A recent study says one in three children, aged 9 to 11, has borderline or high cholesterol levels. The study, conducted in Houston, drew interest at the 2014 annual meeting of the American College of Cardiology in Washington, D.C.
The recent findings reinforce recommendations the National Heart, Lung and Blood Institute (NHLBI) made in 2011. NHLBI guidelines call for universal, routine cholesterol screening for children before and at the end of adolescence (specifically, at ages 9 to 11 and 17 to 21).
A ‘heads-up’ on children at risk
Michael Rocco, MD, Medical Director of Cardiac Rehabilitation and Stress Testing, Section of Preventive Cardiology, at Cleveland Clinic, who did not participate in the study, says screening gives doctors and parents a heads-up about their children’s long-term health risks for atherosclerosis or plaque-clogged arteries.
“Early identification of people at risk is important because atherosclerosis, buildup of plaque in arteries, is a process that begins early and progresses through life,” he says.
Study finds high cholesterol in kids
Researchers at Texas Children’s Hospital looked at indicators for increased heart risk in blood samples taken from more than 12,000 children aged 9 to 11 years old.
Results showed that 30 percent of the participants had borderline or abnormal cholesterol levels. About the same number were obese. Both high “bad” cholesterol readings and obesity can increase the chances of heart disease later in life.
Screening guideline changes
The NHLBI recommends screenings that include total cholesterol levels, high-density (HDL or “good”) cholesterol versus low density (LDL or “bad”) cholesterol, as well as triglyceride levels. Before the 2011 update, the guidelines limited recommended testing to children who had specific risk factors such as diabetes, obesity or a history of heart disease in the family. Many experts still support this targeted, case-by-case approach to testing.
Before the expanded 2011 guidelines, families often missed opportunities to identify at-risk children. As many as 60 percent lost out on early screening and the opportunity to start heart-healthy lifestyle changes, experts say.
Some parents question screening
Despite the updated recommendations, many parents are still unsure about the benefits of testing and treating children for a condition usually associated with older adults.
Dr. Rocco points out that testing is not geared toward medicating children. Only a very small percentage of children or adolescents with significantly elevated cholesterol levels and strong family history of early heart disease would be considered for medications. The aim, instead, is to increase awareness about risk factors and needed lifestyle changes in children with worrisome cholesterol readings. “We also want to institute these changes at a young age when they may be most beneficial,” Dr. Rocco says.
“It’s not about medicating children at an early age,” he says. “These guidelines are not there to identify people specifically for treatment, but to identify children potentially at risk so that the appropriate management is instituted.”
An early start on heart-healthy habits
Some healthcare professionals question the wisdom of widespread screening. Not all pediatricians and cardiologists feel that universal screening is necessary or wise.
They stress that physicians should always discuss healthy lifestyle choices with families that have children of any age. Heart-healthy living includes eating a well-balanced diet, (with an emphasis on lean protein, fresh vegetables and fruit), and eliminating sugary sodas and trans fats. Experts also recommend engaging in daily physical activity.
Promoting awareness of those choices and encouraging healthy habits from an early age will help set children up to become healthier adults.