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Cholesterol and Kids: Facts to Know

Sedentary lifestyle and lackluster nutritional habits can be cholesterol and weight problems for kids.
Sedentary lifestyle and lackluster nutritional habits can be cholesterol and weight problems for kids.
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Once thought of as a disease of middle age, heart disease -- including atherosclerosis, heart attacks, strokes and other blood vessel problems -- is a growing concern among our children and adolescents.

Causes

According to the Centers for Disease Control and Prevention's (CDC) National Center for Health Statistics (NCHS), the incidence of overweight kids and teens (children between the ages of six and 19) has tripled since 1970 -- today more than 30 percent of American kids are considered overweight or obese.

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The American Heart Association, along with other childhood obesity experts, blames the epidemic on our growing sedentary lifestyle and lackluster nutritional habits. Think of days filled with television, video games and other technology that encourages us to sit, and diets filled with fast food and highly processed foods.

But weight and lifestyle aren't the only culprits. Heart disease can also be in our genes: Family history of early heart disease, diabetes and high blood pressure also increases our odds for atherosclerosis (plaque building up in arteries), high cholesterol and lipid abnormalities.

See the next page to learn about early detection and treatment options.

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In the July 2008 issue of "Pediatrics," the American Academy of Pediatrics (AAP) outlined new aggressive guidelines on pediatric lipid screening and heart health. Based on the growing obesity epidemic among American children, the AAP recommends baseline screening -- a fasting lipid profile test -- for at-risk children and adolescents begin between the ages of two and 10.

What will land kids on the at-risk list?

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  • Being overweight or obese This is especially true for kids who are at or above the 85th percentile for weight. Although the AAP recommends testing for all children with a body mass index (BMI) that indicates a weight problem, it's important to note that this might not be enough. A study conducted at the University of Michigan and published in August 2009 in the "Archives of Pediatric and Adolescent Medicine," suggests a child's BMI alone is not an adequate way to predict who should be screened for high cholesterol. According to the study, weight alone would miss about 50 percent of children with high cholesterol and 30 percent of kids would be unnecessarily tested.
  • Having diabetes
  • Having a family history of high cholesterol or premature heart disease (onset before age 55 for men, 65 for women) or a family history that is unknown

According to the American Academy of Pediatrics, children and adolescents ages 12 to 19 should aim for total cholesterol levels of less than 170 mg/dL, LDL levels less than 110 mg/dL, HDL levels 35 mg/dL or higher, and triglyceride levels less than 150 mg/dL.

If a child's results are normal, follow-up testing should be done in three to five years. But for those kids with high cholesterol readings, the next step is a visit to a pediatric cardiologist followed by a treatment plan.

Treatment Options

For children who are overweight or obese, lifestyle changes are the first line of action. Nutritional counseling is helpful for creating a diet low in saturated fats and cholesterol. And exercise is key: According to the CDC, kids and teens should get 60 minutes (or more) of physical activity every day.

Are statins OK for kids? Prescribing statins to children and adolescents is still controversial because there is no long-term data available. However, both the AAP and American Heart Association's most recent recommendations include prescribing medications to pediatric patients who are unsuccessful with diet and lifestyle modifications (and who have given good effort to dietary changes and increased physical activity), especially when there is a family history that puts them at additional risk.

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