Kids and cholesterol

Staff Writer
Columbus Parent

Overweight children should be routinely screened for high cholesterol and medicated as young as 8, according to new recommendations from the American Academy of Pediatrics, the nation's largest pediatricians group.

The doctors who issued the guidelines said changes are urgent because of the rise in childhood obesity and the increased risk of Type 2 diabetes and heart disease in children and adults.

Research over the past four decades shows that cardiovascular disease begins early in life.

The group recommends that cholesterol-lowering drugs be considered for children 8 or older who have an LDL cholesterol level of 190 or higher.

LDL stands for low-density lipoprotein and is known as "bad" cholesterol. HDL, or high-density lipoprotein, is known as "good" cholesterol.

Medication also might be warranted for those with lower levels who have a family history of early heart disease or who have diabetes, they say.

Cholesterol levels -- and what constitutes high cholesterol -- vary between genders and age groups.

The academy also suggests low-fat milk for children between 1 year and 2 years old who are overweight or obese and for those with a family history of obesity, high cholesterol or heart disease. Previously, whole milk was recommended for all infants until their second birthdays.

One in three children born in Ohio is overweight by age 8.

The guidelines should prompt more, and earlier, discussion about weight and its potential consequences, said Dr. Robert Murray, director of Nationwide Children's Hospital's Center for Healthy Weight and Nutrition.

"It's been apparent for a while now that there's a big problem brewing here," he said. "We're starting to see the medical community react to 25 years of the obesity epidemic with a much more aggressive stance."

Fallout from being overweight and obesity, which often are accompanied by high cholesterol, includes high blood pressure, diabetes, orthopedic problems and sleep disorders.

Concerns about medicating children at younger ages are inevitable, particularly because there isn't a lot of research into the effects of the cholesterol-lowering drugs in young people, Murray said.

There are several classes of drugs used to treat high cholesterol, including statins such as Lipitor and Zocor. The most serious potential side effects of statins are liver damage and muscle problems.

Murray said as long as doctors follow the guidelines, the drugs would be used sparingly and in extreme cases. The recommendations call for a specialist to be involved if cholesterol medicines are prescribed to a child, for example.

Exercise and diet should be the primary approach to lowering high cholesterol, the guidelines stress.

"I think that we often are reticent to declare a chronic disease such as this in a child, but it's important to do that," said Dr. Randy Wexler, a family physician who practices at Ohio State Family Medicine in Gahanna.

Taking high cholesterol seriously at a young age is the key to preventing serious trouble in adulthood, he said.

"The benefits are going to be seen decades away," Wexler said.