Did you also know that the risk factors associated with CVD include too much bad fat (low-density lipoprotein), too little good fat (high-density lipoprotein), high blood pressure, type 1 or 2 diabetes, smoking and obesity?

Now for the shocker, did you know that 3 out of those 6 risk factors have been identified in children as young as 2 years? Early signs of atherosclerosis, commonly known as clogged arteries are now being seen in children and young adults in the form of fatty streaks and fibrous plaques—yuck!

This finding was so disturbing, the American Academy of Pediatrics (AAP) decided to retire its 1998 policy statement on cholesterol in childhood and replace it with a clinical report titled, “Lipid Screening and Cardiovascular Health in Childhood.”

The new guidelines, published in the July 2008 issue of Pediatrics encourage parents of overweight or obese children, or those with a family history of obesity, cardiovascular disease, or high cholesterol to skip whole milk altogether and go straight to low-fat (1 or 2 percent) milk once weaning begins in children between 12 and 24 months of age. The AAP also recommends low-fat dairy products for all children older than 2 years. In other words, it’s time to cut the fat.

The report does not say that whole milk is bad. Nor does it say that every child should go straight to low-fat milk. What it is saying is that the formerly rigid recommendation of whole milk from 12 to 24 months has now been modified in order to take current or future risk factors into consideration, specifically to reduce the lifelong risk of cardiovascular disease by improving lipid and lipoprotein concentrations during childhood.

These new guidelines represent a major policy shift; something seldom seen within the AAP. I don’t know how many times I was told that the fats found in whole milk were essential to the proper development of my baby’s brain. Turns out, though, that the past recommendations were derived from evidence linking the healthy amount of fat in breastmilk with brain development. (So much for the theory that cow milk and human milk are similar.)

Whole milk contains about 3.5 to 3.8 percent fat, and reduced or low-fat contains one or two percent. Based on the new recommendations, low-fat milk is considered a healthy alternative for children who are already overweight or obese, or have family risk factors, because they would still be getting some fat in their diets, and may already have sufficient fat levels in their bodies.

After age two, your toddler can start drinking the same kind of milk that the rest of the family drinks, including skim (fat-free).

What if the low-fat diet along with an increase in physical activity doesn’t work and your child’s still has too much LDL and not enought HDL? Hold that thought…because the next step is to give children 8 years and older cholesterol-lowering drugs. Now that’s a scary thought.