High cholesterol isn’t a problem limited to adulthood. In fact, it’s becoming more common in children. The Centers for Disease Control and Prevention reports that among youths aged 12-19 years, 14% of kids who are normal weight and 43% of children who are obese have at least one abnormal cholesterol level.
The alarming aspect of those numbers is that typically kids with high cholesterol move on to become adults with high cholesterol, which may eventually lead to heart disease.
That’s why the American Academy of Pediatrics (AAP) recently announced new guidelines for when children should have their cholesterol levels checked, as a part of other updates for well-child visits. Their aim is for early prevention:
All children, regardless of risk or family history, should have their cholesterol checked between ages 9-11.
Previously the AAP did not have formal guidelines associated with the timing of testing for the general pediatric population, choosing instead only to test those children with risk factors, such as obesity, diabetes, or family history. The problem with this initial philosophy for children, and one of the reasons for the change, is that high cholesterol is usually a silent condition. It can happen with or without the presence of obesity, diabetes, or family history.
The young age range for when children should be tested may be surprising for some parents, but studies have shown that the negative effects of high cholesterol in children may occur early in life and without screening the general population, those children at-risk remain undetected.
Even if your child doesn’t have high cholesterol, which is the ideal scenario, it’s helpful for your pediatrician to have a baseline level before your child goes through puberty. The choice of age range 9-11 is based primarily on the potential to intervene more effectively if an abnormality is detected in this age group relative to younger children.
Early testing means early prevention. If we can catch children with high cholesterol early, we have a better chance of helping them to reverse the negative consequences associated with the disease. Too much cholesterol can lead to a buildup of plaque on the walls of the arteries that transport blood to the heart and other organs. When this happens, arteries can become narrowed and blocked.
The good news is that early prevention in children can lead to better chances for reversal of the disease. And relatively speaking it is easier to change the habits of a 10-year-old than that of an adult.
So what do those interventions look like? Typically in our lipid clinic we recommend lifestyle changes such as diet and exercise to help decrease high cholesterol levels.
Here are some general recommendations we give our patients for maintaining a healthy diet and lowering their cholesterol:
- Read food labels carefully
- Limit dietary fat to less than 25% of total daily calories (in particular, reduced saturated fats to less than 10% of daily calories)
- Limit cholesterol to less than 300 mg per day
- Choose nonfat or low-fat milk and dairy products
- Increase intake of fruits, vegetables, and whole grains
- Limit screen time to two hours or less per day (including gaming devices and computers)
- Be active for 60 minutes every day
If your pediatrician does not mention cholesterol testing for your child at his next well-child visit, and your child is between the ages of 9-11, I recommend you bring it up. Checking cholesterol levels in this age range is an important step to ensure that children are on the right track for a healthy heart later in life.