pediatricians urge cholesterol testing for kids

by Diane Lofshult

Food for Thought:

In July, the American Academy of Pediatrics (AAP) issued new cholesterol screening and treatment recommendations for children in a policy statement that appeared in that month’s issue of Pediatrics. The current report replaces a position statement issued back in 1998.

The latest guidelines have taken on “new urgency,” according to AAP, “given the current epidemic of childhood obesity with the subsequent increasing risk of type 2 diabetes mellitus, hypertension and cardiovascular disease in older children and adults.” The report recommends targeting overweight children because they are “in a special category” of risk and “in need of cholesterol screening regardless of family history or other risk factors.” The AAP suggests that screening should begin as early as age 2 but no later than age 10, and says that a fasting lipid profile is the best testing method.

The AAP report has stirred up some controversy owing to its recommendation to screen kids at such an early age and to “consider” the use of cholesterol-reducing drugs for kids over age 8 with high LDL levels. However, the researchers were quick to point out that these were worst-case scenarios and that interventions for kids with elevated cholesterol readings should focus on weight reduction, increased physical activity, nutrition counseling and—for overweight kids as young as 1 year old—consumption of reduced-fat dairy products.