LDL cholesterol management
with the new recommendations for testing kids at age 10 for familial hyper cholesterolemia, 1. is it that a recommendation even if there is known diagnosis of genetically high cholesterol in the family? 2. For those kids in that category, Do you recommend restricting ghee and even healthy fats like those in avocado and nuts at that young age when they also need fat for development, how do you balance?
- Testing at age ~9–11: Yes. Universal lipid screening at 9–11 years is recommended, and earlier targeted testing (as early as 2 years) if there’s a parent/sibling with familial hypercholesterolemia (FH) or very high LDL. If FH is known in the family, test the child sooner rather than waiting to 10, and consider genetic cascade testing if a pathogenic variant is identified in a parent. - Food/fats for kids with FH: Children need fats for brain and growth, so we don’t go “low‑fat.” The goal is smart fats and portion control: limit saturated fat (ghee, butter, coconut oil, high‑fat dairy, fatty red meats) and favor unsaturated fats (oils like canola/olive/peanut, nuts, seeds, avocado, oily fish). Practical balance: use minimal ghee (occasional 1/4–1/2 tsp on dal/roti for flavor, not daily), keep total saturated fat roughly ≤7–10% of calories, and include nuts/seeds/avocado in kid‑sized portions (e.g., 5–10 almonds or 1–2 tsp nut butter, 2–3 slices avocado). Emphasize high‑fiber foods (millets/rolled oats, chana/rajma, vegetables, fruit), low‑fat milk/curd, and active play. Know your numbers: fasting lipid panel by age 2–8 if FH is suspected, then at 9–11 Renu and I are NOT Pediatricians so do consult your child's pediatrician if more specific questions, or a special lipid clinic....