Getting to the Heart of the Matter: Cholesterol Screening for Kids
Parents have been asking me if their children should have a blood test to screen them for cholesterol. Well let me do more than chew the fat on this topic, and provide some information.
Cholesterol is a fat substance which is made by the liver, or which can be introduced into the body from the foods we eat. Once inside the body, cholesterol contributes to our becoming overweight or obese and gets deposited in blood vessels, increasing our risk of heart disease.
The National Heart, Lung, and Blood Institute, recently updated its screening guidelines which were endorsed by the American Academy of Pediatrics because it appears that cholesterol can start accumulating in the body even in childhood. These organizations are now recommending that all children between the ages of 9 and 11 years be screened for cholesterol, and screened again between 17 and 21 years. They also recommend all children over the age of 2 who are at risk for elevated cholesterol get a screening test, and even if the level is normal, should continue to get screened every 3 to 5 years.
So when is a child at risk of high cholesterol? The following represent some key risk factors:
This could mean that as many as 3 out of every 4 children will probably need to be screened because they fall into a risk category even before age 9. The initial blood test is one that does not require children to fast. But even if you do not screen your child early, or he or she has a normal cholesterol level as a child, you should still pay attention to trying to keep their cholesterol levels low. You can do this by reducing the amount of high cholesterol and saturated fats in your child's diet by cutting back on the amount of high fat dairy products and high fat meats that they eat. Another good idea is to exercise regularly as a family to reduce the build-up of the types of cholesterol in all of us that can later affect the heart.
The AAP is also now recommending that if diet or exercise by themselves do not help lower cholesterol, then a cholesterol-lowering medication usually recommended for adults can be tried in children 10 years or older, but discuss with your child’s doctor to see if the benefits outweigh the risk of using these medications in your child, which currently would involve less than 1% of all children.
Hopefully tips like these will allow you to get to the heart of the matter when it comes to knowing a little more about whether or not to screen your child for cholesterol.
Lewis First, M.D., is chief of Pediatrics at Vermont Children's Hospital at Fletcher Allen Health Care and chair of the Department of Pediatrics at the University of Vermont College of Medicine. You can also catch "First with Kids" weekly on WOKO 98.9FM and WPTZ Channel 5, or visit the First with Kids video archives at http://www.FletcherAllen.org/firstwithkids.