How young is too young for kids to get cholesterol checked?

by Dr. Andy Oakes-Lottridge / November 22, 2011

If you’re like me (in your 40’s) then you probably have had your cholesterol checked before.  The same goes for those in your 30’s, 20’s…but how young is too young to check cholesterol levels?  According to an expert panel endorsed by the American Academy of Pediatrics, ALL kids between the ages of nine and eleven should have their cholesterol checked. 

This new recommendation is a major departure from conventional practice.  As recently as last month, all major medical groups agreed that we should be checking the cholesterol levels in kids only if they had certain risk factors.  Those factors included being overweight, leading a non-active lifestyle, or a strong family history of cholesterol problems or heart disease.  This change in screening testing is raising questions.  Are we really reducing the risk for heart disease in these kids, or are we just producing more customers for cholesterol drugs like atorvastatin? 

Supporters of this change point to evidence that indicates a significant number of kids with high cholesterol get missed if one only tests those who have risk factors such as those mentioned above.  The American Academy of Pediatrics also argues that only about 1% of kids would actually be advised to take cholesterol lowering medications.

So here’s what we know.  Cardiovascular dise ase changes start in the arteries in childhood.  Estimates of 20-30% of kids with elevated cholesterol may be active, have a normal weight, and not have a family history.  Cholesterol levels normally drop during puberty, so to get an accurate picture, we need to check them before puberty AND remember to check levels again in their late teen years. 

If you have a child of at least nine years of age who is overweight, not active, or there is a family history of heart disease and cholesterol problems, then you probably need to have already had a conversation with your doctor about getting their cholesterol checked. 

If your child has no risk factors for elevated cholesterol, then there is no need to rush to your doctor’s office.  However, at their next well-child visit, don’t be surprised if your doctor recommends getting the cholesterol screened.  This will require a simple blood test.  Admittedly, getting blood drawn can be a scary prospect for some kids, and this will surely prevent some parents from following through. 

Don’t worry, even if the cholesterol is elevated, the most common recommendation will be to increase the child’s activity, reduce fats in the diet, and reduce weight if necessary.  The threshold for starting an adolescent patient on cholesterol lowering medications will be much higher than for an adult patient. 

Life-style changes such as exercise and diet certainly are easier said than done.  Nevertheless, these new cholesterol screening recommendations should increase awareness among all of us (doctors and patients alike) of the risks of cholesterol levels in our kids.  Of course, we doctors should already be having these life-style conversations with all the parents in our practices, but if the blood cholesterol level helps even a few to take life-style changes more seriously, then perhaps that’s how we should measure success.