Cholesterol in Kids: What Parents Must Know

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Meet the author

Dr. Vedala Ramakrishna is a highly accomplished medical professional and entrepreneur specializing in preventive diabetes care, medical research, and healthcare innovation. With an MBBS degree and numerous certifications, including diabetes prevention from RSSDI, stem cell technology from Biotecnika, and advanced training in 3D bioprinting from ACES TRICEP ANFF Materials (Australia), Dr. Ramakrishna brings a wealth of expertise to his practice.

A certified master trainer in Basic EMT by NSDC and a leader in infection prevention and control recognized by WHO, Dr. Ramakrishna also holds credentials in scientific and medical writing from ICMR-NIE. He is a permanent member and clinician of the CLINETHIC Independent Ethics Committee and serves as a consultant for healthcare projects.

As the Founder and Managing Director of Project Biogen Heart and Vedala’s Medical Vision Healthcare Services Private Limited (VMVHS), he leads initiatives in preventive healthcare, tissue engineering, and regenerative medicine, blending clinical expertise with innovative healthcare solutions.

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Introduction: Cholesterol in Kids

Humans have all experienced the teenage years, the young age when the mind runs free of hurdles, emotions, quotients, rituals, bonds, rules, and discipline.
Every teenaged child (boy/girl) would want to try new appetite mongers to percolate their taste buds and to inhale the aroma of great food, to envisage the upcoming times of food to be eaten at different restaurants, joints, cafeterias, roadside dhabas and more.
However, on the downside, teens may not know the dangers or problems they might encounter while having their taste buds satiated—the primary concern is CHOLESTEROL.

But before learning about cholesterol, let us try to understand and learn a few basics of it.
Usually, in a lipid profile investigation report, the significant things that anyone will notice are these:

1. Total cholesterol measures the overall level of cholesterol in the human blood. A level below 200 mg/dl is considered good.
2. LDL—This is commonly called “BAD CHOLESTEROL”—it may increase the risk of heart disease. A level of less than 100 mg/dl is considered good.
3. HDL – Commonly called “GOOD CHOLESTEROL.”” High levels of HDL may help reduce the risk of cardiac or heart disease. A level above 60 mg/dl is considered to be good.
4. Triglycerides – These in high levels may increase the risk of attaining heart disease. It is desirable to have a level below 150 mg/dl.
5. VLDL – High levels of this may increase the chances of heart problems.
6. Hyperlipidemia is a broad umbrella term that includes many conditions (pathological but not physiological) that cause high levels of lipids in the human blood. These include high cholesterol (high levels of LDL and total cholesterol), high levels of LDL cholesterol, and high triglycerides.
7. Dyslipidemia means there is a high amount of lipids (LDL, total cholesterol Triglycerides), way above the normal range, and a decrease of HDL lipids in the blood.
8. Hypercholesterolemia is when the total cholesterol level is above 200 mg/dL.

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Understanding Cholesterol Ratios and Their Importance Across Generations

Also, if noticed, several ratios can be calculated from a given lipid profile report, which tells or provides more additional information about a human’s cardiovascular health.

1) LDL/HDL Ratio—This ratio is usually calculated by dividing the LDL level by the HDL level. A calculated ratio below 3.5 is usually considered a good factor.
2) Total cholesterol/ HDL Ratio – You can calculate it by dividing the total cholesterol level by the HDL level. A ratio calculated below 4.5 is considered to be good.
3) Triglycerides/ HDL Ratio—This ratio is usually calculated by dividing the triglyceride level by the HDL level. A calculated ratio below 2 is considered to be good.
4) VLDL/LDL RATIO – this ratio is usually calculated by dividing VLDL LEVEL by LDL level. A calculated ratio below 0.3 is considered as good.
5)  ATHEROGENIC INDEX OF PLASMA (AIP) – This ratio is usually calculated using the logarithm of the triglyceride/HDL ratio. An AAP value calculated below 0.11 is considered to be good. (These ratios provide additional information to physicians or cardiovascular specialists).

