LOW CHOLESTEROL DIET (DIETA BAJA EN COLESTEROL) and MEDICATION

Foods that can help lower cholesterol

• A variety of whole- and multi-grain products, such as bran and oats
• Fatty fishes, such as salmon, mackerel and albacore tuna
• Foods rich in antioxidants, such as fruits and vegetables
• Foods high in omega-3 fatty acids, such as avocado, flax seeds, olive oil and canola oil
• Foods rich in plant sterols, such as nuts like walnuts and almonds

The American Heart Association lists these foods to avoid (or consume in moderation):

Foods to avoid (or consume in moderation)

• Animal products high in saturated fat (beef, lamb, veal, pork, duck, goose, cream, cheese, butter, egg yolk)
• Fried foods
• High-fat processed meats, such as hot dogs and sausages
• Simple sugars (found in soft drinks, candy, cakes, cookies and other baked goods)
• Saturated oils, such as coconut and palm oil
• Shortening, partially hydrogenated margarine and lard

INFORMATION FROM AMERICAN HEART ASSOCIATION:

Reduce saturated fat in meat and poultry

The American Heart Association recommends a diet that emphasizes fish and poultry and limits red meat. The amount of saturated fat in meats can vary widely, depending on the cut and how it’s prepared.

Here are some ways to reduce the saturated fat in meat:

• Select lean cuts of meat with minimal visible fat. Lean beef cuts include the round, chuck, sirloin or loin. Lean pork cuts include the tenderloin or loin chop. Lean lamb cuts come from the leg, arm and loin.
• Buy “choice” or “select” grades rather than “prime.” Select lean or extra lean ground beef.
• Trim all visible fat from meat before cooking.
• Broil rather than pan-fry meats such as hamburger, lamb chops, pork chops and steak.
• Use a rack to drain off fat when broiling, roasting or baking. Instead of basting with drippings, keep meat moist with wine, fruit juices or a heart-healthy oil-based marinade.
• Cook a day ahead of time. Stews, boiled meat, soup stock or other dishes in which fat cooks into the liquid can be refrigerated. Later, remove the hardened fat from the top.
• When a recipe calls for browning the meat first, try browning it under the broiler instead of in a pan.
• Eat chicken and turkey rather than duck and goose, which are usually higher in fat. Choose white meat most often when eating poultry.
• Remove the skin from chicken or turkey before cooking. If your poultry dries out too much, first try basting with wine, fruit juices or a heart-healthy oil-based marinade. Or leave the skin on for cooking and then remove it before eating.
• Limit processed meats such as sausage, bologna, salami and hot dogs. Many processed meats – even those with “reduced fat” labels – are high in calories and saturated fat. Such foods are often high in sodium, too. Read labels carefully and eat processed meats only occasionally.

Eat more fish

Fish can be fatty or lean, but it’s still low in saturated fat. Eat at least 8 ounces of non-fried fish each week. Choose oily fish such as salmon, trout and herring, which are high in omega-3 fatty acids. Prepare fish baked, broiled, grilled or boiled rather than breaded and fried, and without added salt, saturated fat or trans fat. Non-fried fish and shellfish, such as shrimp, crab and lobster, are low in saturated fat and are a healthy alternative to many cuts of meat and poultry.

Research has shown the health benefits of eating seafood rich in omega-3 fatty acids, especially when it replaces less healthy proteins that are high in saturated fat and low in unsaturated fat. Including seafood high in omega-3 fatty acids as part of a heart-healthy diet can help reduce the risk of heart failure, coronary heart disease, cardiac arrest and the most common type of stroke (ischemic).

Eat less meat

Try meatless meals featuring vegetables or beans. For example, think eggplant lasagna, or instead of a burger, consider a big grilled portobello mushroom on a bun. Maybe substitute low-sodium beans for beans-n-franks. Or treat meat as a sparingly used ingredient, added mainly for flavor in casseroles, stews, low-sodium soups and spaghetti.

Cook fresh vegetables the heart-healthy way

Try cooking vegetables in a tiny bit of vegetable oil and add a little water during cooking, if needed. (Or use a vegetable oil spray.) Just one or two teaspoons of oil is enough for a package of plain frozen vegetables that serves four. Place the vegetables in a skillet with a tight cover and cook them over very low heat until done.

Add herbs and spices to make vegetables even tastier. (It’s a healthier choice than opting for pre-packaged vegetables with heavy sauce or seasonings.) For example, these combinations add subtle and surprising flavors:

• Rosemary with peas, cauliflower and squash
• Oregano with zucchini
• Dill with green beans
• Marjoram with Brussels sprouts, carrots and spinach
• Basil with tomatoes

Start with a small quantity of herbs and spices (1/8 to 1/2 teaspoon for a package of frozen vegetables), then let your family’s feedback be your guide. Chopped parsley and chives, sprinkled on just before serving, can also enhance the flavor of many vegetables.

Use liquid vegetable oils in place of solid fats

Liquid vegetable oils such as canola, safflower, sunflower, soybean and olive oil can often be used instead of solid fats, such as butter, lard or shortening. If you must use margarine, try the soft or liquid kind.

