Panel Wants Cholesterol Tests for More Kids

Tuesday, July 8, 2008

The American Academy of Pediatrics Committee on Nutrition has updated its 10-year-old cholesterol screening and treatment guidelines. "Expect to see much more testing," says Nicolas Stettler, an assistant professor of pediatrics at the Children's Hospital of Philadelphia and an author of the new guidelines, published today.

The previous recommendations called for testing only kids 2 and older whose parents have heart disease or high cholesterol levels, or whose disease and cholesterol information is not known. The new guidelines recommend testing all kids with risk factors for heart disease (more than 30 percent of U.S. children, Stettler says) starting at age 2 and no later than age 10. That includes kids who are obese or overweight, who have diabetes or high blood pressure or who smoke.

Why the change? According to the report, data suggest that changes in arteries that can lead to heart disease often begin in childhood and that early treatment, including diet changes, physical activity and medication, can prevent problems.

The new guidelines recommend doing the blood test after a 12-hour fast. Expect insurers to cover the test, which runs $150 to $200, but call your carrier for a list of approved labs.

The optimal LDL ("bad" cholesterol) level for most kids is 110 or lower. If it's higher than 160 (or sometimes 190, depending on other risk factors), the new guidelines recommend that doctors prescribe a cholesterol-lowering drug, such as pravastatin, together with dietary changes. For now, kids younger than 8 are not likely to get a prescription, Stettler says, because few drugs have been tested in younger kids.

One more new recommendation: Kids older than 12 months can drink low- or reduced-fat milk instead of whole milk. Previous guidelines didn't allow the switch until age 2.

-- Francesca Lunzer Kritz

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