New guidelines recommend screening children for high cholesterol
The process of atherosclerosis, the medical term used to describe the build-up of fat and cholesterol-filled plaques in the arteries of the body, begins in childhood and progresses slowly into adulthood. High cholesterol is a risk factor for coronary heart disease in adults, but some children may be at risk for premature coronary heart disease if they have high cholesterol levels earlier in life. The National Lipid Association has issued new guidelines stating that children 9 to 11 should be screened for high cholesterol. In addition, children with a family history of premature heart disease and high cholesterol should be screened at age 2.
What the news means to you
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FH is more prevalent than type 1 diabetes, yet remains under-diagnosed and under-treated.
Anthony F. Porto, MD.
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Cholesterol is a naturally occurring substance found in all foods derived from animals such as meat, poultry, seafood, eggs and dairy products. Cholesterol is needed as a building block for hormones and a component of cell membranes. But high levels of cholesterol are a major factor contributing to heart disease and stroke. High cholesterol can affect the health of children, especially those who are overweight or have a family history of high cholesterol or premature heart disease.
The National Lipid Association’s recommendations are part of new guidelines for the screening, diagnosis and treatment of inherited high cholesterol, or familial hypercholesterolemia (FH), a genetic condition that impairs the ability to process bad cholesterol, the low-density lipoprotein that clogs arteries. It’s one of the most common serious genetic conditions, affecting at least one out of every 500 people worldwide.
FH is more prevalent than cystic fibrosis, Down syndrome and type 1 diabetes, yet it remains under-diagnosed and under-treated. Some estimates suggest that only about 20 percent of patients with FH are properly diagnosed and, of those, less than half receive appropriate treatment. FH is a genetic problem and can be passed down from parent to child. While there is no cure for FH, early identification is essential in the prevention of premature cardiovascular disease.
Treatment for FH begins with a low-fat, high-fiber diet, with plenty of fruits and vegetables and regular exercise. These modifications can decrease cholesterol levels by as much as 10 percent. Children should also maintain an active lifestyle, ideally, exercising on most days for at least 30 minutes. If diet and exercise changes are not sufficient to lower cholesterol, a variety of cholesterol lowering drugs can be started.
Dr. Porto is an attending pediatric gastroenterologist at Yale-New Haven Children’s Hospital, where he serves as co-director of a multidisciplinary clinic that provides evaluation, management and monitoring of children with a broad range of lipid disorders, including fatty liver, high cholesterol levels and FH. Dr. Porto is an assistant professor of pediatric gastroenterology at Yale School of Medicine.
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