Almost every adult, and probably most school aged children, have heard about how bad cholesterol and fats are. Cholesterol is not fundamentally evil as it is vital for healthy life. When fats are broken down in the body they join cholesterol and proteins to make new molecules called lipoproteins which travel through the bloodstream. Lipoproteins are mainly two types, low-density and high-density. The low-density is “bad” as they tend to form plaques in the wall of blood vessels.
Cholesterol and fats are the main fuel for the body and are stored and used in different ways. Cholesterol is found in every cell in the human body and keeps our cells working smoothly. Cholesterol also supports the production of hormones and vitamins. So the trick is to maintain a healthy level.
Many parents think of cholesterol as a health concern that only affects adults. Unfortunately this isn’t true. About 1 in 250 children have high cholesterol levels that aren’t related to diet, exercise or lifestyle but a problem in their genetic code. The most common form is called heterozygous (one gene is abnormal and the other is a normal) familial hypercholesterolemia. The good news is if identified and treated the risk can be reduced by 80%. Rarely the child can inherit the malfunctioning gene from both parents and need immediate treatment.
It is important that the child’s pediatrician know if the parent, grandparent, aunt or uncle suffer from early (below age 55 for males and 65 for females) heart attacks. Your pediatrician can decide how early to test cholesterol levels. The American Academy of Pediatrics recommends screening between 9 and 11 with no known risk factors.
The other problem with fats in children is fatty liver disease. This is when triglycerides, a specific kind of fat, build up in the liver. Over time this can lead to liver damage. Fatty liver disease has become much more common in children and teens. It is now the most frequent cause of liver disease worldwide.
Risk factors for fatty liver disease are as follows: a BMI over 85%, central obesity, type 2 diabetes, abnormal levels of blood lipids, including cholesterol and other fat-like substances, sleep apnea, family history of fatty liver disease. Fatty liver disease usually is part of a metabolic syndrome which is associated with insulin resistance, high blood pressure, high triglycerides, and obesity. Some females have irregular menstrual periods.
Fatty liver disease usually has no symptoms. Occasionally children may complain of pain in the upper-right abdomen. Diagnosis is done with blood tests, an ultrasound and possibly, a liver biopsy.
Surprise!! The treatment is that is best is lifestyle change: cutting back on processed sugars and fats and increasing daily exercise. If fatty liver is not treated it can lead to scarring and eventually to liver failure. It is the most common cause of liver transplants in adults.