More kids need cholesterol screening, experts warn

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Cardiovascular disease is the leading cause of death in North America and throughout the developed world. High cholesterol is the biggest contributor to this problem. High levels of LDL (i.e., "bad cholesterol," as opposed to HDL or "good cholesterol") cause hardening and clogging of arteries, restricting blood flow and oxygen to the heart, eventually leading to heart attack.

Until recently, we thought that high cholesterol was an adult problem. After all, cholesterol-related problems don't typically surface until middle age, and reasonably healthy people under the age of 40 generally don't have to worry about it too much.

Cholesterol screening for kids?

With the rise of childhood obesity, health experts are beginning to rethink their cholesterol screening recommendations. In 2008, the American Academy of Pediatrics stirred controversy with new recommendations saying that, under certain conditions, it may be advisable for children as young as 2 years of age to be screened for high cholesterol.

More specifically, according to their report, for kids who are overweight or obese, who have hypertension or diabetes, or who have a family history of high cholesterol, "the first screening should take place after 2 years of age but no later than 10 years of age."

The AAP report cites "the negative effects of excess dietary intake of saturated and trans fats and cholesterol" as well as "the obesity epidemic, the metabolic/insulin-resistance syndrome, and the decreased level of physical activity" as causes for their new recommendations. 

A widespread problem

Thirty years ago, this wasn't a serious issue, as childhood diabetes and hypertension were not widespread, and only 5% of the population under 18 was obese. Today, nearly 18% of the under-18 population is obese, with one third being overweight. Meanwhile, at the current rate of growth, diabetes prevalence is projected to explode over the next few decades.

In this light, it's not surprising that a new CDC study reports that 20.3% of youths between the ages of 12 and 19 have abnormally high cholesterol levels.  The report states that "32% of all youths would be candidates for lipid screening," with 22.3% of overweight youths and 42.9% of obese youths likely needing medical intervention to combat high levels of bad cholesterol.

Surprisingly, the same study found that 14.2% of young people who are not overweight have high cholesterol. While some of this is related to heredity, it also underlines the fact that overweight and obesity are not the only indicators of an unhealthy lifestyle. Overall dietary health and amount of exercise are far more important considerations than physical appearance.

Who should be screened, and what can parents do?

Based on these studies, there are four ways to determine whether your child needs a cholesterol screening:

1.      Is your child overweight or obese?

2.      Is your child's diet heavy in meat, dairy, eggs, saturated or trans fats, or carbohydrates?

3.      Does your child exercise less than 30 minutes per day?

4.      Do you have a family history of high cholesterol?

If you answer yes to any of these questions, talk to your family doctor about whether a cholesterol screen is recommended for your child.

If your child is found to have high cholesterol, or if you wish to prevent your child from having these problems, there are concrete steps you can take. First of all, ensure that your child gets at least 60 hours of exercise. Second, limit his or her meat intake to less than two servings per day, and limit dairy intake to no more than three servings. Meanwhile, ensure that your child gets plenty of vegetables, fruits, and whole grains.

If your child lives a healthy lifestyle but has high cholesterol due to hereditary factors, talk to your doctor about options for lowering cholesterol, whether through a dietary regimen or prescription medication. 

Staff Writer