Children and Heart Disease: The Tough American Truth

Most parents probably don’t think about their children’s cholesterol levels. However, high levels of cholesterol are a major factor contributing to heart disease and stroke, and medical research shows that cardiovascular disease has its roots in childhood.  With the dramatic epidemic of childhood obesity, more and more kids are at risk.

In July 2008, the American Academy of Pediatrics made new recommendations for cholesterol screening in children. Screening is advised for children with a family history of high cholesterol or blood fats, or a family history of premature heart disease (age 55 or younger for men, age 65 or younger for women). Screening is also recommended for kids who are overweight (at or above the 85th percentile), and who have other risk factors such as smoking, diabetes, or high blood pressure.  The first screening is recommended after age 2, but no later than age 10. Children under age 2 should not be screened.  If the fasting lipid profile is normal, a child should be screened again in three to five years.  For kids aged 8 and older with extremely high cholesterol levels, treatment should be considered.

However, treatment of high cholesterol in children is controversial. Many doctors believe that diet and exercise are the best initial treatment for children age 2 and older who have high cholesterol or who are obese.

The American Academy of Pediatrics recommends treating high cholesterol in children with prescription drugs, such as statins, for children age 8 and older if a child has a high level of low-density lipoprotein (LDL, or “bad”) cholesterol.  This course of treatment is based on research that suggests heart disease in adulthood can begin to develop early in a child’s life if his or her cholesterol level is too high.

Many doctors disagree that cholesterol-lowering drugs are an appropriate treatment, since little research has been done on the safety and effectiveness of these drugs in children, especially on the long-term effects.  Certain cholesterol medications, such as Niacin, are not recommended for children due to safety concerns.  Some doctors also think few children have a cholesterol level high enough to require cholesterol-lowering drugs as treatment.

Recent research suggests that taking a DHA supplement can support healthy cholesterol levels in children.  A double-blind study, funded by the US National Institutes of Health (NIH), recruited 20 children ages 9-19 with inherited high cholesterol.   The children received nutritional counseling based on national guidelines on cholesterol lowering and healthy diet for six weeks.  They were then randomly assigned to receive either a DHA supplement or a placebo daily for six weeks.

After the DHA supplementation, the children’s blood vessel function was restored to the levels of healthy children.  The results were published in The International Journal of Clinical Pharmacology and Therapeutics.  Researchers concluded that DHA supplementation has the potential to at least delay early onset coronary arteriosclerosis (narrowing of the arteries).

Given the disparity in the medical community about treating high cholesterol in children, talk to your child’s doctor about what’s best for your child, including exercise and heart-healthy diet options.