DEAR DR. DONOHUE: My daughter, age 12, has a cholesterol level of 216. Her pediatrician says this is too high. I thought that 200 was normal, and she’s not far from that. The doctor wants to recheck her. If her number stays the same, what would you recommend? I don’t like the idea of giving her drugs. – K.O.

ANSWER: The normal cholesterol value for children isn’t the same as a normal value for adults. The average cholesterol reading for children her age is 160 mg/dL (4.1 mmol/L). The 75th percentile for children her age is 173 (4.5). The 75th percentile means 75 percent of 12-year-old children have a cholesterol level less than that. High cholesterol in childhood assures high cholesterol in adulthood and, at a young age, the serious heart consequences that come from such an elevation. Autopsies on many young soldiers in the Vietnam War showed that their arteries were beginning to close off from cholesterol buildup. They were in the late teens or early 20s.

Experts recommend that any child with a cholesterol level higher than the 75th percentile make serious efforts to lower it. These children must exercise daily. Your daughter can do any activity she likes – like jumping rope, jogging, swimming, dancing or brisk walking – but she has to get in 30 minutes of exercise. She should keep fatty foods and cholesterol-rich foods to a minimum. If she’s overweight, she has to restrict calories too.

Changing a child’s diet is serious business. Children are growing, and slipshod restrictions of food could affect their health. A dietitian can guide you in proper nutrition for her diet. She must stay on the diet and exercise program for six months to a year before being retested. If there has been no change in her cholesterol by then, medicines should be considered.

DEAR DR. DONOHUE: My husband has diabetes, so I read food labels carefully. Often, I see “sugar alcohols” listed. What are they? Are they sugar, and should he not eat foods with them? I’ve been ignoring them, but I am beginning to wonder if I’m doing the right thing. – B.K.

ANSWER: Sugar alcohols are neither sugar nor alcohol, and the name confuses people. They’re found in many “sugar-free” foods as the sweetener. Their chemical structure looks a little like a sugar and a little like an alcohol, but that’s as close as they get to being either.

These substances can raise blood sugar a bit, but the rise is slow. They contain from 0.2 to 2.5 calories per gram. Sugar (carbohydrate) has 4 calories per gram.

You can safely ignore them if a food contains less than 10 grams of sugar alcohol.

If there’s more than 10 grams of sugar alcohol in a product, take half the amount of listed sugar alcohol and deduct that from the total grams of carbohydrate listed on the label. That’ll give you the carbohydrate load of the food.

Names of sugar alcohol include sorbitol, mannitol, xylitol, lactitol and isomalt. Many sugarless gums contain sugar alcohol. The kind I chew has 1 gram of sugar alcohol in each stick.

The diabetes booklet explains the ins and outs of diabetes and its treatment. Readers who would like a copy can order one by writing: Dr. Donohue – No. 402, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order for $4.75 U.S./$6.75 Can. with the recipient’s printed name and address. Please allow four weeks for delivery.

DEAR DR. DONOHUE: How often does a person with high blood pressure have to see the doctor? I think my doctor is overdoing my visits. I have friends with high blood pressure who see the doctor only once a year. I see mine every month. Isn’t this overkill? – F.B.

ANSWER: The frequency of visits for patients with high blood pressure depends on how high the pressure is and whether it is controlled. Very high readings that aren’t coming down require frequent visits. A change of medicines also requires frequent visits. Once pressure returns to or near to normal, then visits can be two or three times a year or maybe less often.

If you have your own blood pressure machine – they’re not expensive – perhaps your doctor won’t schedule your visits so frequently.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Readers may also order health newsletters from www.rbmamall.com

Copy the Story Link