Cholesterol Tests for Kids
Here's something about children that most of us don't know, which is connected to some facts that most of us do know.
Most people know that America is an increasingly obese nation. Most people know that obesity is a risk factor for heart disease, stroke, diabetes, osteoarthritis and lots of other threats to health and life. Most people know that obesity can raise blood cholesterol levels, and that adults often have cholesterol tests to determine if their levels are dangerous.
For the first time, medical experts are recommending that all children also have their cholesterol checked.
It’s not just a sound health-care practice, it’s a sad reflection that kids are getting fatter right along with the rest of us. And that the seeds of heart disease, diabetes and strokes are sown early in life.
Approximately one-third of U.S. children are overweight or obese. And although being overweight doesn’t always result in high cholesterol, it’s always a reason to check.
As described in the Los Angeles Times, although kid cholesterol tests have become an unfortunate necessity, the recommended procedure is not the same as the one for adults. Tests should be given at least once when kids are between 9 and 11, and again when they’re between 17 and 21. They’re not usually necessary every year.
And the kid cholesterol test doesn’t require fasting, as the adult test does. It involves either a blood draw or maybe just a finger prick in the doctor's office. If the first test suggests abnormal cholesterol levels, a fasting cholesterol test would be the next step.
The panel’s recommendations were published in the journal Pediatrics.
Even overweight children typically don't suffer heart attacks, but looking for precursors of heart disease is an effort to head that future event off at the pass. "Heart disease is the No. 1 cause of death in our society," said Dr. Stephen R. Daniels, the panel chairman. "We know the process that leads to those deaths begins in childhood. We also know that people who are able to maintain a low risk through childhood and early adulthood have a lower risk.”
The National Heart, Lung and Blood Institute – a branch of the National Institutes of Health (NIH) – developed the guidelines for testing cholesterol in kids, and they were endorsed by the American Academy of Pediatrics. Heart specialists and pediatricians called them long overdue.
The previous guidelines, dating to 1992, said children should be given cholesterol screenings only if their family history included heart disease or high cholesterol.
Experts predict that the most immediate impact of universal cholesterol screening for children will be imparting a sense of urgency among parents and primary caregivers to improve kids’ diets and exercise habits if the test discloses higher than normal cholesterol, whether or not they’re overweight. (Just as overweight people can have normal cholesterol, sometimes cholesterol can be elevated even if you aren’t carrying extra pounds.) They don’t anticipate widespread prescription of medication.
According to one study mentioned in The Times’ story, no one knows how many children have abnormal cholesterol, but more than 28% of children who are overweight may have metabolic syndrome. That’s a cluster of risk factors including high blood pressure and high cholesterol.
In addition to the cholesterol test, the new report suggests other ways to monitor and manage heart risk in children. They include:
- exclusively breast-feeding babies for the first six months of life;
- feeding children a diet low in saturated fat beginning at 1 year;
- counseling children about diet and exercise if they score above the 85th percentile on weight-height charts (that threshold means the child’s weight is higher than 85% of other children at that height).
The guidelines suggest different diets depending on a child's weight and whether he or she has high blood pressure or high cholesterol.
We’ve written often about the misguided, expensive and potentially dangerous medical practice of over-testing. But this isn’t one of those situations. Although some cholesterol tests for kids might signal a need for changes in behavior, changes that might seem overly restrictive as if you can’t let a kid be a kid, parents must realize they’re only making an investment in the future.
And that sometimes doing what’s best for a child brings positive change for the whole family.