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 United States, 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 encourage healthy eating in childhood and adolescence—appropriately limiting cholesterol, saturated fat, and trans fat—as this may protect against 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, a blood test to measure cholesterol may provide useful information.
Cholesterol testing may be most appropriate for youths with a parent with a high total cholesterol level and those with a family history of premature heart disease (parent or grandparent with disease before 55 years of age).
Cholesterol testing can also be appropriate for youths judged to be at higher risk because, for example, they are overweight, consume excessive amounts of saturated fats and cholesterol, or smoke.
When overweight or obese
Cholesterol testing is advised for overweight youths, when the individual’s body mass index (BMI) is at or above the 85th percentile. The BMI should be calculated at least once a year by the youth’s health care provider. For an obese youth (one whose BMI is at or above the 95th percentile), laboratory tests to measure cholesterol levels may be recommended every 2 years starting at 10 years of age.
Links
National Heart, Lung, and Blood Institute: Cholesterol basics
Keep Kids Healthy: Cholesterol in children
Children’s Hospital Boston: Cholesterol, LDL, HDL & Triglycerides
Sources
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Barlow SE and the Expert Committee. Expert Committee recommendations regarding the prevention, assessment, and treatment of child and adolescent overweight and obesity: summary report. Dec 2007 (suppl). Pediatrics 120:S164-S192. Available onlne at http://pediatrics/aappublications.org. Accessed 10 Jan 2008.
S2
Nemours Foundation. Cholesterol and your child. Reviewed Jan 2005. Available online at http://www.kidshealth.org. Accessed 9 Jan 2008.
S3
Haney EM et al. 1 Jul 2007. Screening and treatment for lipid disorders in children and adolescents: systematic evidence review for the US Preventive Services Task Force. Pediatrics 120(1):e189-e214. Available online at http://pediatrics.aappublications.org. Accessed 9 Jan 2008.
S4
Kavey RE et al. American Heart Association guidelines for primary prevention of atherosclerotic cardiovascular disease beginning in childhood. 25 Mar 2003. Circulation 107(11):1562-6. Available online at http://circ.ahajournals.org. Accessed 9 Jan 2008.
S5
US Preventive Services Task Force. Screening for lipid disorders in children (topic page). Jul 2007. Available online from the Agency for Healthcare Research and Quality at http://www.ahrq.gov. Accessed 10 Jan 2008.
S6
American Academy of Family Physicians. Heart disease: assessing your risk. Available online at http://familydoctor.org. Accessed 19 Jul 2004 and 19 Jan 2008.
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Berg AO, for the US Preventive Services Task Force. Screening for lipid disorders: recommendations and rationale. 2001. Am J Prev Med 20(3S):73-76.
