Screening Children for Cholesterol – Obesity Epidemic Spurs New Guidelines

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The obesity epidemic in children has reached such grand proportions that the American Academy of Pediatrics has issued new guidelines for treating children at risk for heart disease, type 2 diabetes and metabolic syndrome. The prospect of treating a child with cholesterol lowering medication is somewhat frightening. Nevertheless, the report “reemphasizes the need for prevention of cardiovascular disease by following Dietary Guidelines for Americans and increasing physical activity, and also includes a review of the pharmacologic agents and indications for treating dyslipidemia in children”. The report is co-authored by Drs Stephen Daniels (University of Colorado School of Medicine, Denver), Frank Greer (University of Wisconsin Medical School), and the Committee on Nutrition, published in the July 1 2008 issue of Pediatrics.

The newest data emphasizes the negative effects of saturated fats, trans fats, carbohydrates, cholesterol, obesity and lack of physical activity in children as it relates to cardiovascular disease and metabolic syndrome in adult life. Medications (statins), are recommended for children with following conditions, after age 10:

No risk factors for heart disease:
• LDL-C levels persistently >190/mg./dl despite diet therapy
Risk factors including high blood pressure, smoking, obesity and family history:
• LDL levels persistently >160 despite diet therapy
Children with diabetes:
• LDL levels >130

All children over 2 years of age should follow Dietary Guidelines for Americans. Nutritional counseling and lifestyle changes should be implemented for children who are at highest risk for adult onseet of cardiovascular disease – inactivity, obesity and elevated LDL-cholesterol levels. Any child at risk, between the ages of 2 and 10 should be tested with a cholesterol profile.

Previous studies show that cholesterol medications should be prescribed to prevent the formation of plaque, or atherosclerosis, in children as young as eight years old, using the lowest possible dose.(1) In March 2007, the American Heart Association issued a statement supporting drug therapy for children at risk for heart disease. (2)

Please review the Dietary Guidelines for Americans, and take them seriously. Set a good example to your children by remaining active – encourage your children to do the same by promoting regular exercise and recreational activities that keep them moving. If your child is overweight, speak with your Pediatrician now to obtain nutritional counseling. Get involved in school programs that encourage physical fitness. The childhood obesity epidemic has indeed become a matter of urgency.