New guidelines propose cholesterol screening all 9-12 year olds

Even though children and adolescents don’t suffer from the effects of high cholesterol and other dyslipidemias when they are young, lifetime risks for heart disease include high cholesterol and the earlier that risk is found, the earlier it can be dealt with.

Discussion about screening children for lipid and cholesterol have gone one for decades without much clear consensus. Until recently even if high cholesterol levels were discovered the proper intervention was unclear since the effects of putting growing children on restricted diets wasn’t known. A few years ago, some groups recommended that all children get screened regularly starting as young as age 3 but there was great resistance to this in part because we weren’t going to intervene if the labs came back abnormal and in part because the test is best done fasting and that wasn’t practical. The discussion then changed to say that only those children with a family history of high cholesterol or dyslipidemias needed screening but this recommendation ended up missing a large number of children who had elevated levels even though their family history was normal.

New recommendations are being forwarded that seem much more reasonable and practical to implement. The National Institutes of Health convened a panel of Pediatric and cardiovascular experts and after culling the research and debating what the best approach to screening should be have come out with the recommendation that all children be screened once between the ages of 9 and 12 and again between 17 and 21. The screening test doesn’t have to be a fasting specimen and only if that one is high does a fasting blood test need to be performed.

If the follow up test shows an elevated cholesterol or lipid levels, following the DASH diet is the first step. This diet, rich in fruits, vegetables, whole grains, and low or non-fat dairy is a healthy diet for anyone but can be adapted for early adolescents and young adults easily.

New recommendations take time to gain acceptance and get implemented of course but this one seems like a reasonable approach to screen and intervene with lifestyle changes when needed.