What is high cholesterol in children?
High cholesterol in children refers to an elevated blood level of cholesterol at a young age. High cholesterol is one of the main risk factors for heart disease in adults. Over the past 20 years, the importance of recognizing and managing high cholesterol in children has become more appreciated. With many pediatricians now tackling high cholesterol in school-age children and younger, an understanding of the risk it poses and its prevention is paramount to healthy development.
What causes high cholesterol in children?
There are a number of different causes of high cholesterol in children. In general, they can be broken down into genetic factors and lifestyle factors. Genetic factors refers to qualities or characteristics that are inherited from parents. In general, these are difficult to alter or change. If a parent has a high cholesterol level, the chances are much higher that the child will have a high cholesterol level as well.
Lifestyle factors refer to potentially manageable issues such as diet and exercise. High cholesterol is often related to a diet high in fat and cholesterol. Fast foods, red meats, and dairy products are often high in fat and cholesterol. Likewise, obesity and lack of exercise can contribute to an elevated cholesterol level in children.
Where the signs and symptoms of high cholesterol in children?
The problem with a high cholesterol level is that over time it contributes to plaque development in the arteries throughout the body. Eventually, over many years, this can cause a significant decrease in the artery opening and impaired blood flow. Plaque buildup in the coronary arteries, the blood vessels feeding the heart muscle with blood, can contribute to a heart attack. Plaque buildup in the arteries feeding the brain with blood often contributes to strokes.
Fortunately these problems take many years to develop. The risk of a heart attack or stroke in a child with a high cholesterol level is near zero. The vast majority of children with high cholesterol levels have no symptoms whatsoever. Symptoms such as chest pain, palpitations, or syncope in children are typically unrelated to high cholesterol levels.
How is high cholesterol in children diagnosed?
High cholesterol in children can be diagnosed fairly easily with a blood specimen. A fasting lipid profile is a blood test that is usually drawn first thing in the morning after an 8 hour fast. A fasting specimen is usually required because even a small amount of food intake can alter the test results significantly.
A fasting lipid profile breaks cholesterol levels down into total cholesterol, LDL (low-density lipoprotein) levels, HDL (high-density lipoprotein) levels, and triglyceride levels. Normal values are determined by the age and gender of the child.
How is high cholesterol in children treated?
The American Academy of Pediatrics (AAP) recently updated their guidelines on the treatment of high cholesterol in children in 2008. In almost all cases in children, lifestyle changes are initially used to try to lower cholesterol levels. Medications are reserved for significantly elevated levels that do not respond to lifestyle changes.
Lifestyle changes for the treatment of high cholesterol in children primarily involve eating a healthy diet and maintaining a healthy weight. Cutting back on fast food, red meat, dairy products, and other foods high in fat and cholesterol is the first step. Increased exercise and weight loss when needed is also recommended.
Medications for high cholesterol in children are usually reserved for those who have persistently elevated levels despite diet, exercise, and weight control. Currently the AAP recommends consideration of medication for children 8 years and over who have LDL levels persistently above 190, or above 160 in the presence of other risk factors such as diabetes or a strong family history.
In summary, high cholesterol in children is a growing problem. Early recognition and treatment can prevent significant complications down the road.