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Am Fam Physician. 2000;61(3):685-686

See related article on children with hypercholesterolemia.

What is high blood cholesterol?

High blood cholesterol, also called hypercholesterolemia, is an unhealthy level of cholesterol in the blood. Having high levels of blood cholesterol can cause your child to have heart problems when he or she gets older. But there are changes you can make in your child's diet now to lower the blood cholesterol.

How can I help my child eat right?

The first step to reducing cholesterol levels is to follow the “step 1” diet of the American Heart Association. This diet is low in cholesterol and saturated fat and high in complex carbohydrates. It provides energy and protein for normal activity and growth.

What are some examples of good foods?


The first meal of the day is a good time to give your child foods that are high in fiber, such as cereals and whole-grain breads. Fruits, juices, cheeses and yogurt are also good. Use skim or low-fat milk rather than whole or 2% milk.


Use whole-grain breads and rolls to make a better sandwich. Whole grains increase the total fiber in your child's diet. Give your child whole-grain crackers with soups, chili and stew, and always serve fresh fruit (with the skin) with meals.

Here are some ways to make healthier sandwiches:

  • Use low-fat or fat-free lunch meats. They are good in sandwiches or cut into strips on top of a salad.

  • Put leftover chicken or turkey strips in a tortilla to make a cold fajita (add strips of raw red and green peppers and onions). Use fat-free sour cream as a dressing.

  • Stuff a pita-bread “pocket” with vegetables, fat-free cheese and bits of leftover grilled chicken.

  • Cut up vegetables such as onion, carrot, celery and green peppers to add to tuna salad. Mix vegetables and water-packed tuna with fat-free mayonnaise or, for a different taste, mix with a fat-free salad dressing.

  • Chunky bits of leftover chicken mixed with fat-free mayonnaise, raisins, shredded carrots and sliced almonds is a great chicken salad. Serve it in a pita-bread pocket. Top it with salsa for a Southwestern flavor.

  • Mix cranberry sauce and fat-free mayonnaise to add to a turkey sandwich.

  • Put natural peanut butter together with an all-fruit jelly for an old favorite.

  • Sliced ham and low-fat or fat-free cheese with honey mustard is great on rye bread.

  • Low-fat cheese makes a good sandwich with tomato slices and mustard or fat-free mayonnaise on a roll.

  • Slice leftover pork tenderloin and top with barbecue sauce for a hot or cold sandwich.

  • Make grilled-cheese sandwiches with low-fat or fat-free cheese and serve them with raw carrot and celery sticks.

What snacks are good for my child?

Fruits, vegetables, breads and cereals also make great snacks for children. Here are some ideas for ways to serve these foods to your kids:

Fruits (Bite-size pieces of fruit look good to kids):

  • Fruit bits stirred into nonfat yogurt

  • Strawberries

  • Raisins

  • Grapes

  • Pineapple chunks

  • Orange or grapefruit sections

  • Bananas cooked lightly in apple juice

  • Apple slices with natural peanut butter

  • Dried fruit mixes


  • Baked potato with low-fat cheese sprinkled on top

  • Carrot sticks

  • Celery sticks with natural peanut butter

  • Raw broccoli and cauliflower florets with a low-fat dip or salsa


  • Cheese: use 1% fat or fat-free cottage cheese or ricotta cheese

  • Water-packed tuna mixed with fat-free mayonnaise on top of celery sticks or low-fat crackers

  • Yogurts: use fat-free yogurt. Try topping it with sunflower seeds, chopped dried fruit or a spoonful of oat bran


  • Low-fat cereals or cereal bars

Sweets and desserts:

  • Fat-free frozen yogurt

  • Juice bars

  • Sherbet and sorbet

Other snacks:

  • Popcorn: use “lite” or nonfat versions (try sprinkling popped corn with a little garlic, onion or chili powder)

  • Rice cakes

  • Low-fat pretzels

  • Roasted peanuts in the shell

  • Sunflower seeds, pumpkin seeds

  • Fat-free or baked potato chips

  • Bagels and low-fat bagel chips

  • Low-fat breadsticks

  • Low-fat pita chips


  • Maple syrup or fruit syrups make good toppings for fat-free yogurt

  • Pizza made with fat-free cheese

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