NOW WHAT IS CHOLESTEROL, and should this era or generation alpha know about it? Why not!
Every generation since time immemorial has faced problems with CHOLESTEROL (Known or unknown), and even now, people face it –not just teens but tweens (adolescents), youth, adults, and veterans.

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CHOLESTEROL

Cholesterol is a wax or fat substance present in the human body, in blood, and in cells. Cholesterol is good in ample quantities that are found in the blood and in all cells of the body. It’s essential for good health because its usage is required for the proper functioning of cells, tissues, vitamins, body hormones, and also many acids that are useful for digestion.
The human body produces cholesterol, which is needed for sustenance and growth. At the same time, our bodies also need to consume cholesterol through food. Commonly, cholesterol is found in egg yolks, butter, cheese, dairy products, coconut-based foods, and foods like cakes, chocolates, and biscuits. Experts always recommend eating as little dietary cholesterol as possible.

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The Hidden Dangers of High Cholesterol in Kids

The body requires cholesterol to work in the correct order, but if the child has more cholesterol, it can or may occlude or narrow the child’s arteries and can clog.

Suppose a child has more Cholesterol (Hypercholesterolemia). In that case, it may cause heart-related problems (at a young age as well!!) and can be a hindrance towards the growth factor and substantiated yard pool of health. Because the risk of coronary artery disease (CAD) looms around very much sighted or far sighted, if the child’s cholesterol is unchecked or if ignored.

Why CAD is common at a young age and also in the early 40s because of excessive elevation of LIPID PROFILE and ALCOHOLIC FATTY LIVER – due to obesity, TYPE 2 DIABETES, and HYPERLIPIDEMIA – Altogether causing early CAD – which is absolutely difficult to reverse back, unless treated with strict diet regime and medication regime.

• 77 million people above the age of 18 years in India are Diabetic, and 25 million above the age of 18 in India are pre-diabetic. More than 100 million people in India are struggling with OBESITY.
• Data shows an estimated 17.9 million people to be have died from CVDs in 2016 – This CVD single-handedly represents 31 percent of all global deaths.
• Hypercholesterolemia is one type of dyslipidemia in which the lipid levels, or fats, are very high or abnormal in the blood.

If left untreated, then it can pave the way for cardiovascular diseases (CVDs), which include atherosclerosis, strokes, angina pectoris, and also peripheral arterial disease. Though people are being aware or made aware of this particular scenario through the immense propagation of public health medicine, childhood dyslipidemia has to gain much-needed attention. Parents should be prone to this particular disorder, and more importance must be given to it.

The primary causes of CHILDHOOD OBESITY in India include very poor dietary choices, physical inactivity, a highly sedentary lifestyle, and overconsumption of high-calorie-low nutrient diets – due to the high-level popularity of processed snacks and JUNK-FAST FOOD – which inadvertently cause OBESITY and WEIGHT GAIN.

“Foods such as bakery products, beverages, burgers, caffeinated drinks, noodles, pizzas, and sugar-sweetened drinks are the main causative factors of “CARDIOMETABOLIC RISK.”

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The Link Between Childhood Obesity and Cholesterol: Understanding the Risks

• In 2022, 6.9% of girls and 9.3% of boys globally were living with obesity.
• Obesity rates show significant variation across countries and regions.
• Global Obesity Rates: Pacific island countries report some of the highest obesity rates worldwide.
• World Obesity Day 2024 Statistics: Over 12.5 million children aged 5 to 19 years are overweight globally.
• Childhood Obesity in India: Obesity among children in India has increased significantly over the past 20 years, with 70% of the urban population being overweight.
• India’s Global Ranking: India ranks third globally in obesity, highlighting a critical public health issue.
• Health Risks of Excess Belly Fat: Belly fat acts as an inflammatory organ, contributing to conditions such as fatigue, Type 2 diabetes, and coronary artery disease (CAD). Read more data on https://www.obesityevidencehub.org.au/collections/trends/children-global-context

Obesity occurs when the body stores more calories as fat than it uses. When a person consumes a high amount of energy, typically found in foods rich in fats and sugars, without engaging in regular physical activity, the excess energy is stored as fat. The main symptoms of obesity include breathlessness, increased sweating, snoring, difficulty with physical activities, frequent tiredness, joint and back pain, low self-confidence and self-esteem, and feelings of isolation, among others.

