Health officials have issued new recommendations for cholesterol screening in children because of the alarming proportion of kids with abnormal levels and evidence of atherosclerosis – a disease normally thought of as an adult medical problem.
The recommendations from the The National Heart, Lung and Blood Institute (NHLBI), are designed to help reverse the epidemic of obesity, and the related diseases that are rapidly growing in children.
I recently had the opportunity to attend the presentation of the much-anticipated guidelines at the American Heart Association Convention in Orlando, Fla., and as I looked around at the sparsely-filled room, I can't say I was surprised.
The room was set up with seats to accommodate 600 professionals, but there were fewer than 200 in attendance. Perhaps it was because it was an evening presentation, or maybe it reflects physician frustration at the enormity of the public-health issue of obesity – with its secondary problems of hypertension, hypercholesterolemia and resultant heart disease.
In any case, these guidelines need to be widely disseminated within the medical community.
The comprehensive review began with a computer-generated initial list of 1 million articles. The final product incorporated the top research on the topic, representing a derived-consensus document.
Here are the key takeaway points:
- High cholesterol in children is related to the development of heart disease as an adult.
- With the obesity epidemic, cholesterol levels are rising even higher.
- Reduction in obesity will lower cholesterol levels.
- Early intervention is needed for hypercholesterolemia and poor health habits in children (the behaviors as well as the diseases continue into adulthood).
- Initial management for abnormal serum cholesterol is education about healthy diet and exercise.
- Healthy diet education is best handled with the entire family involved and the help of a dietitian.
- Examples of healthy diet include the DASH diet and the Mediterranean diet.
- There should be universal screening for elevated cholesterol for ages 9-11 years.
- There should be earlier screening for high-risk individuals.
- Medications may be needed in about 1 percent of children (upwards of 200,000 children).
- Parents must increase the activity level of children and reduce time spent in front of the television and computer. The recommended activity level for 5 years and older is one hour of moderate to vigorous exercise per day.
Quite simply, this list should be posted in every physician’s office across the United States.
Dr. Robert J. Tozzi is the chief of pediatric cardiology and founder of the Pediatric Center for Heart Disease at Hackensack University Medical Center in Hackensack, New Jersey. He is also the director of the Gregory M. Hirsch Hypertrophic Cardiomyopathy Center and a Fox News contributor.
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