As rates of childhood obesity climb, cholesterol becomes more of a concern in children. As of February 2011, the American Academy of Pediatrics does not recommend routine cholesterol testing in all children, only those at high risk for cardiovascular disease later in life.
Cholesterol
According to Stedman's Medical Dictionary, cholesterol is "an abundant steroid in animal tissues, especially in bile and gallstones, and present in food, especially that rich in animal fats." Cholesterol is found in every cell of the body, and circulates throughout the bloodstream joined with proteins. It plays a prominent part in atherosclerosis, or hardening of the arteries. Elevated cholesterol can be present at a young age.
Childhood Screening
The AAP currently recommends that health care workers who treat children use a fasting lipid profile to test children over the age of 2 with certain risk factors. These factors are a strong family history of heart disease or high cholesterol, being adopted, being overweight or obese, having high blood pressure, smoking cigarettes, or having diabetes. The child's first screening should be completed between the ages of 2 and 10.
Cholesterol Levels
In children over the age of 8, low-density lipoproteins, or LDLs, are considered normal when less than 110 mg/dl. They are considered borderline between 110 mg/dl and 129 mg/dl, and are considered elevated at 130 mg/dl. Total cholesterol is normal at less than 170 mg/dl, borderline between 170 mg/dl and 199 mg/dl, and elevated at greater than 200 mg/dl. LDLs are most often used to guide treatment of high cholesterol.
Treatment of High Cholesterol
The initial treatment for children with elevated cholesterol is dietary change and an increase in physical activity. If this does not change the LDL cholesterol level to acceptable treatment levels, treatment with medication may be necessary. In children with no risk factors, a level of over 190 mg/dl warrants medication. In children with two or more risk factors, a level of over 160 mg/dl needs medicine. In a diabetic child, anything higher than 130 mg/dl needs to be treated.
Healthy Diets for All Children
To optimize the health of your child, encourage a diet full of fruits, vegetables, fish, whole grains and low-fat dairy. Limit the intake of fruit juice and sugar-sweetened foods and beverages. Limit trans fats, found in foods made with partially hydrogenated fats, to less than 1 percent of calories per day. Most importantly, model a healthy diet by making healthy choices yourself.
References
- "Pediatrics"; Lipid Screening and Cardiovascular Health in Childhood; Stephen R. Daniels, et al.; July 2008
- HealthyChildren.org: High Cholesterol Levels In Children
- "Circulation"; Dietary Recommendations for Children and Adolescents; 2005
- "Pediatrics"; National Cholesterol Education Program: Highlights of the Report of the Expert Panel on Blood Cholesterol Levels in Children and Adolescents; March 1992
- Stedman's Medical Dictionary, 25th Edition, 1990
