New guidelines from the U.S. National Institutes of Health (NIH) make a surprising recommendation: There should be general one-time screening of children ages nine to 11 for high cholesterol.
These guidelines, issued by the NIH and endorsed by the American Academy of Pediatrics in their journal Pediatrics, suggest that identifying early risk factors that are known to increase one s risk for heart disease as an adult would allow doctors and parents to make changes early on that would benefit the child later in life. According to Dr. Daphne Hsu, a pediatric cardiologist at the Children s Hospital at Montefiore in New York, If you find high cholesterol, it will give you extra ammunition to talk to the family and talk to the children about the need for changes in diet and exercise. To this effect, the early cholesterol screening could be used to jump-start a discussion about tackling childhood obesity, and would provide increased motivation to deal with the problem early on.
Additionally, early screening could help identify children with a genetic predisposition to high cholesterol. A few of these kids (less than 1 percent of all children) would then qualify for medication to lower cholesterol levels.
Opponents of the new recommendation, however, suggest that there is not enough evidence showing that this early screening would do any good. The U.S. Preventive Services Task Force, in fact, has concluded that there is no evidence that exercise or diet interventions for children would lead to any improvement in cholesterol or health once these children reach adulthood.
ACSH's Dr. Gilbert Ross explains his mixed reactions to the new guidelines: It could be important to identify early the extremely small number of children who have a strong genetic predisposition to high cholesterol, he says. However, I question the assumption that childhood cholesterol levels have anything to do, directly, with obesity, as the discussion seems to indicate. Of course, it would be beneficial to get children and parents talking about the importance of maintaining a healthy weight. But targeting cholesterol as a way to fight obesity does not make sense."
