Making sure your children's hearts stay healthy. (planning a low-fat diet) (includes related information on low-fat snacks)

Making sure your children's hearts stay healthy

Do you have high blood cholesterol? Do any of your young or middle-aged relatives have atherosclerosis, a form of hardening of the arteries? Did someone in your immediate family die of a heart attack in the prime of life? If the answer to any of these questions is yes, take your child to a doctor.

The American Academy of Pediatrics has issued a statement recommending routine cholesterol screening for all children in families that have a history of heart disease or high blood cholesterol. If a child's blood cholesterol level is high, the Academy recommends a modified diet that supplies no more than 30 percent of its calories as fat. The American Health Foundation calls 140 (milli-grams per deciliter of blood) an "achievable and desirable" level for a child's cholesterol; over 176 is considered high. (For adults, high is anything above 200.) The recommendations, which are for all children over age two, follow similar ones issued earlier by the American Heart Association, the National Institutes of Health, and the American Health Foundation.

Until last fall, the Academy of Pediatrics had never issued specific advice on cholesterol testing and dietary recommendations. The accumulation of evidence changed that, however. "We felt the time had come to have a policy," says Laurence Finberg, MD, chairman of the Academy's nutrition committee. It is desirable to find out which children are at risk, he adds. Indeed, it is estimated that 30 to 40 percent of children have high blood cholesterol, and up to 80 percent of those children will carry it into adulthood. Adults with high blood cholesterol, as is widely known, are at increased risk of heart disease.

Of course, there's no proof that lowering blood cholesterol levels in children will in itself prevent heart disease in adulthood. That evidence will take scientists another generation to gather. Still, records show that children in countries with a high incidence of coronary heart disease, such as the United States, have a higher cholesterol count than children in countries with a low incidence.

A number of studies back up the theory that heart disease begins early in life. Compelling evidence comes from autopsies performed on soldiers with an average age of 22 who died in Korea and Vietnam. More than half of those young soldiers showed some degree of atherosclerosis.

But the disease may begin long before age 22, as researchers have learned by observing the children of a Louisiana city called Bogalusa, much the way adults have been followed in many other studies. The Louisiana researchers interviewed thousands of children about their parents' habits and health as well as analyzed blood, measured blood pressure, and assessed diets. In addition, autopsies performed on 88 youngsters who had died of illness or in …