High cholesterol
Beginning in childhood, the waxy substance called cholesterol and other fatty substances known as lipids begin to build up in the arteries, hardening into plaques that narrow the passageway. During adulthood, plaque buildup and resulting health problems occur not only in the arteries supplying blood to the heart muscle but in arteries throughout the body (a problem known as atherosclerosis). For both men and women in the U.S., the number one cause of death is heart disease, and the amount of cholesterol in the blood greatly affects a person’s chances of suffering from it. The experts even encourage reducing cholesterol intake in children and teens as a way to prevent heart disease in adulthood.
For those under 20 years of age and at low risk, cholesterol testing is usually not ordered routinely. However, when a youth is at risk, cholesterol measurement provides useful information. The American Academy of Pediatrics recommends “selective” screening, as outlined below, to identify those at high risk of having high blood cholesterol levels as adults and increased risk of heart disease:
Cholesterol testing is appropriate for youths with a parent with high blood cholesterol level and those with a family history of premature heart disease (parent or grandparent with disease before age 55).
Cholesterol testing can also be appropriate for children judged to be at higher risk because, for example, they are overweight, consume excessive amounts of saturated fats and cholesterol, or smoke.
Links
Cholesterol: Excellent basic information is available from the National Heart, Lung, and Blood Institute at http://www.nhlbi.nih.gov/health/dci/Diseases/Hbc/HBC_WhatIs.html; the articles on cholesterol and cholesterol in children from the University of Maryland Medicine web site, http://www.thoraciconcology.com/careguides/cholesterol, are also recommended
Cholesterol in children: On the Keep Kids Healthy web site, http://www.keepkidshealthy.com/nutrition/cholesterol.html, a pediatrician explains to parents, using the guidelines of the American Academy of Pediatrics, how to assess cholesterol in children
Sources
American Academy of Family Physicians. Heart disease: assessing your risk. Available on the Internet at http://www.familydoctor.org/x2756.xml. Accessed July 16, 2004.
American Academy of Family Physicians. Summary of policy recommendations for periodic health examinations. 2003 Aug. Available on the Internet from the National Guideline Clearinghouse at http://www.guidelines.gov/summary/summary.aspx?doc_id=4183&nbr=3208. Accessed July 19, 2004.
American Academy of Pediatrics, Committee on Nutrition. Cholesterol in childhood (policy statement). 1998 Jan. Pediatrics 101:1;141-147. Available on the Internet at http://aappolicy.aappublications.org/cgi/content/full/pediatrics;101/1/141. Accessed August 10, 2004.
Berg AO, for the United States Preventive Services Task Force. Screening for lipid disorders: recommendations and rationale. Am J Prev Med 2001;20(3S):73-76.
A.D.A.M., Inc. Children can have high cholesterol, too. 2002 Jun 17. Available on the Internet from the University of Maryland Medicine web site at http://www.thoraciconcology.com/careguides/cholesterol. Accessed August 10, 2004.
