Kids need testing for high cholesterol too

cholesterolBy Betsy Stein

If your pediatrician has recently asked you to get your child's cholesterol tested, there's a reason.

In 2011, the American Academy of Pediatrics started recommending that all kids between the ages of 9 and 11 be screened for high cholesterol and then again between the ages of 17 and 21. Anyone over the age of 2 with a family history is also recommended for screening.

"Cholesterol in kids is what we call a silent issue," said Dr. Esther Liu, chairman of pediatrics at Baltimore Washington Medical Center. "High cholesterol puts you at risk for cardiovascular disease in adulthood, and it starts in childhood. ... It's a progressive disease, you don't think of it until you have a problem."

Dr. Ettaly Jobes, a pediatrician with Chesapeake Pediatrics in Annapolis, said the recommendation from AAP came about in part because of the increasing problem of childhood obesity. It also was discovered that children with high cholesterol actually have atherosclerosis, or hardening of the arteries, and that treating them earlier had more effect.

"We used to only screen kids who had a family history, but we were missing a lot of kids that way," Jobes said.

Parents should make sure to ask about cholesterol screening if their pediatrician doesn't mention it. Overweight children and those exposed to secondhand smoke are most at risk, Liu said, but any child could be affected.

Treating child high cholesterol

Most kids with slightly elevated cholesterol can be treated with lifestyle changes such as a healthy diet and activity, Jobes said. If it's significantly high, Jobes would refer the child to a cardiologist to prescribe medication.

To prevent problems, parents should make sure their kids have a well-balanced diet and are active.

"Some kids are dairy-a-holics," Jobes says. "They eat cheese dips, cheese pizza, cheese gold fish, cheese fries, cheese everything. Kids eat too much cheese and too much fried food."

Liu is a strong supporter of the 5210 Challenge — 5 or more fruits and vegetables every day, less than 2 hours of screen time, 1 hour or more of physical activity, and 0 sugary drinks.

"The biggest barrier to preventative medicine is that kids look fine. Even if your kid is a little overweight, they run around and look healthy," Liu said. "We need to start educating families that even though their kids don't look sick, they may be."

Since the new recommendations have gone into place, Jobes has found some unexpected results, however.

"I am personally surprised by the number of heavy kids who have normal cholesterol. I don't get it," she said. "It doesn't help me. I want it to be high so I can get them to do something about it. ... I wish I could tell their parents that it's poisoning their blood but in many cases, it's not."

At least not yet.