Disclaimer [ENGLISH]
Disclaimer: This material is for educational purposes only. You, the reader, assume full responsibility for how you choose to use it. It is not intended to provide medical advice, diagnosis or treatment, nor does it replace the advice or counsel of a doctor or health care professional. Reference to a specific commercial product or service does not imply endorsement or recommendation of that product or service by CPCMG.
Note
The following information is intended to be used when the above labs are ordered as a screen for generally healthy children. If you are reviewing lab results that were ordered for a child who is sick, please discuss these with your healthcare provider.
Cholesterol
Checking cholesterol in children
- In following the guidelines of The American Academy of Pediatrics, CPCMG has started routinely checking cholesterol levels for children in the following age groups:
- once between 9 and 11 years old
- after the age of 17
- at other visits when needed
- Why is this test done?
- Too much cholesterol in the blood can be harmful by creating build-up in the arteries called “plaque.”
- This can lead to heart problems later in life.
- How is this test done?
- Most of the time, this test is done from a blood sample obtained through a poke of the finger in the office.
- Sometimes your child’s healthcare provider might ask you to take your child to the lab for blood tests done on a sample from a vein.
- If your child had elevated LDL or Triglyceride levels from a non-fasting sample, your child’s healthcare clinician may request a follow up fasting lab to recheck the levels.
- This means the test should be done when your child has had no food or drink (except water) for 8 hours before the test.
- What is measured with this test?
- Total cholesterol
- LDL or low density lipoprotein - we want to keep it low.
- HDL or high density lipoprotein - we want to keep it high.
- Triglycerides are a type of fat in the blood. High blood triglycerides can increase the risk for heart problems later in life.
Tips for decreasing elevated cholesterol (LDL and/or Total) and/or triglycerides
Nutrition
- Increase whole grains like whole-wheat bread and oats.
- Decrease refined grains like white bread and white rice.
- Increase fiber intake from foods like fruits, vegetables, whole grains, and beans.
- Limit fast food - aim for no more than 1 time per week, ideally less often is better.
- Limit sodium and ultra-processed foods. These are convenience foods like chips, packaged cookies or baked goods, fast food, and sugary drinks.
- Limit added sugars in foods and drinks. Eliminate juice, soda and other sugar sweetened beverages.
- Drink water and plain milk only (not chocolate or other flavored milk).
- Limit saturated fat and trans-fat in foods - these are fats that are solids at room temperature (like butter).
- Increase fish and omega 3 intake.
- Eat breakfast every day.
- Eat family meals as often as possible.
Physical Activity
- Aim for 60 minutes of physical activity per day.
- The best kind of exercise for kids is any type of movement they enjoy and will do regularly!
Tips for increasing HDL cholesterol
Small changes in nutrition and physical activity habits can make a big difference.
- Foods high in fiber like fruits, vegetables, beans, legumes, and whole grains.
- Healthy fats like fish, olive oil, avocados, and nuts.
- Exercise, especially cardiovascular exercise. The best kind of exercise for kids is any type of movement they enjoy and will do regularly!
Prediabetes (Fasting Glucose 100-125 or Hemoglobin a1c 5.7-6.4%)
Checking blood sugar in children
If your child has high blood sugar (glucose or hemoglobin A1C) in the “prediabetes” range, they are more likely to develop diabetes.
- This can lead to long-term problems including:
- Heart disease
- Vision loss
- Kidney disease
- Small lifestyle changes can help prevent Type 2 diabetes.
Tips for managing high blood sugar
Nutrition
- Eat meals and snacks on a routine schedule.
- Eat smaller portion sizes.
- Choose calorie-free drinks (like water) and unflavored milk.
- Increase fruits and vegetables.
- Eat three servings of dairy per day.
- Limit high-fat foods and snacks.
- Eat less fast food.
Physical activity
- Goal of 60 minutes of moderate-to-vigorous exercise per day.
- It doesn’t have to be all at one time.
- It doesn’t have to be organized sports.
- In moderate physical activity, a person can talk, but not sing.
- In vigorous activity, a person cannot talk without pausing to catch a breath.
- The best kind of exercise for kids is any type of movement they enjoy and will do regularly!
ALT (Alanine Transaminase)
Checking ALT in children
- ALT is an enzyme from the liver.
- There are many reasons your child’s ALT level might be high
- Less common causes include using some medications and some viral infections.
- The most common cause is "fatty liver disease." Over time, this can cause liver damage.
- In most cases, lifestyle changes such as the ones listed below can make the ALT normal again, and the risk of long-term liver problems can be decreased.
Tips for managing high ALT
Managing weight
- In general, we want younger kids to keep their weight steady instead of gaining weight.
- In general, we recommend medically supervised weight loss to help teens safely lose 5-10% of their weight, which tends to help normalize ALT levels
Nutrition
- Decrease portion sizes.
- Avoid sugar-sweetened beverages. Choose calorie-free drinks (like water) and unflavored milk instead.
- Increase fruits and vegetables.
- Limit highly processed foods.
- Limit frequency and size of snacks.
- Reduce calories from fast food.
Physical Activity
- Aim for less than 2 hours of screen time per day.
- Aim for 60 minutes of moderate to vigorous physical activity every day.
- In moderate physical activity, a person can talk, but not sing.
- In vigorous activity, a person cannot talk without pausing to catch a breath.
- The best kind of exercise for kids is any type of movement they enjoy and will do regularly!
The CPCMG WELL Clinic supports families in making healthy changes by improving habits in nutrition, physical activity, sleep, screen time, and social and emotional wellbeing. If you want a referral for your child, please discuss with your child’s pediatrician.
Click here to learn more about the CPCMG WELL Clinic.
Last Reviewed: N.M. MD, Nutrition Committee, A.R. DO 11/2023