Taking aim at high cholesterol in kids.

Taking aim at high cholesterol in kids

Studies have shown that heart disease can begin very early in life (SN: 10/8/88, p.234), but medical experts are only beginning to establish prevention guidelines for children. The American Academy of Pediatric recommended this week that physicians test for high blood levels of cholesterol and other lipids in children with a family history of heart disease. The American Heart Association had announced an almost identical recommendation last May.

The academy's Committee on Nutrition recommends cholesterol tests for all children older than 2 years with a parent, sibling, grandparent, uncle or aunt who has hyperlipidemia -- excess blood lipids -- or who had a heart attack before age 50 (men) or 60 (women).

The committee cautions against testing children with no family history of heart disease because the screening tests can yield inaccurate results, causing parents or doctors to put normal children on restrictive diets or drugs.

The committee recommends that high-risk children undergo a series of cholesterol tests in a laboratory under controlled conditions. Although expensive, these tests are more accurate than ones done in doctors' offices and are more likely, among those at high-risk, to uncover those who have truly dangerous levels, says committee member Edward F. Bell of the University of Iowa in Iowa City.

Although researchers do not yet know what cholesterol levels make children prone to heart disease, the committee suggests that children with levels exceeding 176 milligrams per deciliter might benefit from a reduction in dietary fat.

Whether cholesterol-reducing drugs work in children is not known. The committee warns against drug therapy unless a child's level excees 200 milligrams per deciliter -- and then only if efforts to restrict the diet have failed to lower levels.