Twenty-five percent of American youth have at least one adverse marker for cholesterol, setting them up for health problems down the line.
Lukas Settecase, 4, could be one of them. He is a Chicagoan who loves the Cubs, Spiderman and is optimistic about getting a new heart.
"It's going to come but it's gonna take a long time," he said with a smile in his hospital room at Lurie Children's.
His heart was compromised from cancer treatment he has received since being diagnosed with leukemia at just 10 months old. His mom Aliza has three other children at home and pushes good nutrition as the key to healthy living. It is a message that seems to be getting through more broadly, as Dr. Amanda Perak details in the study published in the Journal of the American Medical Association.
She found 7 percent of children had high cholesterol in surveys from 2009 to 2016. That was down from 10 percent a decade earlier -- but it's still too high.
"When someone has elevated cholesterol levels even in childhood we know that can start to clog arteries," said Dr. Perak, who is a pediatric cardiologist. "Instead of being a nice clean surface for the blood to flow through it becomes a little stickier and smaller and smaller and eventually in adulthood so small they can end up with a heart attack."
Dr. Perak found about 1 in 4 teens and 1 in 5 younger children had unhealthy levels of at least one of type of blood fat, including cholesterol and triglycerides.
"If we can intervene now and get them on a healthy lifestyle, cholesterol levels (tend) to come down and control all those other risk factors such as body weight and obesity. We would be able to prevent them from having cardiovascular disease," she said.
The doctor and her colleagues said the mixed bag of results could reflect stubborn rates of childhood obesity, perhaps offset by U.S. kids eating fewer snack foods containing unhealthy trans fats.
"The fact obesity continues to get worse continues to be extremely concerning... I do think that's a critical emergency," Dr. Perak said.
For Lukas, the challenge now is to actually put on weight, and then make good choices with the help of mom.
"Anytime I create a meal I have a vegetable along with the food and of course a protein," said Aliza. "We teach that at home and we are very strict they have to finish everything in their meal before the dessert."
Aliza thinks Lukas may grow up to be a doctor.
"I would not be surprised -- he knows more about all this stuff than a lot of people," she said with a smile.
Lukas is on the list for a donor heart that could come anytime -- today, tomorrow, maybe six months from now.
The little boy can't wait for the days when he gets back home for good.
When asked how strong he feels, he answered: "Stronger than a lion."