Elevated Cholesterol, Triglycerides & HbA1c
You get the dreaded lab results: high cholesterol, triglycerides, or HbA1c.
We all have busy lives. We don’t have time to change our daily eating habits or exercise. First, don’t get overwhelmed. Try to make one small goal at a time. One example is to replace one unhealthy food item (eg. sweets or deep fried foods) with one more nutritious food item (eg. fruits or baked lean protein).
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So, what are lipids? Lipids are the umbrella term for fats that include total cholesterol, LDL (low density lipoproteins), HDL (high density lipoproteins), and triglycerides. Cholesterols are necessary for the systems in our bodies to function, including the nervous system and immune system. Triglycerides are important too for energy storage and vitamin absorption. HDL cholesterol helps cleanse away LDL cholesterol. Unfortunately, extra lipids are not good for our bodies.
Why does it matter? Children with elevated cholesterol may have an increased risk of heart issues, such as atherosclerosis, which is the buildup of plaque inside the artery walls. This may lead to premature cardiovascular disease in adulthood. About one-half of children with abnormal total cholesterol and LDL levels continue to have elevated levels in adulthood!
When do we do a blood test? This depends on each child’s age and risk factors. One risk factor is obesity, defined by a child’s body mass index (BMI). But even youth with normal weight still can have abnormal lipid levels.
What are the causes of elevated total cholesterol and LDL? Excessive dietary intake of saturated and trans fats.
What causes elevated triglycerides? Excessive intake of refined carbohydrates and simple sugars.
Other causes include obesity, type 2 diabetes, hypothyroidism, and familial hypercholesterolemia. So if we screen during childhood, then we have the chance to intervene NOW. Check out this Healthy Children article for more information.
What about HbA1c? Hemoglobin A1c is the average of your child’s glucose level over the past 3 months. An elevated level at or over 6.5% is a marker for diabetes. Some kids fall into a borderline range, considered prediabetes.
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Make heart-healthy living a priority for the whole family.
Help decrease your child’s elevated total cholesterol, LDL, triglycerides level, HbA1c, or increase low HDL level by encouraging changes in everyone’s diet at home:
ENCOURAGE YOUR CHILD TO TRY:
Fibers
fruits
vegetables
whole grains
beans
chickpeas
lentils
peanuts
Polyunsaturated and monounsaturated fats
nontropical vegetable oils (Canola, olive, peanut, sunflower)
peanuts
tree nuts, flax, chia seeds, pumpkin seeds
avocado
tofu
edamame
cabbage
fortified eggs
seafood
low-fat dairy products
REDUCE AND AVOID:
Reduce Saturated fats
tropical vegetable oils (coconut oil, palm oil)
full-fat dairy products
reduced-fat dairy products
meat
Avoid trans fats
margarine
commercial baked goods
deep-fried foods
processed snacks (chips, crackers, microwave popcorn)
refrigerated dough
Children also with elevated triglycerides or elevated HbA1c should ALSO be encouraged to reduce certain types of carbs:
EAT HIGH AND COMPLEX CARBS:
whole wheat bread
non-starchy veggies (lettuce, cucumbers, broccoli, tomatoes, green beans)
small portions of starchy vegetables (corn, peas, small portions of potatoes), beans, fruits, dairy products
Choose healthy proteins such as skinless chicken trimmed of fat, fish, turkey, lean roast beef, beans, peas, lentils and nut
REDUCE REFINED CARBOHYDRATES AND SIMPLE SUGARS:
candies
cookies
baked goods
regular sodas
white bread
white pasta
crackers
sweet breakfast items
The confusing thing is that kids do need carbohydrates for energy as well. Check this Healthy Children article for more detail about the importance of nutritious carbs. For athletes who want to “carb load,” this is a separate discussion that is addressed in this Healthy Children article.
Read this Healthy Children article for more information about type 1 diabetes in children.
Talk to a registered dietician. If no improvement of total cholesterol or LDL levels, then consider restricting fat intake. (Do not restrict fat and cholesterol intake between 1-2 years old.)
Physical activity:
The AAP recommends DAILY vigorous physical activityat least 60 minutes for kids over age 6 years old.
Limit sedentary behavior - TV, videos, movies, video games, tablets, phones, social media. Go here for more information.
Address daily stress by taking time to relax and unwind.
Prioritize healthy sleep.
Resources: Summary of Healthy Children and UpToDate articles