Chapter 6: Triglyceride-lowering treatment in children

RATIONALE Non-pharmacological treatment of high triglycerides TLC includes dietary modification, weight reduction, increased physical activity, reducing alcohol intake, and treatment of hyperglycemia (if present). As for adults, the evidence that TLC will reduce serum TG levels and/or improve clinical outcomes is weak. Nonetheless, in the opinion of the Work Group, it is reasonable to advise children with high fasting levels of serum TGs (45.65 mmol/l [4500 mg/dl]) to adopt TLC based on similar considerations as mentioned in Guideline 5.1. Dietary changes that may reduce serum TGs include a very low-fat diet (o15% total calories), medium-chain TGs, and fish oils to replace some long-chain TGs. Dietary modification should be used judiciously, if at all, in children who are malnourished. Input from a social worker may be helpful if there are concerns that the patient or his/her parents are unable to safely implement TLC.