Question 1

What is cholesterol?

Accepted Answer

Cholesterol is a waxy material that can be made by your body or come from foods you eat.  It does some important things in your body.  It is used to make some hormones and to build your cell walls.  Unfortunately, having the wrong balance of cholesterol can lead to health problems such as coronary artery disease (the blockage of arteries carrying blood to your heart) and strokes.

Question 2

Why should my children have their cholesterol tested?

Accepted Answer

In 2011, new guidelines recommended “Universal Screening”, meaning that ALL children, at certain ages, have their cholesterol tested. Guidelines have previously recommended checking cholesterol levels in children with certain risk factors.  Unfortunately that selective screening was not as effective, missing 30-60% of children with significant cholesterol problems.  The change to checking ALL children surprised many.  Part of the reason for the broader testing is to identify a disease called Familial Hypercholesterolemia (FH).  It occurs in 1 in 250-300 people in America and, in its most severe form, can lead children to start developing blockages in their arteries during childhood and adolescent years.  Most people with FH can be diagnosed by a cholesterol blood test along with a family history of premature heart disease.  In a family that is unaware that they have FH, the first signs can be when a family member has a heart attack.  Many people with FH have a normal body weight.  Since you can’t feel high cholesterol, many people with FH are first diagnosed when they get the routine blood test.  Universal screening of children helps identify those children so that they can learn about healthy choices and treatment options before their arteries start to show signs of plaque (blockages).

To learn more about FH, visit the FH Foundation: theFHFoundation.org(http://thefhfoundation.org/)

The newest American Heart Association/American College of Cardiology 2018 Guidelines for Cholesterol also recommend screening children for cholesterol problems:  Guideline on the Management of Blood Cholesterol(http://www.onlinejacc.org/content/early/2018/11/02/j.jacc.2018.11.003)

The American Heart Association also published a Scientific Statement in 2019 Regarding Cardiovascular prevention in children: Cardiovascular Risk Reduction in High-Risk Pediatric Patients(https://www.ahajournals.org/doi/10.1161/CIR.0000000000000618)

Question 3

When should children have their cholesterol tested?

Accepted Answer

If children already carry a “risk factor” for developing heart disease in the future, then they should have their cholesterol tested before age 9.  If they have no other risks, then it is reasonable to wait until between the ages of 9 and 11 to test a child’s cholesterol.  These same guidelines also recommend rechecking a child’s cholesterol between the ages of 17 and 21.  These recommendations were updated and supported in the 2018 AHA/ACCGuideline on the Management of Blood Cholesterol (http://www.onlinejacc.org/content/early/2018/11/02/j.jacc.2018.11.003)and the AHA 2019 Scientific Statement Cardiovascular Risk Reduction in High-Risk Pediatric Patients.(https://www.ahajournals.org/doi/10.1161/CIR.0000000000000618)

The ages when screening of kids cholesterol is done are crucial times in a child’s growth and maturity.  Between 9 and 11 many children are experiencing the onset of puberty.  They are also becoming “pre-teens” who are starting to make their own decisions…and develop their own habits.  This is a great time to discuss your family’s wellness strategy with your primary care provider.  How are you doing?  Are there choices your child is making that worry you?  Are you a good role model of wellness for your child?  No one is perfect, so don’t worry.  Take this opportunity to take a snapshot of your family’s wellness and then set goals for the next year or more.

The next age group for routine screening is between the ages of 17 and 21.  At this stage, your child is progressing into young adulthood.  They have new responsibilities, new pressures, and new priorities.  How can you and your child’s primary care provider work together to ease this transition and support them in making healthy choices?

Question 4

What are normal cholesterol results in children?

Accepted Answer

Normal, borderline, and high cholesterol results in children:

https://static.wixstatic.com/media/fa74ed_262117393da6444288bcc87c52885150~mv2.png

https://static.wixstatic.com/media/fa74ed_2c8b149389094cd699af70f934303871~mv2.png

For children with no known risk for high cholesterol or heart disease, it is ok to have the test performed without fasting.

If a child has any suspected risk for high cholesterol or heart disease, then your healthcare provider may prefer a fasting test.  Fasting usually mean eating no food and drinking no beverages other than water for 12 hours.  Please ask your healthcare provider for their recommendations so that your child can have the most accurate test completed.

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