Why I Screen Kids For Cholesterol

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Dr. Monica Wonnacott

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Why I Screen Kids For Cholesterol

Lots of parents are really surprised when I order cholesterol screening for their child.

We often tend to think that high cholesterol is only a problem in adults. But the AAP actually recommends that we screen kids between age 9 and 11 for cholesterol. We also want to screen kids who have a family history (parents or grandparents) of high cholesterol, “high blood pressure, diabetes, smoking, or obesity.” (Source: healthychildren.org.)

Why?

Kids with high cholesterol become adults with high cholesterol. If we can take steps early on to improve long-term health, we will. There might be a genetic predisposition. And, some other health issues can cause elevated cholesterol levels—we want to catch these as early as possible.

How do we screen?

It’s a blood test. We order a regular blood draw and then send it off to the lab for analysis. The results will give us a baseline to work from.

The table below is directly from the AAP—note, cholesterol levels and classifications are very different in kids vs. adults.

Classification

Total Cholesterol

Low-Density Lipoprotein (LDL)

Acceptable

less than 170

less than 110

Borderline

170-199

110-129

High

greater than 200

greater than 130

Of note: some organizations use 160 as the cut off in kids. But, be aware that the reference ranges listed for labs are usually adult norms (<200 for total) and not kids. Don’t be fooled into thinking your child is in the clear at a level of 180. All numbers are in mg/dL.

LDL vs HDL Cholesterol

In a nutshell, LDL cholesterol = bad. HDL cholesterol = good.

LDL cholesterol is the bad cholesterol because it causes plaque to build up in the arteries and reduces the blood supply to the heart. (Think heart attack.)

We want to know the total cholesterol (LDL + HDL), but we’re really concerned about the LDL levels.

Pro Tip: Familial Hypercholesterolemia is a condition passed down through families. It causes the LDL to be very high from birth (the CDC uses the cut of of >160, while the NIH uses >135 for kids) and can cause early heart attacks. It generally requires treatment with medications.

And what about Triglycerides?

Triglycerides are also another type of fat (or lipid) that comes with a lipid or cholesterol panel of tests. Triglycerides come from the food you eat (especially saturated fats, trans fats, added sugar, and alcohol) and from consuming more calories than your body needs. High triglycerides increases your risk of heart disease and stroke.

How to keep cholesterol in check

Diet and exercise. Those are the keys.

Food

No one wants to hear it, but the foods that we as American’s love to eat are the worst for our health. Afterall, what’s more American than a burger, fries, soda, and a milkshake? In short, cholesterol comes from fats (think oils and fried foods) and animal products (meat, cheese, milk, eggs, and yogurt). Now there are definitely better and worse fats (e.g., olive oil is generally considered superior to palm oil), but if you want to lower your cholesterol you simply need to eat less of these cholesterol-laden meals and snacks.

Pro Tip: Sugar is tricky. When you eat too much, your liver makes LDL cholesterol (the bad kind) and decreases your HDL (the protective/good kind). The excess calories from sugar can also raise your triglycerides.

Foods that help lower cholesterol come from the earth. These are fiber rich foods like veggies, fruits, beans, legumes, and whole grains.

Pro Tip: If moving to a complete whole foods-plant based diet feels too extreme, try “meatless Monday” and drinking water instead of soda or juice. It’s all about making sustainable changes to improve your long term health.

Exercise

The amount of exercise kids need really depends on their age.

Littles (age 3-5) need a bunch. Think 3 hours of physical activity a day.

Kids older than 6 should get 60 minutes of exercise on most days.

Healthy eating and regular exercise make such a difference in a child’s health. If you have concerns about your kid’s diet or level of physical activity, talk to your pediatrician. She can help you come up with a plan or make adjustments unique to your situation.

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