POZDRAVLJENI!
SEM ZASKRBLJENA MAMA 6 LET STARE HČERKE.NA SISTEMATSKEM PREGLEDU SO UGOTOVILI POVIŠAN HOLESTEROL (6.7). LIPIDOGAM JE POKAZAL PREVISOKO VSEBNOST “SLABEGA HOLESTEROLA” TER PREVELIKO NESKLADJE MED OBEMA.
NA PREGLEDU PRI SPECIALISTU PA JE BILO SKUPNEGA HOLESTEROLA CELO 8.5. ZDRAVNICA JE PREDPISALA ZDRAVILA IN SVETOVALA DIETO.
NAJBOLJ ME JE ZMOTILA REAKCIJA HČERKINE PEDIATRINJE,SAJ NAJ BI BILA REŠITEV V UŽIVANJU TABLET, DA BI POTEM “NORMALNO” ŽIVELA.
VELIKO DAM NA ZDRAVO PREHRANO IN NISEM PRISTAŠ TEGA , DA DOBIŠ ZDRAVILA IN POTEM ŠE NAPREJ UŽIVAŠ SLABO PREHRANO.
MORAM POVEDATI, DA JE HČERKA OD MALEGA PROBLEMATIČNA GLEDE PREHRANE. JEDLA BI SAMO KAK POMFRIT ALI PIŠKOTE, OD SADJA PA SAMO JABOLKA. SEDAJ SMO SAMO Z DIETO ZBILI HOLESTEROL NA 6.27.
RADA BI ŠE VAŠE MNENJE O TEM, HČERKI RES NEBI RADA DAJALA TABLETE ŽE TAKO ZGODAJ, KAJTI STRANSKI UČINKI NISO PRAV LEPI.
GLEDE PREHRANE SE ZELO RAZLIKUJEJO MNENJA ,GLEDE VSEBOVANJA HOLESTEROLA V NEKATERIH ŽIVILIH (V DOLOČENI LITERATURI SO MANDLJI PRIPOROČLJIVI, NEKJE PA JIH ODLOČNO ODSVETUJEJO).
ZA NASVET IN ODGOVOR SE VAM IZ SRCA ZAHVALJUJEM.

Spoštovani!

Vaše vprašanje sem poslal več kolegom, da bi dobil njihovo mnenje. Vam sporočim.

Zdravljenje hiperholesterolemije pri otroku je po moji osebni presoji (nisem si vzel časa, da bi proučil literaturo v podrobnostih) usmerjeno predvsem v zmanjšan vnos holesterola v vidnih in prikritih oblikah, zmanjšan vnos celotne energijske vrednosti hrane ter v ustrezni telesni aktivnosti, kar mu bo omogočilo zdrav vzorec življenja tudi kasneje. Na spletu sem med priporočili našle le dva prispevka, katerih izvlečka prilagam. S tega spletnega naslova si lahko naročite katerega od njih (za plačilo) v celoti.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11345978&dopt=Abstract: This updated statement reviews the scientific justification for the recommendations of dietary changes in all healthy children (a population approach) and a strategy to identify and treat children who are at highest risk for the development of accelerated atherosclerosis in early adult life (an individualized approach). Although the precise fraction of risk for future coronary heart disease conveyed by elevated cholesterol levels in childhood is unknown, clear epidemiologic and experimental evidence indicates tha the risk is significant. Diet changes that lower fat, saturated fat, and cholesterol intake in children and adolescents can be applied safely and acceptably, resulting in improved plasma lipid profiles that, if carried into adult life have the potential to reduce atherosclerotic vascular disease.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=8310979&dopt=Abstract: An expert committee was convened to determine specific criteria for overweight to be integrated into routine preventive screening of adolescents. Body mass index (BMI) should be used routinely to screen for overweight adolescents. Youth with BMIs > or = 95th percentile for age and sex, or > 30 (in kg/m2) should be considered overweight and referred for indepth medical follow-up to determine underlying diagnoses. Adolescents with BMIs > or = 85th percentile but

STRATEGIES TO LOWER CHOLESTEROL LEVELS IN CHILDREN AND ADOLESCENTS

The individualized approach to lowering cholesterol levels calls on the cooperative effort of health care professionals to identify and treat children and adolescents at highest risk of having high blood cholesterol levels as adults and increased risk of coronary heart disease.
Selective Screening

Children and adolescents who have a family history of premature cardiovascular disease (Positive family history is defined as a history of premature (130 mg/dL) — Examine for secondary causes (thyroid, liver, and renal disorders) and familial disorders, screen all family members, initiate Step-One diet, followed by the Step-Two diet, if necessary.
Step-One and Step-Two Diets
The Step-One diet calls for the same nutrient intake recommended for the population approach to lower cholesterol levels, ie, 10 years of age after an adequate trial of diet therapy (for 6 to 12 months) and whose LDL-cholesterol level remains >190 mg/dL or whose LDL-cholesterol level remains >160 mg/dL and there is a family history of premature cardiovascular disease (<55 years of age) or two or more other risk factors (Table 1) are present in the child or adolescent after vigorous attempts have been made to control these risk factors.
The recommended drugs for the treatment of hypercholesterolemia and high LDL-cholesterol levels in children are the bile acid sequestrants cholestyramine and colestipol, which bind bile acids in the intestinal lumen. They have documented efficacy, relative freedom from adverse effects, and are apparently safe when administered to children. Other pharmacologic agents are not recommended for routine use in children and adolescents except in consultation with a lipid specialist.

IZ: Pediatrics Volume 101, Number 1 January 1998, pp 141-147

Zdravljenje hiperholesterolemije se vselej ravna po oceni globalnega
tveganja za bolezni srca in žilja. Pri mladenki je zelo malo verjetno, da
njeno tveganje presega 20%, razen seveda, če ne gre za družinsko
hiperholesterolemijo.
Če sta starša “zdrava”, če mlada dama ne kadi, če nima zvišanega krvnega
tlaka, če ni sladkorna bolnica, zdravil SPLOH NE POTREBUJE, ampak le – kot
pametno ugotavlja tudi mati- ZDRAV NAČIN PREHRANE: veliko sadja in
zelenjave, malo mesa in mesnin (predvsem manj mastno ” belo” meso in ribe)
ter REDNO TELESNO AKTIVNOST.
Kontrola holesterola po 3-6 mesecih!

Mateja Bulc