Marc S. Jacobson, MD . Fellowship: Univ of Maryland,Adolescent Medicine . Attending Pediatrician - Schneider Professor of Pediatrics - Albert Einstein College of Medicine . www.DrMDK.com
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Host: Seem to hear a lot about old people worry about their cholesterol, but we are in pediatrics, should we worry about cholesterol even in little kids? Marc S. Jacobson: Even in little kids, but particularly those little kids who have parents or grandparents who have had a heart attack or a stroke before the age of 60. Those are the high risk children and the children who have that kind of family history should have a cholesterol test sometime after the age of two and before the age of five. Host: If the cholesterol is high what would I think you mean? Marc S. Jacobson: High cholesterol in a young child with the positive family history of really heart disease. Host: What figure would you consider high? Marc S. Jacobson: What number is high? The cholesterol for children, 200 is a high number, 170 is a normal number, 170 or below through the total cholesterol. If we talk about the LDL, the Low-Density Lipoprotein cholesterol, a number of less than 130 is a good number. Host: So in other words the number game is important even in young age group. Marc S. Jacobson: Even in young children. In order to prevent them from getting sick when they get older not that they are going to get a heart attack or a stroke when they are a child but in order to keep them healthy because we know the plaques that form in our arteries that result in heart attacks and strokes start soon after birth, accelerate during adolescence and then develop over the decades of our adult life. So if we can prevent them from their starting, children will live longer and healthier. Host: So in other words if you have high cholesterol in the kid say 3-4 years old. How would you approach the problem to lower the cholesterol a little bit? I will just say the bad cholesterol to be taken out? Marc S. Jacobson: That's right; the important thing to do for a child of that age is to asses their diet. To find out what they like to eat, what they usually eat and see if we can help them and their family learn to make healthier choices. So we focus on what they are currently eating and use a trained nutritionist or registered dietitian to asses that and then to help the family eat better. And it works better if the whole family does it not if one person is single bound as the culprit so to speak. Host: In other words that’s in the kitchen, the kid make rapid. Marc S. Jacobson: That’s right. It's not going to happen that all family is going to sit around eating meatball heroes and child is going to eat a salad. People have to -- families eat as a family and that's important because cholesterol is shared in the family as well. Host: And we also have a problem kids on exercising as much. An exercise will help lower the bad cholesterol little bit? Marc S. Jacobson: Exercise is important, it lowers, it helps keep the balance of lipids in triglycerides, which we haven't mentioned that's another kind of fat in the blood. So, exercise is important for lowering triglycerides which helps raise the good cholesterol and gets everything in better balance. Right kids don't have the same opportunity to exercise that they had years ago, they don't just run out in there neighborhood and play very often. They are much more restricted. Host: So if you have a kid in, the father had a heart attack at 28 or something like that, it was a big concern; the first cholesterol you would check in a cue will be recommended at what age? Marc S. Jacobson: Age two. Host: Age two. If that was normal at age two, when would you repeat it again? Marc S. Jacobson: Repeat it again during school age between 5 and 10 and once during adolescence, but the chance that it's going to develop into a serious problem if it's normal at two is very level. Host: So it's a good sign if the cholesterol is say from 60 from 70 and that's such a good sign for -- Marc S. Jacobson: Yes. Host: So at that point you would credit the family to change the eating habits or control them a little bit and encourage more activity. Marc S. Jacob
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