Growing Up Healthy: Fat, Cholesterol, and More
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No Alt TextMany Americans consume too many calories and too much fat, especially saturated fat, trans fat, and sugar. These eating patterns are one cause of America’s high rates of obesity and heart disease.  
As a parent or caregiver, you can help your child develop healthy habits that can last a lifetime. Although many things influence children, adults are still the most important role models. The single best predictor of a child with a healthy weight and lifestyle is parents who set a good example by making healthy food choices and engaging in regular physical activity. If heart disease runs in your family, your child is at greater risk for it in adulthood, making this even more important.  
Read on for information from the American Academy of Pediatrics about fat in food and healthier food choices. If you have specific questions about your child’s nutrition, talk with your child’s doctor or a registered dietitian. 

Fat in food: how much for children?

Childhood is the best time to start heart-healthy eating habits. But eating healthy for most children doesn’t mean following adult goals for cutting back on total fat, saturated fat, trans fat, and cholesterol, particularly for children younger than 2 years. Fat is an essential nutrient that supplies the energy, or calories, children need for growth and active play and should not be severely restricted.  
However, if your child is younger than 2 years and overweight or at risk for overweight, or has a family history of high cholesterol or heart disease, reduced saturated fat dietary choices may be appropriate. Check with your child’s doctor or a registered dietitian before restricting fat in your child’s diet. When children are between the ages of 2 and 5 years, encourage them to gradually choose foods with less fat, saturated fat, and trans fat. By age 5, their overall food choices, like yours, should include heart-healthy foods such as nonfat or low-fat dairy products, skinless chicken, fish, lean red meats, whole grains, fruits, and vegetables.  
Keep in mind, restricting a child’s eating too much may harm growth and development or encourage undesirable eating behaviors. Before making any drastic changes in a child’s eating plan or physical activity habits, talk with your child’s doctor or a registered dietitian. If your child is younger than 2 years and obese or overweight, consult your child’s doctor before restricting fat or calories, such as with reduced-fat (2%) milk.  

How is saturated fat different than other fat?

Saturated fat is usually solid at room temperature, compared with liquid fats such as oil that contain unsaturated fats. Saturated fats come mostly from animal sources, such as butter, cheese, bacon, and meat, as well as stick margarine. Polyunsaturated and monounsaturated fats are found in vegetables and fruits such as olives, soybeans, and nuts. Trans fats are fats that begin as good fats but are chemically changed to keep foods fresh longer; unfortunately, they can be bad for your cholesterol levels. They are found in baked goods and processed foods. Reading Nutrition Facts labels and ingredients to look for saturated and trans fats can help you determine how much of these fats are present in a particular food.  

Cholesterol: where does it come from?

Cholesterol is made by your body to help form the walls of cells and organs. It is an important part of the brain and nervous system. The liver converts fat that you eat into cholesterol. Cholesterol also comes from your diet; it is found in large amounts in shrimp, octopus, squid (calamari), and organ meats such as liver. Eggs also contain cholesterol in lesser amounts. Foods higher in cholesterol do not need to be avoided but should be eaten in moderate amounts. 

