You've heard it a thousand times over: Kids today are too fat; they don't exercise; they play too many video games. Earlier this week the American Academy of Pediatrics released new guidelines stating that children as young as 2 may need a cholesterol test, and it sparked quite a controversy by saying that even in elementary school, some kids need a statin prescription. But it's important for families to know that most kids with high cholesterol can avoid medications. Only if a child has very high lipid levels because of an inherited disease, like familial hyperlipidemia, will a drug probably be in order; just 1 percent of kids probably qualify. "Those children can exercise and diet all they want, and it's really not going to change all that much," says Jennifer Li, pediatric cardiologist at Duke University Medical Center.
Assuming a child does not have a genetic predisposition to high cholesterol, the answer rests in that familiar doctor's order: lifestyle modification. So parents be warned; you'll need to dig deep on this one—and you might just shed pounds and improve your own cholesterol readings in the process. Li's prescription for helping families bring down a child's high cholesterol:
Move together. Slip into your sneakers, and prepare to sweat for at least 30 minutes a day. Younger children need the family support, Li says, or an exercise program is not going to be successful. Get their heart rate up with aerobic exercises like soccer, basketball, swimming laps, hiking, and running.
Shop and cook with a purpose. Ditch junk food, and cut out the sweetened beverages, including sports drinks; incorporate more fruits and veggies, and add more fiber into their diets—and yours. The new guidelines call for switching to low-fat milk at age 1.
Slow down, and supervise eating. Avoid catching your meals on the run—and don't let your children grab and go, either. Try to eat meals together as a family. If midday hunger is a challenge, offer fruits and vegetables.
Limit the screen time. The average child gets six hours of screen time a day, but television and video games should be the reward for moving around, says Li, not a foregone conclusion. And sorry, but Li doesn't think Nintendo Wii, the video game that requires some physical activity, does the job.
Learn the numbers. For a kick in the pants, get the whole family's blood pressure, cholesterol, and blood sugar tested. Abnormal lab tests help establish attainable targets for everyone, and a support network is crucial to success.
Consider a formal weight-loss plan. Programs for youth that involve exercise, getting weighed, and nutritional or psychological counseling can provide an extra layer of support and motivation. Nearly all academic centers have such programs, but YMCAs and other community centers typically have options, too, says Li.