Parents’ pampering is natural for any or every parent towards their children/kids (as the love of a parent is unconditional and a God-given gift), but total pampering without mindful awareness of what the child is eating may be a disturbance factor. Now, any parent(s) may wonder that while cholesterol affects adults, its effect is seen even in children.

Well, there is no surprising factor that cholesterol shows tremendous reservation and coherence even in children. Young children also pose a threat of having artery diseases by high cholesterol – and this may cause damaging conditions such as heart attacks or stroke if left untreated. Read about weight- loss at https://journals-times.com/2024/08/11/weight-loss-redefined-the-ayurvedic-approach-to-sustainable-fat-loss/

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Understand what lipoproteins are?

Lipoproteins are round-shaped particles made of fats (lipids) and proteins. These lipoproteins travel in the stream of blood and enter into cells. They also carry cholesterol and triglycerides into the cells. Lipoproteins are synthesized in the human liver and the human intestines, and they also arise from different metabolic changes based on functions and capabilities. Lipoproteins are classified depending on their mobility as they travel in the bloodstream and into the cells.
Cholesterol is marginated and differentiated based on what kind of lipoprotein it is attached to and which lipoprotein will carry it.
There are many subtypes, which are:-

• Low-density lipoprotein (LDL)

Cholesterol, carried by low-density lipoprotein (LDL), is a harmful or dangerous type. The reason is that this particular LDL carries cholesterol, which can accumulate in our arteries and form plaques. High levels of LDL cholesterol could be the cause of an increase in the risk of heart disease and stroke. Foods very high in LDL cholesterol are whole milk, butter, cheese, doughnuts, cakes, cookies, forms and forms of red meat, etc.

• High-density lipoprotein (HDL)

This lipoprotein is good for the human body as it carries cholesterol, which lessens the risk of heart disease or stroke. This HDL carries away the cholesterol from the blood back into the liver. The primary job of this HDL is to remove the fat molecules, like phospholipids, triglycerides, and cholesterol, from the body’s cells and transport them back to the liver so they can be broken down. Foods such as olive oil, avocado, whole grains, bran, brown rice, cereals, legumes, apples, raspberries, pistachios, almonds, chia seeds, one egg (yolk – which contains vitamin D, iron and carotenoids. Egg yolk can actually decrease atherosclerotic plaque size.

• Very low-density lipoprotein (VLDL)

VLDL is basically produced by the liver. VLDL particles substantially carry triglycerides, which is also one type of fat. VLDL contributes to the buildup of plaques in arteries. VLDL carries triglycerides, whereas LDL carries cholesterol. Foods that are high in sugar levels and alcohol content can increase VLDL levels. Foods such as red meat, butter, whole milk, cream, and fried foods can harm the body.

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Understanding Cholesterol in Kids: Causes, Testing, and the Importance of Awareness

• Prominent and profound research has shown that high cholesterol can also change arteries in young kids, and it may have an adverse conditional change.
• Every parent should be aware of lipid testing and encourage their children to incorporate it into their lives.
• Testing under the age of 2 is not advised. From the age of 2 to 8, testing is advised only if the child has any problematic outcomes, such as heart disorders, or if the child has risk factors like diabetes or obesity. Familial problems, such as diabetes and high blood pressure, may affect the child. Certain outside factors may also be included.
• A thorough lipid profile is advised by the age of 9 to 11. Testing during 12 to 16 is not required as it’s the pubertal phase, where a lot of changes occur internally and externally. But if any health conditions occur, testing is advised.
• By the age of 17 to 21, again, testing is necessary as lipid levels will stabilize by that time.
• It is also very important to test and understand the outcome. Ideally, LDL should be less than 130 mg/dL, which is good. HDL greater than 60 mg/dL may not be appropriate for the child’s health condition.
• Now, the most uncommonly or commonly asked question is what causes high cholesterol. The answer lies all around us, but we may not have had the vision, foresight, or hindsight to notice it.

