Is it OK for my 12 year-old daughter to take fish oil pills? She's got high levels of cholesterol and triglycerides. -- ID, Fairfield

Don't run to the supplement aisle until you run this by your pediatrician.

Research shows that omega-3 fats called DHA and EPA in fish or fish oil can reduce elevated triglycerides and reduce heart disease risk. Triglycerides are a blood fat, like cholesterol, and are the body's main vehicle for fat storage. Abnormally high triglycerides signal increased risk of heart disease and diabetes. High cholesterol levels early in life may play a role in the development of heart disease in adulthood.

The American Heart Association's guidelines for omega-3s advises individuals without heart disease to eat a variety of fish (preferably fatty types like salmon, trout, sardines, tuna and mackerel) at least twice a week. That supplies roughly 500mg a day of DHA and EPA omega-3s. For those with heart disease, the AHA suggests 1,000 mg per day of DHA and EPA, preferably from food, although capsule form should be considered with a physician. Elevated triglycerides may warrant an even higher omega-3 dose only under a physician's supervision. Experts warn that fish oil may interfere with certain medications and that taking too much fish oil may cause health problems.

So, how does your child fit into these adult-driven recommendations?

First, does she consume a cardio-protective diet alongside regular exercise? That alone may be enough to treat her abnormally high lipids. I'm guessing your daughter struggles to eat a balanced diet as most kids -- let alone most adults -- do. If so, seek a referral to a registered dietitian who can guide your family toward a heart-healthy diet and lifestyle changes.

If your daughter is unable or unwilling to take in omega 3s adequately from food, ask her doctor to review any risk factors such as: Severity of lipid abnormalities; weight status; family history of cardiac disease; smoking; and other illnesses like diabetes, thyroid disease or high blood pressure. The higher the risk, the more likely a doctor would favor fish oil supplementation for a young adult.

In recent years, with the surge in obesity, doctors are now considering omega-3 supplementation and even medication more often for severe cases where high lipids in children and adolescents do not respond to diet and lifestyle modification.

I do applaud you for aggressively addressing your child's cardiovascular risk. Just remain cautious until we have more clinical trials on supplements and medications used in the pediatric population. Nutritional supplements, unlike prescription drugs, are not regulated by the FDA for safety and efficacy.

Courtney Sansonetti, RD, CDE, CD-N, is a medical nutrition therapist and certified diabetes educator for Rehabilitation Associates, Inc., 1931 Black Rock Turnpike. E-mail your questions to