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Am Fam Physician. 2004;69(4):937-938

What is high cholesterol?

High cholesterol is an unhealthy amount of cholesterol in the blood. A high level of cholesterol can cause heart problems when your child gets older. High cholesterol can be lowered with weight loss, exercise, and changes in what your child eats.

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 (which come from animal food products, such as meat, butter, and cheese), and high in complex carbohydrates (which come from plant products, such as whole grains). It provides energy and protein for normal activity and growth.

What are some examples of good foods?

  • Breakfast: The first meal of the day is a good time to give your child foods that are high in fiber, such as whole-grain cereals and breads and fresh fruit. Use skim or low-fat milk rather than whole milk or 2 percent milk. Low-fat cheeses and yogurt also are good breakfast foods.

  • Lunch: Use whole-grain breads and rolls to make a healthier sandwich. Whole grains increase the total fiber in your child's diet. Give your child whole-grain crackers with soups, chili, and stew. 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 makes 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. Serve them with raw carrot and celery sticks.

Snacks that are good for children

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

Fruits

Bite-size pieces of fruit look good to kids:

  • Fruit bits stirred into fat-free 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

Vegetables

  • Baked potato with low-fat grated cheese sprinkled on top

  • Carrot sticks

  • Celery sticks with natural peanut butter

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

Protein

  • Cheese: use 1 percent 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: Try topping fat-free yogurt with sunflower seeds, chopped dried fruit, or a spoonful of oat bran.

Cereals

  • Low-fat and low-sugar cereals or cereal bars

Sweets and desserts (small servings only)

  • Fat-free frozen yogurt

  • Juice bars

  • Sherbet and sorbet

Other snacks

  • “Lite” or fat-free popcorn (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

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