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Common Causes of High Cholesterol in Kids and How to Address It

1. Diet: Eating a diet high in saturated fats or trans fats can be harmful to health. Both types of fats are very dangerous and unhealthy for the human body. Saturated fats primarily come from animal sources, which include meat and dairy products. It’s important to be mindful of the intake of these fats to maintain overall health.
2. Heredity: Ancestral heritage or familial members with high cholesterol may be another leading factor.
3. Obesity: Not having any physical activity and poor diet, which is comprised of eating unhealthy food, are major factors.

The major onus is on knowing how to control or lower cholesterol. Again, the answer lies in awareness and acknowledgment.
Parents should be aware of what to eat and what not to eat. Henceforth, parents should be the first in line to check their health, cholesterol, and wholesome health levels and diagnoses before embarking on their kids’ health and safety.

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The main viewpoints for preventing cholesterol in the children

1. Eating a stomach-heart-liver healthy diet, which includes – a) every green leafy vegetable – given by god to us (which we have to acknowledge and pray sometimes, at all times!!) As a parent, the primary duty is to teach and incorporate awareness about food habits and the dangers of eating JUNK FOOD, which harms and affects the liver, causing NON-ALCOHOLIC FATTY LIVER (leading to PANCREATITIS), which is nowadays very common in teenagers. THIS ASPECT IS VERY DIFFICULT TO REVERSE BACK TO NORMALCY.
2. Associated with junk food, teenagers, adolescents, and adults are also addicted and habituated to alcoholic and acidic beverages – which cause damage to the stomach and intestines  (which causes H.PYLORI infection, which DAMAGES the lumen of STOMACH and INTESTINES – where there is bloating of gases) and liver. Foods made from recycled oil cause elevated cholesterol and triglycerides. A lipid and liver profile runs parallel to each other in knowing the health status of a teenager or an adult, whereas SGOT/SGPT and Serum Alkaline Phosphatase run parallel as well.
3. A whole-meal bread and chapattis, brown rice, whole-meal, wholegrain breakfast cereals. Whole grains comprising oatmeal are a good option. It takes the filling mantle to another level in the stomach and also cuts down the LDL cholesterol. You can try for popcorn, brown rice, and barley.
4. Eating a stomach and mouthwatering servings of fruits. Eat at least 5 portions of a fruit and a vegetable a day. Antioxidants in fruits and vegetables have the immense benefit of having great fiber and also keeping the blood pressure low.
5. Eating limited and needed whole grains. Try to include wholegrain starchy food during a meal.
6. Non-vegetarian food lovers may eat lean meats along with poultry, and fish (Sea food). Eating fish twice a week is good for non-vegetarian lovers as it’s a very good source of proteins and also omega-3, which actually helps in lowering triglycerides in the human body. 
7. Consumption of very low-fat milk or non-fat dairy products.
8. Consumption of healthy fats, which are found in vegetable oils and also in nuts.
9. Totally cut off or limit drinks to a very low size and also sugar-added foods.
10. Teenagers should be aware by burdening themselves with bulky musculature is not at all good for their body. Excessive consumption of fats and proteins for building their body is not safe as it may have adverse effects and cause an untoward action on heart musculature.

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Other things to follow

• Make yourself and your family aware of what you are eating, know the ingredients, facts, statistics, and labels about different cholesterol foods, such as saturated and trans fats, and lessen your cholesterol intake.
• Advice, follow, encourage, push, inspire, get inspired, and acknowledge physical activity—primarily brisk/power/fast walking. Include a lot of aerobics (within home/outside/anywhere in this world). Every adult and teen should be physically prone to being more proactive for at least an hour, and it helps more than that.
• Maintain a consistent weight for yourself and your kids and follow hand, body, and food hygiene.
• Try to include unsaturated fats in the diet, usually found in canola or safflower oils. These fats lower LDL levels.
• Eating whole grains like brown rice or whole wheat is a good idea. These foods usually have high fiber and do not raise blood sugar levels. They actually lower cholesterol levels and make your tummy feel full and yummy.
• Try to be more active as a family unit. Remember that kids follow what parents do, so inspire them to be healthy, active, hygienic, and clean, have a good bodily odor and dental odor, and, more importantly, be good human beings.
• Inspire and encourage your kids to join sports or any physical activity.
• Limit mobile or screen presence to no more than 2 or 3 hours.

