the shape of animals and comic characters are not designed for parents. Yet, in one year over 100 new cereals and 1,400 new snack items may hit the market.

The message children learn from these commercials is that a fun-looking product is good to eat. The music, color, graphics, and gags say nothing about nutrition, just the taste. More than anything, the advertisements are designed to imprint the product on children's minds so they, in turn, pressure you into purchasing it.

Granted, the awareness of the public toward sugar content has grown dramatically. So much so, that many products have reduced sugar content. While this appears good, it has lulled parents into a false sense of health security. They look at the label for sugar content and seeing it is reduced, feel confident about the purchase. But now equal awareness is needed of fat and cholesterol content.

These forces working against you -- peer pressure and advertising -- are formidable enemies.  So you have to retaliate with the strongest weapon you have, education.

Teach your children, starting as early as possible, about the importance of healthy eating.  Teach your children the difference between good and bad food, along with the difference between good and evil. Try to develop their tastes toward more healthy eating, preparing them for the day when their bodies might not deal so lightly with fat and cholesterol.

Many of the recipes presented in this book are aimed at providing tasty, sweet treats of a more healthy composition. Use the techniques presented for your child's favorites, and nobody will notice the difference. For example, I recently made a batch of low-fat, low-cholesterol chocolate chip cookies, modifying a recipe found on the bag of chocolate chips. I threw away the egg yolks and replaced the volume with a tablespoon of cooked oatmeal. Over a period of time, and substituting a low-fat margarine for shortening, I finally cut the margarine to half the suggested amount, adding a tablespoon of good olive oil.  I used half of the suggested chocolate chips, sometimes substituting white chocolate pieces or sweetened carob chips. The result was a one gram of fat cookie (compared to 2, 3, or even 4 in prepared brands) that never drew a word of complaint from hungry children and friends.

But as with adults, scare tactics, force, and punishment will not work. Some flexibility and understanding is necessary. 

Start by explaining, in simple terms, that too much fat is not good. Don't strive for perfection or for the degree of self-control you expect from yourself. Look for a library book that deals with the subject from a youngster's viewpoint, or ask your local Public Broadcasting Station if they plan to air a show on the subject.  Several excellent ones have been produced.

Make a game out of interpreting television advertisements and product labels. Have them make a list of items that look good on television, then study the labels in the market. Let them see how commercials can deceive and how to make education, informed judgements about that they buy and eat. Give them a small reward if they find the item containing the least fat or no tropical oils. Have them write a letter to a manufacturer asking for product information or requesting they reduce the fat type or content. Or, have them prepare a scrapbook of labels that they might be able to use for a school project.

In addition, make sure they exercise or perform some activity that involves body movement.  While sports are excellent, some tend to concentrate on specific areas of the body, or don't really provide the aerobic benefits we assume. Get them involved in something they can also practice around the house -- dancing, bicycling, tae kwon do, skating.

We know a young lady who volunteered at the local hospital. She won recognition for the hours she worked and her parents were glad for the exercise she got walking around the hospital.  If she worked over four hours in a day, the hospital provided $2.50 credit in the cafeteria. But instead of eating healthy, she used the credit to purchase four ice cream snacks every time she volunteered.

If possible, get them away from the television, especially if they watch with dangerous company -- a bag of snacks. It's easy to understand why a study at John Hopkins School of Medicine revealed that 33% of children tested had high cholesterol values.

How do you handle resistance to change?  You might gently show children people who have had strokes or heart attacks. Let them talk and spend a little time together, discussing how poor health can drastically change a lifestyle. You might also have to show them more graphic examples of heart disease and arterioloscleroses. A recent PBS film showed vividly the process

of lesions forming, reducing blood flow, and finally a complete stoppage and stroke. The film began with an overweight man eating an extremely high-fat meal, including lamb chops and whipped cream desserts. Then, the camera panned inside the man, showing the arteries in the brain growing narrow until exploding blood.

This general awareness, however, must be met with practical examples and alternatives, and compromises.

Don't try to eliminate everything at once. It's okay if you're daughter has a special lunch out that includes high-fat fast food, like a hamburger weighing in at over 30 grams of fat. She just shouldn't follow it later that night with a malt or high- cholesterol dinner. Your son doesn't have to prefer greens to ice cream, as long as he understands that certain items should be eaten in moderation, or for special occasions.

Concentrate on teaching your children the art of trade-off as we've talked about in this book. Get them to look for alternatives themselves, such as making a milkshake with non-fat frozen yogurt instead of ice cream, or eating fruit to compensate for a snack earlier in the day.

If candy is a must, let them have only a portion of the bar. Show them the math that calculates percentages of fat. For example, the recommended serving of one filled chocolate bar is less than three squares, totalling seven grams of fat. Strive for half of that, but be happy if your child doesn't eat the entire bar at once -- 35 grams of fat!

Can we expect our children to count fat and cholesterol with the same diligence as we adults?  Probably not. But, we can make them aware of the problem. We can start turning their taste and attitudes toward the correct path.

We expect them to be health conscious in every other way. We teach them to avoid accidents, stay away from trouble, apply common sense and good values to decisions. We try to pass along our values and beliefs. It should be no different when it comes to eating.

It may be difficult. So, keep these major points in mind:

    Start as early as you can. A child's tastes may shift over the years, but the pattern is set in the earliest years. If you begin early enough, heathy eating habits will become the standard, not a new regime inflicted by adults following a new fad.

    Avoid, if at all possible, "their's" versus "my" meals". Don't give into pressure from any member of the family.

    Be flexible. Understand the impact of peer pressure and strive for a system of trade-offs and compromises.

    Be alert for all potential problems -- fat, sugar, and salt.

    Get your children involved in physical activity, competitive or otherwise. Limit television and video game privileges, if you have to.

    Use the time you spend calculating fat and cholesterol values as quality time with the children. Let them help you look up values, or find labels. Not only will it improve their eating habits but their math skills as well.


Coronary heart disease starts in childhood. The pain, suffering, and cost, however, can be reduced or eliminated is we start teaching our children. Don't wait for your child to decide if they like fruits and vegetables. A poor diet will start to have its effect immediately, mentally and physically, leaving life-long scars.