We’ve long known that cardiovascular problems begin at a young age. This fact was recently highlighted when the American Academy of Pediatrics released new guidelines on preventing heart disease. Its clinical report suggests parents have their at-risk children tested for low density lipoprotein (LDL) cholesterol and begin statin medication treatment for certain children as young as 8.
Other groups advise optimizing cholesterol levels in childhood, too. A team of researchers from the University of California, San Diego, writing in the Aug. 5, 2008, issue of the American Heart Association journal, Circulation, recommends aggressive intervention to lower cholesterol levels as early as childhood as the best approach to reduce the incidence of coronary artery disease. Yet this group does not advocate using drug therapy. It suggests achieving lower cholesterol levels through "TLC"—therapeutic lifestyle changes, such as diet and exercise.
If your pediatrician recommends medication, ask about a trial period of three to six months of lifestyle changes. These include plenty of outdoor play such as roller-blading, walking or biking to school and indoor sports like swimming, gymnastics and basketball.
The other lifestyle piece involves dietary changes. Leading health organizations have long recommended lowering dietary fat to less than 30 percent of calories, saturated fat to less than 10 percent of calories and no more than 200 milligrams of cholesterol a day. But how does that translate into what to serve for breakfast, lunch and dinner?
Don’t let the details bog you down. Research shows that an overall diet that emphasizes vegetables, fruits, whole grains, beans, nuts and fish helps protect against cardiovascular disease. The fiber in plant foods can help lower cholesterol and their mix of antioxidants helps reduce inflammation that’s also linked to heart disease.
Foods can make an impact
For many years, the emphasis was simply about reducing saturated fat and dietary cholesterol. Now we know a carefully planned diet can reduce the risk of cardiovascular disease as much as statins, at least in adults, without possible side effects. Canadian researchers found a combination of soy protein, almonds, oats, barley—in a mainly vegetarian diet known as the Portfolio Diet—reduced LDL cholesterol in adults with high cholesterol by an amazing 28 percent. (Another group that ate a diet simply low in saturated fat along with a statin drug experienced a 31 percent lower LDL.)
What are some easy changes? Swap white bread for whole wheat bread. Trade white rice for nuttier brown rice, even if it’s a "minute" type. Add oatmeal wherever possible—as hot breakfast cereal, in cookies, as a topping for apple crisp and in meatloaf.
Beans are another good cholesterol-lowering food and can be incorporated into dips, soups, salads and sandwich wraps. Certain vegetables and fruits are naturally rich in plant sterols, which block the absorption of cholesterol. These include cauliflower, broccoli, Brussels sprouts, blueberries, oranges and lingonberries.
The new guidelines also suggest serving reduced fat milk, instead of whole, to babies starting at age 1.
A registered dietitian can be a tremendous asset by reviewing your child’s dietary habits and making practical suggestions that won’t break the bank. Luckily, good nutrition and an active lifestyle are all that most children need to achieve healthy cholesterol levels.
This column is not intended to substitute for
• American Academy of Pediatrics Clinical Report, pediatrics.aappublications.org/cgi/content/full/122/1/198
• Lyon Diet Heart Study, americanheart.org/presenter.jhtml?identifier=4655
• American Dietetic Association, eatright.org (Click on Find a Nutrition Professional for a registered dietitian in your area)
Cereal on Toast
• 1/4 cup whole grain cereal flakes, crushed
• 1 Tbsp. chopped almonds
• 1 small apple, sliced
• 1 Tbsp. dried cranberries
• 1/4 cup water
• 1/8 tsp. cinnamon powder
• 1/2 Tbsp. vanilla extract
• 1/4 cup skim milk
• 1 egg white
• 1/2 Tbsp. sugar
• 2 slices 100 percent whole wheat bread
• 4 sprays margarine spray
• 1 Tbsp. light syrup
Mix chopped almonds with crushed cereal and set aside. In a small microwavable round dish, combine sliced apple, dried cranberries and water. Microwave fruits for 2 minutes and then sprinkle with cinnamon. Set aside. Combine vanilla extract, skim milk, egg white and sugar in a small bowl. Dip one slice of bread into the milk mixture, letting it soak on both sides. Coat the bread with the crushed cereal mixture. Over medium low heat, heat medium size skillet, coated lightly with nonstick spray. Cook coated bread on both sides until golden brown (about 2-3 minutes on each side). Pour 1/2 Tbsp. of light syrup on each toast and top with fruit mixture, and finish with cinnamon powder.
Nutrition content per slice: 248 calories, 6 grams fat, 0 grams saturated fat, 45 grams carbohydrates 6 grams fiber, 25 grams whole grain.
Recipe printed with permission from Beyond Rice and Beans: The Caribbean Latino Guide to Eating Healthy with Diabetes by Lorena Drago, MS, RD, CDN, CDE.
Christine M. Palumbo is a registered dietitian in Naperville, where she happily consumes heart-healthy nuts, canned salmon, beans, extra virgin olive oil, oatmeal and home-popped popcorn. If you have any column suggestions, send them to her at Chris@ChristinePalumbo.com.