Should Children Be Screened for High Cholesterol?

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National recommendations call for doctors to check cholesterol levels in children and adolescents when parents or grandparents have been diagnosed with heart disease prior to age 55 or when a parent has total cholesterol over 240. However a new study has found that hyperlipidemia (high cholesterol) is so much more common in children today, that routine cholesterol screenings would benefit children who do not meet these guidelines and would otherwise be missed.

In a study conducted by the West Virginia University, researchers analyzed the results from family histories and fasting lipid tests of more than 20,000 fifth-grade students. Seventy-one percent met the guidelines for cholesterol screening based on family history. Of the remaining students who would not normally be screened, a third had cholesterol levels high enough to require intervention.

About 1.7% had readings high enough to be candidates for cholesterol medication treatment.

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"We would have missed 36% of children with seriously high LDL, said William Neal, a pediatric cardiologist at West Virginia University and director of the study, called CARDIAC – Coronary Artery Risk Detection in Appalachian Communities. The findings are being published today in the journal Pediatrics.

Not everyone agrees that universal screening is the answer. Dr. Ralph Sacco, president of the American Heart Association (AHA) suggests revamping the current screening guidelines and improving the current screening tools. Dr. Sacco notes that both the AHA and the American Academy of Pediatrics now recommend cholesterol screening in children with personal risk factors for heart disease such as obesity, high blood pressure and diabetes in addition to a risk based on family history.

Although most children have high cholesterol due to genetics, many children today are approaching unhealthy readings due to obesity, poor diets and sedentary lifestyles. The latest statistics indicate that about 17% of US children are obese. For these children, a change in behaviors is recommended prior to initiating cholesterol-lowering medication. These include:

• Regular activity. For children and adolescents, the CDC recommends at least 60 minutes of physical activity each day.
• Choose foods lower in fat, saturated fat and cholesterol
• Increase your child’s intake of fresh fruits and vegetables.
• Substitute refined flour products for whole grains to increase fiber intake.
• Limit the amount of added sugar your child consumes each day from sources such as candy and soft drinks.

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