Good nutrition for the whole family

Chances are that some of your child’s favorite foods are higher in fat and energy (or calories) compared with the amount of nutrients they provide. Try to select foods that have a high content of nutrients (protein, vitamins, and minerals) compared with the amount of calories, fat, and salt. For example,  
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    Have plenty of fresh fruits and vegetables available and ready to eat. Washing and preparing these ahead of time may make it more likely your family will eat them.
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    Include high-fiber, whole-grain foods such as brown rice, whole-grain pasta, corns, peas, and breads and cereals at meals. Sweet potatoes are also a good choice.
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    Choose lower fat or fat-free toppings like grated low-fat parmesan cheese, salsa, herbed cottage cheese, nonfat/low-fat gravy, low-fat sour cream or salad dressing, or yogurt.
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    Select lean meats such as skinless chicken and turkey, fish, lean beef cuts (round, sirloin, chuck, loin, and lean ground beef—no more than 15% fat content) and lean pork cuts (tenderloin, chops, and ham). Buy choice or select grades of beef rather than prime. Trim off all visible fat. Remove skin from cooked poultry before eating.
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    Include healthy oils such as canola or olive oil in your diet. Choose margarine and vegetable oils without trans fats made from canola, corn, sunflower, soybean, or olive oil. Choose tub and liquid rather than stick margarine, which contains trans fats.
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    Use nonstick vegetable sprays when cooking.
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    Use fat-free cooking methods such as baking, broiling, grilling, poaching, or steaming when cooking meat, poultry, or fish.
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    Serve vegetable- and broth-based soups, or use nonfat (skim), low-fat (1%), or evaporated skim milk when making cream soups.
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    Use the Nutrition Facts label on food packages to find foods with less saturated fat per serving. Pay attention to the serving size as you make choices. Remember that the percent daily values on food labels are based on portion sizes and calorie levels for adults.
Milk choices
 

Here are guidelines about what type of milk to give your child.

 
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    Children younger than 12 months—Breast milk is best. Give iron-fortified formula if breast milk is not available.
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    Children 12 to 24 months—Whole milk. Your child’s doctor may recommend reduced-fat (2%) or low-fat (1%) milk if your child is obese or overweight, or if there is a family history of high cholesterol or heart disease. Check with your child’s doctor or a registered dietitian before switching from whole to reduced-fat milk. (Breastfeeding can continue after 12 months of age as long as is desired by mom and baby.)
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    Children older than 24 months—Low-fat or nonfat (skim) milk.
Tips on How to Make Healthier Food Choicesa
Most DaysOnce in a While
FruitSeveral servings of fresh, canned, frozen, or dried fruit, and 100% unsweetened fruit juiceb
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    Pies or desserts with fruit
VegetableSeveral servings of raw and cooked vegetables
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    French fries
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    Creamy coleslaw
Grains
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    Whole-grain mini bagel or English muffin
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    Whole-grain chips or breads high in fiber
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    Low-sugar, low-fat, high-fiber granola bars and baked goods
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    Donut or Danish pastry
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    Fried potato or corn chips
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    Cookie or cupcake
Meat, poultry, fish, dry beans, eggs, and nuts
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    Baked or grilled skinless chicken
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    Baked or grilled fish
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    Veggie “burgers”
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    Beans, eggs, nuts, seeds, and almond or peanut butter (1 to 2 tablespoons)
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    Fried fish sticks
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    Fried chicken
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    Fried chicken nuggets
Milk, yogurt, and cheese
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    Low-fat (1%) or nonfat (skim) milk
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    Reduced-fat cottage cheese or cheese
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    Low-fat yogurt
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    Ice cream, milkshakes

Don’t forget active play!

Physical activity, along with proper nutrition, promotes lifelong health. Active play is the best exercise for kids! Parents can join their children and have fun while being active too. Some fun activities for parents and kids to do together include playing on swings, riding tricycles or bicycles, jumping rope, flying a kite, making a snowman, swimming, or dancing. The daily recommendation for exercise for children (adults also) is at least 1 hour per day. This takes commitment from parents, but the rewards are time together and better health.  

Serving up healthier food choices

It’s important for children and adults to be sensible and enjoy all foods but not to overdo it on one type of food. Also, no food should be forced or forbidden. When children think a food is forbidden by their parents, it often becomes more desirable. However, children should know that sweets and higher fat snack foods in appropriate portions are OK once in a while. See Tips on How to Make Healthier Food Choices when considering fat, saturated fat, and cholesterol in food choices. 

For more information

American Academy of Pediatrics 
Academy of Nutrition and Dietetics 
US Department of Agriculture Food and Nutrition Service  
www.fns.usda.gov (includes information on SNAP [Supplemental Nutrition Assistance Program] and WIC [Women, Infants and Children] benefits) 

Listing of resources does not imply an endorsement by the American Academy of Pediatrics (AAP). The AAP is not responsible for the content of external resources. Information was current at the time of publication.

The information contained in this publication should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.

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