underweight very active child with high cholesterol

My daughter is 8 1/2 years old and barely weighs 40 lbs. She is somewhat of a picky eater, but does love fruits and veggies. She runs track and is a figure skater. Her total cholesterol is 195 (H) her HDL is 59 her triglycerides are 63 and her LDL is 123 (H). The doctor said to eat a healthier diet along with exercise. I honestly don't think I could possibly add exercise to what she already does. She runs track 3 days a week for 1 hour, figure skates 2- 3 days a week for 1-2 hours and on top of that she swims, rides her bike and plays outside. She eats a lot for her size but I thinks its because she burns a ton of calories. She does LOVE pizza, spaghetti, and chicken nuggets but does not eat them often except for pizza she loves pizza. Any suggestions on a diet I could change to, since adding exercise is not an option.
Thanks

[Renee Radenberg]

Genetics do play a part in cholesterol. Usually when children do have high cholesterol, it is from hereditary origins. Research has shown that it is the quality of fat that makes the difference in lowering cholesterol, not an overall lowering of all fats. It is recommended that all Trans fats and saturated fats are not consumed, but omega-3 fatty acids and monounsaturated fats can be eaten. To break that down simply it means nuts, seeds, and peanut/olive oils can be eaten. Suggest having her eat a moderate fat diet to help lower their cholesterol. Moderate fat diet means = use polyunsaturated (omega 3, corn oil, nuts, etc) fats and monounsaturated (olive oil, canola oil, peanut oil, etc) fats, no saturated fats and no Trans fats. Eat low fat meats (chicken, fish, loin of pork) or non-meat sources (soy products, nuts), low fat vegetarian combinations (rice & beans, pasta & beans, low fat cheese & pasta), fat free or low fat dairy products (skim milk, 1% milk, low fat cheese, low fat yogurts, low fat soy milk/yogurt), use plant oils, non trans-fat margarines, and eat a lot of fruits and vegetables. Eat daily high fiber breads and cereals (oatmeal). Hope this helped you.