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Chindull Mantra

Adults and kids should know the “CHINDULL mantra” (chillin’ life and dulling stress). This mantra serves a mindful meditation purpose in life, where we all chill as a family about life and dull stress out of our lives—which actually makes us humans more energetic and proactive and makes us the ones with high-stridden personalities in reality.

This serves another purpose of reducing blood pressure, controlling human emotions, and making ourselves a better and more attestable being.

Try to follow this mantra and prioritize it. Also, include meditation, yoga (if possible), and singing “Alaaps.” Singing is a stress buster in every way possible. So even if your voice doesn’t sound like a singing professional, do sing. IT HELPS!!!

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Treatment point of sub-view

• As such usually, statins are the medication of choice for high LDL in adults, and also these are gaining popularity amongst children.
• The safest statins for children usually are: Pravastatin, as such, is one medication that is approved for children of 8 years having familial hypercholesterolemia; Rosuvastatin is approved for children of 7 years.
• Subsequently, atorvastatin, lovastatin, simvastatin, and fluvastatin are approved for children 10 years old with hypercholesterolemia.
• Fenofibrate is also used to lower LDL Cholesterol and increase HDL cholesterol.
• Ezetimibe is also used to lower the LDL cholesterol.

SOPs of good FAT-FREE HEALTH

Now, if we were to write down or jot down a few standard operating procedures or PROTOCOLS (SOPs) as such for good health for centuries to come, we have to go to our roots and branches to say. Not that these are unknown to people (Adults especially) all over the world, but to make them aware of what they already know, and so goes for their children.

Healthy Lifestyle Tips for Families

1. Hygiene Practices:
   • Wash your hands and your children’s hands with soap regularly.
   • Teach and maintain proper dental hygiene by brushing teeth twice daily.
   • Bathe regularly (up to thrice daily if needed) and emphasize bodily cleanliness.
2. Focus on Health:
   • Improve your family’s heart, mind, liver, kidney, and gut health through daily care and attention.
   • Prioritize homemade meals over outside food to ensure nutritious and safe eating.
   • Ensure your family gets at least 7 hours of good sleep nightly.
   • Stay hydrated by drinking plenty of water and encouraging kids to do the same.
   • Quit smoking and drinking alcohol—completely—and teach kids the importance of healthy habits.
3. Physical and Mental Well-being:
   • Go for daily walks as a family and encourage children to stay active.
   • Explore nature together by visiting fields and paying attention to plants and the environment.
   • Reduce screen time and increase offline activities.
   • Practice gratitude daily as a family, and pray or meditate together.
4. Strengthen Relationships:
   • Stay in touch with family and friends daily, not just occasionally.
   • Help your children build relationships with their peers and develop a strong social network.
   • Be proactive as a family in your work, community, and society.
5. Encourage Positivity and Growth:
   • Instill a positive mental outlook in your children and help them manifest their aspirations.
   • Inspire your kids through your hard work and motivate them to learn from experiences.
   • Involve them in meaningful tasks like washing dishes, cleaning, and arranging the home to teach responsibility and physical activity.
6. Family Bonding:
   • Take care of your children’s skin, hair, and overall body health.
   • Laugh, smile, and share happiness as a family—it costs nothing but brings joy to everyone.
   • Build a happy and supportive environment at home.
7. Preventive Care:
   • Focus on preventive health measures like routine check-ups and a clean environment.
   • Always be mindful of your health and your children’s health and life choices.

By following these steps, you create a balanced, happy, and healthy family life filled with positivity and strong connections. Remember, happiness is contagious—spread it freely!

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