Your Child’s Cholesterol
New Screening Recommendations!
By Karen Seligman, M.D.
Many parents may think that maintaining recommended cholesterol levels is a health concern that affects only adults, but this is not the case. Until recently, pediatric experts have suggested cholesterol screening for children if they have a family history of heart disease or high blood cholesterol, or if the children have certain other risk factors. High cholesterol levels can put children at risk for future cardiovascular disease.
New Findings
The American Academy of Pediatrics has now endorsed a recommendation from the National Institutes of Health for all children to have their cholesterol screened. Experts have found that screening only those children deemed high risk by family history misses 30 to 60 percent of children with high cholesterol. The rise in childhood obesity, and in turn childhood diabetes, has been a factor in children’s escalating cholesterol levels.
The new universal screen for high cholesterol is suggested for children between the ages of 9 and 11 and then again for young adults between the ages of 17 and 21. Fluctuating cholesterol levels during puberty make screening more reliable if done at these ages.
The screening requires a simple blood test, which now eliminates the need for the child to fast so that it can be done at any time of the day. It measures the level of non-HDL-cholesterol, or the harmful components of cholesterol, as the HDL is protective. Should this screening be abnormal, a fasting lipid profile would be obtained to get more specific information.
It is still rare that cholesterol lowering statin medications will be prescribed to children. They are used only for those with very high levels at age 10 or older, and those with multiple other risk factors down to age 8 years.
Treatment
The good news is that children with high cholesterol can lower their levels considerably through lifestyle changes.
The first approach is to address a child’s diet and exercise with the possible addition of a dietary supplement. All children should get at least one hour of physical activity per day. With children spending more time at the computer and with other wired devices, this exercise time may need to be a scheduled activity.
As for diet, children should eat no trans fats, less saturated fats and less sugar. Eating more real food and less processed food is important. Eliminating soda and other sugary drinks while increasing fresh fruits and vegetables and whole grains is a good way to lower cholesterol and increase overall health.
In some cases dietary supplements such as fiber supplements or plant sterols and stanols may be advised for high LDL-cholesterol, and fish oil is well tolerated and effective in reducing triglycerides.
Children Are Willing
Addressing your child’s high cholesterol at a young age is an important step toward helping to reduce the risk for heart attack and stroke in the future. And while heart attacks are very rare in childhood, elevated cholesterol contributes to atherosclerosis, the build-up of arterial plaque, which is a slow and cumulative process.
The good news is that the culture seems to be shifting and children are becoming more motivated to get and stay healthy. Just as their attitudes toward tobacco use have changed, they are becoming better educated about healthy diet and exercise.
At your next visit to your child’s pediatrician, initiate a conversation to discuss screening your child’s cholesterol level. After all, prevention is the best medicine. n
Karen Seligman, M.D. is a pediatric cardiologist who specializes in preventive cardiology at Maria Fareri Children’s Hospital at Westchester Medical Center.
