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Cholesterol, Treating High Levels: Teen Version

What causes high cholesterol?

Cholesterol levels in teens are linked to diet, being overweight, or having a parent with high cholesterol.

Why should I treat high cholesterol?

If your cholesterol level is high or borderline high, start this treatment program. If your cholesterol level is normal, it is still a good idea for your whole family to follow these recommendations.

High cholesterol is not the only risk factor for coronary heart disease. Other risk factors are just as harmful: physical inactivity, obesity, and smoking. The more risk factors that you have, the higher your risk of heart disease. Living a long and healthy life requires healthy eating and regular exercise. It is easier to start these habits as a teenager than to have to adopt them as an adult. If you follow most of these recommendations, you are protecting your heart and blood vessels.

How can I take care of myself?

  • Low-fat diet

    The American Heart Association recommends a low-cholesterol, low saturated-fat diet for all adults and children over 1 year of age.

    Eating foods that contain cholesterol raises our blood cholesterol levels. Foods that come from plants, such as fruits, vegetables, and grains, do not contain cholesterol. Foods that come from animals, such as meats, eggs, and milk products, do contain cholesterol.

    Eating saturated fats also raises blood cholesterol levels because fat causes our bodies to make more cholesterol. Even if we don’t eat any fat, the liver produces a small amount of cholesterol each day. Therefore, we will always have some cholesterol in our blood.

    Currently, most Americans get 40% of their daily calories from fat. However, in a healthy diet no more than 30% of the total calories should come from fat. The goal is to eat fat in moderation. You do not have to eliminate fat from your diet entirely. Lower the amount of fat you eat so that fat provides no more than 30% of your daily calories.

    Eating a low-fat diet will help lower your cholesterol level and is rather easy:

    • Eat more fish, turkey, and chicken because these meats have less fat than red meats. Buy lean ground beef or ground turkey for hamburgers. Use lean ham or turkey for sandwiches. Make sandwiches with whole-grain bread. Low-fat cheese can be added.
    • Trim the fat from meat and remove the skin from poultry before you eat it.
    • Avoid eating meats with the highest fat content, such as bacon, sausages, salami, pepperoni, and hot dogs.
    • Limit the number of eggs you eat to 3 or 4 eggs a week.
    • Limit all meats to moderately sized portions.
    • Use 1% or skim (0.5%) milk instead of 2% or whole milk (which is 3.5% fat).
    • Use a margarine product (vegetable oil spread without trans fats) instead of butter.
    • Avoid any food fried in butter or fat. Bake or grill foods instead of frying them. If you prefer fried foods, use special margarine or nonstick cooking sprays.
    • Increase the amount of fiber you eat. Most grains, vegetables, and fruits are good sources of fiber.
    • Choose healthy snacks such as fruits, raw vegetables, and plain unsalted popcorn or pretzels instead of cookies and crackers. Other good snacks are apple slices with peanut butter, orange slices, fruit stirred into nonfat yogurt, juice bars, or low-fat chips.
    • Drink more water and low-fat milk. Avoid soft drinks that have a lot of calories.
  • Family exercise program

    Exercise is the best way to raise the level of HDL (the “good” cholesterol) in your blood. Your goal should be at least 30 minutes of vigorous (aerobic) exercise 3 or more times each week. For exercise to be vigorous it must involve the large muscles of the legs and cause your heart to beat faster. Vigorous exercise also improves your heart’s response to work.

    Try the following forms of exercise:

    • Walk or bike instead of riding in a car.
    • Use stairs instead of elevators.
    • Join a team or learn a new sport (for example, roller skating) that requires vigorous exercise. Swimming and jogging are sports that burn lots of calories. Some sports, such as baseball and football, don’t exercise the heart.
    • Exercise to a video tape or music on TV.
    • Use an exercise bike, dance, or run in place while you watch TV.
    • Limit your TV time to 2 hours or less a day. Sitting activities interfere with physical fitness.
  • Ideal body weight

    People who are overweight tend to have a low HDL and a high LDL, which is the opposite of what is good for them. Achieving an ideal body weight will improve your blood cholesterol levels.

    Fat has twice as many calories as the same amount of protein or carbohydrates. When a person eats less fat each day, he automatically gets less calories from his food each day. A low-fat diet AND exercise are the key ingredients for losing weight.

  • Smoking

    If you are a smoker, a good way to raise your HDL level is to stop smoking.

  • Medicines

    The American Academy of Pediatrics recommends that some teens under 18 years of age should take medicine to lower LDL (bad) cholesterol.

    Medicines may be helpful if you have:

    • Very high LDL (bad) cholesterol levels
    • A parent with early heart disease
    • Diabetes

    Other things that affect whether medicine might be needed to control cholesterol are:

    • Smoking
    • Physical activity
    • Blood pressure
    • Good cholesterol levels

    Your healthcare provider may refer you to a heart specialist to help decide if medicine is right for you.

  • Additional help

    If your level of cholesterol remains high even though you follow these treatment recommendations, talk with a nutritionist about special diets. Also, join an exercise program at a local gym or fitness center. These additional steps will usually help you. If changes in diet and exercise do not lower cholesterol, you may need to take medicine.

When should my cholesterol be rechecked?

Generally, if you have high cholesterol (above the 95th percentile), your cholesterol level is checked again about 2 to 4 months after you start a program to lower it. If the cholesterol level is borderline high (above the 75th percentile), it is usually checked yearly.

Written by Barton D. Schmitt, MD, author of “My Child Is Sick,” American Academy of Pediatrics Books.
Pediatric Advisor 2015.1 published by RelayHealth.
Last modified: 2012-05-21
Last reviewed: 2014-06-10
This content is reviewed periodically and is subject to change as new health information becomes available. The information is intended to inform and educate and is not a replacement for medical evaluation, advice, diagnosis or treatment by a healthcare professional.
Copyright ©1986-2015 Barton D. Schmitt, MD. All rights reserved.

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