Ask the expert: how to handle teen’s high cholesterol

Holly Gooding, MD, MSc
Holly Gooding, MD, MSc

Our pediatrician checked my teenager’s cholesterol and it came back high. What should we do?

 

Anxious parents

 

In 2011, the American Academy of Pediatrics recommended routine cholesterol screening for all young people ages 9-11 and 17-21 years. Since then, we have seen many more young people screened for cholesterol problems, although overall screening rates remain low. Cholesterol is an important part of heart health, along with having a healthy diet, exercise, weight, blood pressure, blood sugar and avoiding all tobacco products. When doctors check cholesterol, it is important to think about all of these healthy heart factors.

The 2011 Guidelines for Cardiovascular Health and Risk Reduction in Children and Adolescents recommend this overall heart healthy approach and give specific recommendations for high cholesterol.

Cholesterol serves an important function in our body, and not all high cholesterol is bad. In fact, we want the high-density lipoprotein (HDL) cholesterol, or “healthy” cholesterol, to be high (greater than 45 mg/dl is best). But the other cholesterol values—total cholesterol, low-density lipoprotein (LDL)-cholesterol and triglycerides—should be kept below certain thresholds if possible. (Total cholesterol less than 170 mg/dl, LDL cholesterol less than 110mg/dl, and triglycerides less than 90 mg/dl are best.)

Most young people with high LDL cholesterol and high triglycerides are best treated with diet and exercise changes. We recommend that these teens:

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From Abu Dhabi to Boston: Brothers’ bond runs deep through kidney donation

brothersFar from the white beaches and turquoise waters of the Persian Gulf, a mother stands in a sea of people, arms wrapped around her sons, as a wave of passengers click the handles of their carry-ons, wheeling them toward their destinations.

Saleema Al Shukri has just arrived at Logan Airport from Abu Dhabi.

It has been six long months since she has seen her sons Saeed, 16, and Ahmed, 23, and her husband Fadel, all of whom temporarily relocated to Boston to begin a journey of hope and healing, while Saleema remained at home to care for the rest of the family.

Two years earlier, at the age of 14, Saeed was diagnosed with kidney dysplasia, a condition that results from the malformation of the kidney during fetal development. While Saeed had remained relatively well his entire life, his doctors in Abu Dhabi noticed that his blood levels started to become abnormal, showing his kidneys were beginning to fail.

Saeed needed a kidney transplant.

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From torn labrum to Harvard hockey MVP

Photo: Elan Kawesch/Harvard Athletics
Photo: Elan Kawesch/Harvard Athletics

Sarah Edney, women’s ice hockey defenseman at Harvard University, has had an impressive college career, scoring 25 goals and 63 assists during her four years playing for the Crimson women. Competing at this level requires an athlete to skate year-round and put in countless hours of off-ice training.

During her senior year, Sarah played a key role in the Crimson women’s 2014-15 season. The team often outplayed the competition, winning every championship, until losing in the National Championship game at the Frozen Four. Sarah was showered with honors and named MVP for the League tournament and second team All-American. The Eastern College Athletic Conference (ECAC) named her defenseman of year in March.

The big surprise? “My best year of college hockey came after hip surgery and without skating for four months.”

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Lyle Micheli: 40 years at the Boston Marathon finish line

From marathon volunteer to injury prevention pioneer—it’s all part of Dr. Lyle Micheli’s mission to keep runners and athletes of all types on the field.

Sore quads. That’s one of Lyle Micheli’s memories from the 1975 Boston Marathon. But Dr. Micheli, Director of Boston Children’s Sports Medicine, wasn’t sore from running. As a medical volunteer at what was a “very informal” event in 1975, Micheli spent the day ducking and “limboing” under the ropes marking the last feet of the 26.2-mile run and making sure the athletes were OK to proceed beyond the finish area.

Since that day, running has gained tremendous popularity. The Boston Marathon has increased from a mere 1,000 runners in 1975 to 30,000 in 2015. Micheli has been at the finish line year after year as a way to give back to his beloved city and the historic race.

The medical tent has matured from an informal crew stocked with Bands-Aids, beef stew and water to a highly sophisticated organization, comprised of multiple teams of medical professionals with designated assignments.

Still, nothing prepared Micheli and other volunteers for 2013. “We weren’t equipped with life-saving equipment.”  Forty years earlier, as a member of the U.S. Air Force, Micheli had received evacuation training. It kicked in—he jerry-rigged a tourniquet from a runner’s jacket and triaged injured spectators.

Micheli will be on hand at the finish line again in 2015. While his primary motivation is community service, Micheli and Boston Children’s Sports Medicine staff and patients reap plenty of benefits from their commitment to the race. “We encourage all of our fellows to attend. It’s a model for mass casualty training.” Plus, the doctors learn by observing elite athletes.

In the last 10 years, for instance, the science of injury prevention has emerged. “We’ve learned how various running techniques and different shoes contribute to injury risk. We’re using this information to guide our Injured Runner’s Clinic at The Micheli Center for Sports Injury Prevention in Waltham.”

For more on Micheli’s other accomplishments in the 1970s, learn how he improvised an innovative solution to solve the challenge of reconstructing a torn ACL in growing children.

 

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