Cholesterol and Children (cont.)
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Dietary Guidelines for Lowering Cholesterol in Children
The American Academy of Pediatrics-recommended diet for the high-risk group is similar to that recommended for the population but restricts saturated fat to 7% of total calories and dietary cholesterol to 200 mg/day. Research in children as young as 7 months of age have demonstrated that these dietary recommendations are safe and do not interfere with normal growth, development, and sexual maturation
The success of this diet depends on a number of factors, including the saturated-fat intake before changes are implemented. Because dyslipidemia is often a familial problem, some children will already be on a diet relatively low in saturated fat. For these children with a genetic cause of dyslipidemia and LDL concentration of ≥190 mg/dL, it is unlikely that diet alone will achieve appropriate concentrations of LDL. Nevertheless, it is important to implement dietary changes that are associated with reduction of LDL concentrations, which may allow for use of lower doses of pharmacologic agents when they are started. Dietary changes are still an important part of any long-term intervention.
Implementation of this more aggressive diet is likely to require involvement of a dietitian to help families make the appropriate changes without compromising good nutrition. There have been anecdotal reports of parents implementing a very low-fat diet without supervision, leading to nutritional insufficiency and failure to thrive. The home environment is very important to help children and adolescents make the best choices and maintain a healthful diet. Parents must be empowered to choose the time and available food and drink for meals and snacks. It is most helpful if everyone in the family is consuming a healthful diet and parents act as a role model for their children.
Dietitians can also help children and their families navigate the food environment outside the house, which has become increasingly important because more children do more eating outside the home environment.
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