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Medical Professionals Disagree on Childhood Cholesterol Testing (October 24, 2012)

The National Heart, Lung and Blood Institute recommended that children receive widespread cholesterol screening. While it may seem like more testing and earlier treatment is good, many doctors disagree, believing that this could lead to medication or other health interventions at an early age. Some health professionals say that these guidelines go too far and carry the risk of over medication, eating disorders and other health problems that could be worse than high cholesterol itself.

Cholesterol Testing Recommendations

This government-appointed panel recommended that all children in the United States should receive blood cardiac tests as young as nine years of age. It also says that testing for children with diabetes, relatives who suffer from heart problems, or other risk factors should start even earlier. The guidelines recommend starting treatment for kids with high blood pressure in the areas of exercise and diet, then moving to medications. This would result in cholesterol drug prescriptions for about one percent of children tested, though the panel recommends against use of medications in kids younger than 10 who don't have a serious health problem.

These guidelines are endorsed by the American Academy of Pediatrics and were designed to help prevent and treat conditions that could put children at risk for developing health problems later in life. This is in part a reaction to statistics that say about a third of U.S. Children weigh more than BMI charts recommend, and about one in 10 has higher-than-ideal levels of blood cholesterol. While almost everyone agrees that preventing health problems is a worthy goal, many doctors disagree with the panel's methods.

The Criticism

One member of the panel itself criticized the decision in the Journal of the American Medical Association shortly after the recommendations had been made. Dr. Matthew Gilman at Harvard Medical School feels that wide screening is inappropriate and that childhood screening should be restricted. He does encourage screening children who are members of families with a strong history of cholesterol problems, however.

Another criticism published in the same journal early in 2012 raised concerns about medication use. Putting children on cholesterol-controlling drugs known as statins could be dangerous, says heart specialist Bruce Psaty and Frederick Rivera, a pediatrician. That's because statins have been tied with muscle damaging conditions even in adults.

More recently, an online critique in Pediatrics suggested that panel members may not have been completely objective when they made these recommendations. Eight of the 14 members of the panel had ties with the drug industry, a situation which is not uncommon, but can be worrying.

Cholesterol Advice for Parents

Childhood weight gain and similar factors don't always lead to adult heart health issues or other diseases, but they can be correlated. Unfortunately, diet pressure and other well-meaning health campaigns early in childhood can lead to psychological problems such as eating disorders or depression. Even in kids who don't develop serious issues, inconsistent messages from grownups can be confusing and disorienting. Adults who are worried about their children's potential health problems may wish to consider having their kids screened if they show signs of risk factors. After all, having test information is usually helpful.

Parents should stop and consider before they make drastic changes in their child's environment or lifestyle, however. Big changes can be upsetting to kids and may not help their health, especially if they put children on the spot. Instead, it's a good idea to focus on a healthy diet and exercise program for the whole family. This will encourage everyone to build good habits and improve the chance of a long life without heart trouble or other dangerous diseases.