Approximately 1 in 3 children in the US may have borderline or high cholesterol, according to a new study recently presented at the American College of Cardiology's 63rd Annual Scientific Session.
The research team, led by Dr. Thomas Seery, pediatric cardiologist at Texas Children's Hospital and assistant professor at Baylor College of Medicine in Texas, analyzed the medical records of 12,712 children aged between 9 and 11 years who were screened for cholesterol levels during a routine physical examination at Texas Children's Pediatrics Associates clinics.
Of these children, 30% (4,709) were found to have high cholesterol (200 mg/dL or more) in line with definitions from the National Cholesterol Education Program.
In detail, the researchers found that boys were more likely to have higher total cholesterol, higher low-density lipoprotein (LDL) - known as "bad" cholesterol - and higher levels of triglycerides (a type of fat found in blood) than girls. Girls had lower high-density lipoprotein (HDL), or "good" cholesterol, than boys.
Children who were obese were more likely to have higher total cholesterol, higher LDL, higher triglyceride levels and lower HDL than children who were not obese, while Hispanic children were more likely to have higher triglyceride levels and lower HDL than non-Hispanic children.
Average total cholesterol of the group was within the normal range, as was LDL, non-HDL and HDL. Mean triglyceride levels were borderline or abnormal.
Evidence that children 'need attention and treatment' for high cholesterol
Researchers say their findings stress the importance of cholesterol-reducing interventions, such as a healthy diet and exercise, to help reduce later-life disease risk.
High cholesterol is a main risk factor for cardiovascular disease (CVD). Although it is rare for a child to develop CVD, high cholesterol may significantly increase their risk for the condition later in life.
According to the American Heart Association, there is evidence that high cholesterol levels in early life can also lead to atherosclerosis in adulthood - the build-up of fatty plaques in the arteries that can lead to heart disease.
With these risks in mind, the fact that this latest research reveals that 1 in 3 children has high cholesterol is alarming.
Dr. Seery notes that the growing obesity epidemic adds to this concern. Childhood obesity has more than doubled in the past 30 years, but with increasing rates of obese children comes an increasing number of children with dyslipidemia - an abnormal amount of cholesterol or fats in the blood.
Dr. Seery comments:
"The sheer number of kids with abnormal lipid profiles provides further evidence that this is a population that needs attention and could potentially benefit from treatment.
If we can identify and work to lower cholesterol in children, we can potentially make a positive impact by stalling vascular changes and reducing the chances of future disease."
Should all children undergo cholesterol screening?
Current guidelines form the National Heart, Lung and Blood Institute, which are supported by the American Academy of Pediatrics, call for all children to undergo cholesterol screening between the ages of 9 and 11 years, and again between 17 and 21 years. But Dr. Seery says that there is some concern in the medical community that these recommendations will lead to many children being prescribed medication that they may not need.
However, he notes that around 1-2% of children with dyslipidemia require cholesterol-lowering medications, and these children tend to be those who have very high cholesterol levels as a result of genetic lipoprotein disorders.
Dr. Seery stresses that the first port of call to reduce abnormal cholesterol levels in children is encouraging them to adopt a healthy diet and engage in regular exercise.
Overall, the research team says their findings provide a "compelling" reason to screen all children for cholesterol levels.
"Kids need to have their cholesterol panel checked at some point during this timeframe [9 to 11 years old]," says Dr. Seery. "In doing so, it presents the perfect opportunity for clinicians and parents to discuss the importance of healthy lifestyle choices on cardiovascular health."
Speaking of the limitations of their research, the investigators point out that universal pediatric screening recommendations were introduced in the second year of the study. This means it is unclear as to whether screening of these children was ordered using universal recommendations, or whether it was carried out based on a child's individual risk factors or family history.
Furthermore, they note that the study only included children from in and around Houston, TX.
Medical News Today recently reported on a study revealing that US and European cholesterol guidelines differ in statin use recommendations, meaning that many individuals may not receive the correct treatment.