KIDS
April 8, 2014

Cholesterol Problems in Kids

Almost a third of children 11 and under had problems with their cholesterol levels. Luckily, such early information means they can be improved.

It's all part of the same picture: We’re worried about our children's weight; we’re worried about their inactivity; we're worried about the amount of time they spend in front of a screen. So it's no surprise that now, we’re worried about their cholesterol levels, too.

It seems unthinkable, but more and more children have cholesterol levels approaching those of middle-aged adults.

First, a quick review. When your cholesterol is checked, the lipid panels are comprised of several values: Total cholesterol, high-density lipoprotein (HDL), low-density lipoprotein (LDL), and Triglycerides.

LDL cholesterol is referred to as bad cholesterol, as it can build up on your artery walls and cause problems.

Children with the worst blood tests were those who were also obese, and one-third of the children screened were obese.

When your LDL is lower, your risk of cardiovascular disease is lower. HDL cholesterol is considered good cholesterol because it helps protect you from the bad effects of LDL cholesterol by keeping it off your artery walls. When your HDL cholesterol is higher, your risk of CV disease is also lower.

Finally, triglycerides are circulating fats that are typically derived from food we eat. Higher triglyceride levels are associated with a greater risk of cardiovascular problems.

A recent study of nine- to 11-year-olds found that one-third of the over 12,500 children in the study had borderline or clear elevations of their total cholesterol.

The findings serve as a dire prediction for the future heart health of American children because the precursors of adult cardiovascular disease, such as changes in the blood vessels that lead to atherosclerosis, can start early in life.

The children were seen for well-child visits at 45 clinics in Texas. Forty-six percent had LDL-cholesterol levels that were borderline high or abnormal, and 44% had HDL-cholesterol levels that are considered borderline low or abnormal.

Boys were more likely than girls to have elevated total cholesterol, as well as having elevated LDL or bad cholesterol and triglycerides. Girls had lower HDL or good cholesterol.

Children with the worst blood tests were those who were also obese, and one-third of the children screened were obese. Among Hispanic children in the study, there was a higher incidence of high triglycerides and lower HDL (good cholesterol) than non-Hispanics.

All in all, a significant number of young kids already showed some very troubling lipid profiles.

Many parents and medical providers have been hesitant to screen children and teens for abnormal blood lipids because they weren't sure whether early detection would make a difference later on, and they feared that too many children would end up on medications.

Medication is not the first line of therapy for most children, however, and the current research suggests that screening can be helpful because reducing the risk of cardiovascular disease in childhood does indeed delay the progression to full-blown adult problems such as heart attacks, strokes, and aneurysms.

The researchers, all at Texas Children's Hospital in Houston, maintain that children should have their cholesterol levels screened periodically, and the results used to guide physicians and parents in making choices about diet, exercise, and, if clearly necessary, medication, that will help reduce a child's risk.

This study supports the recommendation of the American Academy of Pediatrics and the National Health, Lung, and Blood Institute, which have recommended routine lipid screening when children are from nine to 11 years old and again when they are 18 to 21.

Most young children with abnormal lipid profiles do not require medication treatment, another benefit of uncovering cholesterol problems early. Research has shown that adhering to weight loss, exercise, and dietary recommendations especially concerning the amount and types of fat intake can make a difference for future health.

Parents of children who are overweight and under-active may want to talk with their children’s doctors about cholesterol screening. On their own at home, they can make sure family meals include heart healthy foods. The American Heart Association offers helpful guidelines for parents.

All families, regardless of their members' lipid profiles, can benefit from appropriate nutrition and exercise.

The study is published in the Journal of American Cardiology.

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