Use a little liquid oil to:

• Pan-fry fish and poultry.
• Sauté vegetables.
• Make cream sauces and soups using low-fat or fat-free milk.
• Add to whipped or scalloped potatoes using low-fat or fat-free milk.
• Brown rice for Spanish, curried or stir-fried rice.
• Cook dehydrated potatoes and other prepared foods that call for fat to be added.
• Make pancakes or waffles.

Puree fruits and veggies for baking

Pureed fruits or vegetables can be used in place of oil in muffin, cookie, cake and snack bar recipes to give your treats an extra healthy boost. For many recipes, use the specified amount of puree instead of oil. Check the mix’s package or your cookbook’s substitutions page for other conversions. You can:

• Use applesauce in spice muffins or oatmeal cookies.
• Include bananas in breads and muffins.
• Try zucchini in brownies.

Lower dairy fats

Low-fat (1%) or fat-free (skim) milk can be used in many recipes in place of whole milk or half-and-half. (Some dishes, such as puddings, may result in a softer set.)

When it comes to cheeses used in recipes, you can substitute low-fat, low-sodium cottage cheese, part-skim milk mozzarella (or ricotta) cheese, and other low-fat, low-sodium cheeses with little or no change in consistency.

Sauces and gravies

Let your cooking liquid cool, then remove the hardened fat before making gravy. Or use a fat separator to pour off the good liquid from cooking stock, leaving the fat behind.

Increase fiber and whole grains

Consider these heart-smart choices:

• Toast and crush (or cube) fiber-rich whole-grain bread to make breadcrumbs, stuffing or croutons.
• Replace the breadcrumbs in your meatloaf with uncooked oatmeal.
• Serve whole fruit at breakfast in place of juice.
• Use brown rice instead of white rice and try whole grain pasta.
• Add lots of colorful veggies to your salad – carrots, broccoli and cauliflower are high in fiber and give your salad a delicious crunch.

Alimentos que pueden ayudar a reducir el colesterol

Una variedad de productos integrales y multicereales, como salvado y avena.

Pescados grasos, como salmón, caballa y atún blanco Alimentos ricos en antioxidantes, como frutas y verduras

Alimentos ricos en ácidos grasos omega-3, como aguacate, semillas de lino, aceite de oliva y aceite de canola Alimentos ricos en esteroles vegetales, como nueces como nueces y almendras

La American Heart Association enumera estos alimentos para evitar (o consumir con moderación):

Alimentos para evitar (o consumir con moderación)

Productos animales con alto contenido de grasas saturadas (res, cordero, ternera, cerdo, pato, ganso, crema, queso, mantequilla, yema de huevo)

Comida frita

Carnes procesadas con alto contenido de grasa, como perros calientes y salchichas Azúcares simples (que se encuentran en refrescos, dulces, pasteles, galletas y otros productos horneados)

Aceites saturados, como aceite de coco y palma, manteca de cerdo, margarina parcialmente hidrogenada

INFORMACIÓN DE AMERICAN HEART ASSOCIATION:

https://www.heart.org/en/health-topics/cholesterol/prevention-and-treatment-of-high-cholesterol-hyperlipidemia/cooking-to-lower-cholesterol

SPANISH: https://www.fda.gov/drugs/drug-safety-and-availability/su-colesterol

STATIN ( CHOLESTEROL MEDICATION)

• Statins (stat-TENS)

  Why should I take a statin?

  Good question! Statins are medications that help reduce the cholesterol level in your blood. Cholesterol is a type

  of fat which helps your body function normally. High levels of cholesterol may cause your blood vessels to become

  “clogged up”, slowing the flow of blood to your heart, brain and other important organs as you age. While this

  process starts when you are a child, it takes many years before it can cause health problems.

  The medication that has been recommended for you, called a statin, has been shown to help reduce the risk of

  heart disease in people with high cholesterol from genetic conditions, often referred to as FH or familial

  hypercholesterolemia. Statins may also be helpful in reducing health risks in children who are overweight, obese,

  or have other health conditions such as diabetes mellitus, Kawasaki disease, heart transplants, chronic kidney

  disease, and cancer survivors.

  How do I know if I need a statin?

  Your healthcare team will help you decide if a statin is right for you. If your high cholesterol is not caused by a

  medical condition, such as a thyroid problem, you will be taught how to choose foods and snacks that are low in

  fat, and encouraged to become more physically active. You will be asked to repeat a blood test, usually in 3-6

  months, to see if your cholesterol level has improved. If not, it is likely your high cholesterol is genetic, which

  means it is a trait you inherited from one or both of your parents. In that case, your healthcare team will

  recommend a statin to lower your cholesterol to help you stay healthy.

  Are statins safe?

  Yes. Studies have shown that statins are safe and well tolerated by children. Your healthcare team will make sure

  your statin is working properly and is safe for you to take. While muscle aches and pains occurs in some adults who

  are taking a statin, they rarely occur in children. Girls who are sexually active should use an effective form of birth

  control to avoid become pregnant while taking a statin. If pregnant occurs, the statin should be stopped

  immediately. If planning to become pregnant, girls should talk to their healthcare team about when to stop their

  statin before discontinuing birth control.

  How should I take my statin?

  As with all medications, statins should only be taken as prescribed. Statins are a small pill that you take by mouth

  once a day. Many children take it at bedtime, although it can be taken at any time of the day, with or without

  Pediatric Atherosclerosis

  Prevention and Lipidology Group (PeDAL)
• food. Always store you statin in a safe place, away from small children and pets. Be sure to ask for refills before

  running out of your statin and check the expiration date frequently. You should never take medication that has

  expired. Ask your healthcare team or pharmacist if you have any questions or concerns about your statin. Notify

  your healthcare team right away if you feel differ or experience any problems while taking a statin.

  How long will I have to take a statin?

  If your high cholesterol is caused by a genetic trait, which is something you inherited from your parents, without

  medication you cholesterol level will always be high. While eating healthy meals and snacks, exercising, keeping

  your weight under control and avoiding smoking are all important in helping you stay healthy, for people with high

  cholesterol they are not enough. You will need medications from now on to lower your cholesterol level and

  reduce the risk of heart disease when you become an adult. While a statin is the best choice for now, newer

  medications to lower cholesterol may be available in the future.

  Will I be able to play games and participate in sports while I am taking a statin?

  Children can participate in all of their usual activates, including competitive sports and games, while taking a statin.

  Moderate-to-vigorous exercise and physical activity helps the statin work better to reduce your cholesterol levels

  and keep your heart strong. If you have a concern or an underlying health condition, talk with your healthcare

  team about how much and what kind of activities are best for you.

  What else can I do to stay healthy?

  A heart-healthy diet rich in fruits and vegetables, lean protein and whole grains, and staying physically active will

  help to decrease your cholesterol level and reduce the risk of heart attack and stroke when you become an adult.

  Try to develop healthy habits like avoiding smoking (including exposure to second hand smoke) and drinking

  alcohol.

  Parent Tear Sheet

  Use of statins (stat-TENS) in children and adolescents. What parents should

  know.

  Are statins recommended for children with elevated cholesterol?

  Yes. In 2001, the first statin (pravastatin) was approved by the US Food and Drug Administration (FDA) for use in

  children less than 18 years-of-age, but only in those with a genetic condition that causes extremely high levels of

  LDL cholesterol (LDL-C) or “bad” cholesterol. This approved was based on scientific studies which showed that use

  of statins caused no problems with growth, development or reproductive function, and consistently lowered LDL-C

  to a level that helps reduce long-term risk of blood vessel and heart disease.

  Which statins are approved for children?

  All commercially available statins are FDA approved for children, pravastatin starting at age 8, all others at age 10

  and older. Sometimes a statin may be recommended in children less than 8 years-of-age, especially if your child

  has other risk factors or health conditions.

  How are statin taken?

  Statins are taken by mouth once a day, usually at bedtime. They can be taken with or with food. If your child has
• been prescribed other medications, the statin can be taken at the same time. However, you should always check

  with your healthcare team to make sure all medications are compatible. Encourage your child to take medication

  only as prescribed, check the expiration date frequently, and anticipate the need for refills to avoid running out of

  medication. Never give your child medication that has expired. All medications, including statins, should be keep

  out of the reach of younger child. A healthy lifestyle will help your child’s statin do a better job of lowering

  cholesterol.

  What side effects can I expect if my child takes a statin?

  Your healthcare team will monitor your child’s response to the statin and carefully watch for any problems. The

  most common side effect of statins are muscle aches and pains, although they are rare in children. If your child

  experiences any symptoms after starting a statin, notify your healthcare team right away. A simple blood test (call

  creatine kinase or CK) can tell if the statin may be the cause of your child’s muscle complaints. Most often muscle

  aches and pains are due to exercise, strenuous play, or injury, in which case the statin can safely be continued.

  How can I encourage my child to take his/her statin properly?

  Children often forget to take their statin. If your child’s supply of statin lasts longer than it should, he/she is

  missing doses. You may find a pill dispenser, calendar or other reminder system helps your child to be more

  consistent. If your child has difficulty swallowing a pill, ask your healthcare team for suggestions.

  Are there long-term studies of statin use in children?

  While it is always good to remain cautious, 20 year follow-up studies of children who started treatment in their

  teens have shown statins to be both safe and effective.

  How long will my child need to take a statin?

  Without medication, children with a genetic variant have high cholesterol their entire life. Therefore a statin, or in

  the future, some other cholesterol lowering medication, is needed from now on. While a healthy lifestyle is still

  important, it is not sufficient without medication to keep the cholesterol under control and reduce the chances of

  heart disease when your child becomes an adult.

  Will my child be able to play games and participate in sports while taking a statin?

  Children can participate in all of their usual activates. If you have a concern or your child has an underlying health

  condition, talk with your healthcare team about how much and what kind of activities are best.