1 in 5 U.S. Kids Has High Cholesterol

THURSDAY, Jan. 21 (HealthDay News) -- Twenty percent of U.S. children and teens have abnormal lipid levels, an indication of too much bad cholesterol, too little good cholesterol or high triglycerides, federal health officials report.

These abnormal levels can raise the risk for heart disease, which is the leading cause of death in the United States, according to the U.S. Centers for Disease Control and Prevention.

"Obesity may be linked to these high levels," said report author Ashleigh May, an epidemic intelligence service officer with the CDC.

"Forty-three percent of obese youth are eligible for therapeutic lifestyle counseling, and 22 percent of overweight youth were also eligible," she added.

Doctors need to be aware of lipid screening guidelines and treatments, especially for obese and overweight youth, May said, because abnormal lipid levels can lead to heart disease down the road.

"We really need to identify youth early who have these abnormal lipid levels so we can reduce their risk for later heart disease," May said.

The report is published in the Jan. 22 issue of the CDC's Morbidity and Mortality Weekly Report.

Using data from the National Health and Nutrition Examination Survey, May's team looked at lipid levels among 3,125 youths aged 12 to 19 who participated in the survey from 1999 to 2006.

Specifically, the researchers looked at levels of LDL, or "bad," cholesterol; HDL, or "good," cholesterol; and triglycerides.

May and her colleagues found that children and teens who were overweight or obese were more likely to have abnormal lipid levels compared with youths who were normal weight.

In fact, 22 percent of overweight children and teens and 43 percent of obese children and teens had abnormal lipid levels, compared with 14 percent of their normal weight counterparts.

In addition, 32 percent of these young people are candidates for lipid screening, according to American Academy of Pediatrics guidelines.

The guidelines recommend screening for young people with a family history of high cholesterol or premature cardiovascular disease, or having at least one major risk factor for heart disease, such as smoking, high blood pressure, diabetes, or being overweight or obese.

The researchers also found:

• 24 percent of boys and 16 percent of girls had at least one abnormal lipid level.
• 9 percent of 14- and 15-year-olds and 10 percent of 18- and 19-year-olds had low HDL cholesterol, compared with 5 percent of 12- and 13-year-olds.
• 8 percent of whites had low levels of HDL cholesterol and 12 percent had high triglycerides compared with black youths (5 percent and 4 percent, respectively).

Typically, heart disease develops in adulthood. But its risk factors, such as abnormal lipid levels and overweight/obesity, often emerge during childhood and adolescence.

Over the past 30 years, obesity among American's children has increased from 5 percent to more than 17 percent, according to the CDC.

Commenting on the report, Dr. Gregg C. Fonarow, a professor of cardiology at the University of California, Los Angeles, said that, "There is growing evidence that atherosclerotic vascular disease can begin at an early age and that treatment of abnormal blood lipid levels in youth may reduce the lifetime risk of cardiovascular disease."

Current guidelines recommend lipid screening among obese youth, Fonarow noted.

"It is highly notable that one in five youths in the U.S. have abnormal lipid levels and among obese youth, nearly half had at least one abnormal lipid level," he said.

"There is a clear need for aggressive preventive public health measures such as providing quality nutrition at schools, promoting physical activity in schools and the community, and implementing childhood obesity prevention programs," Fonarow added.

Detecting these abnormal lipid levels can lead to appropriate counseling of children and their families, he said. Only a few would need cholesterol-lowering medications such as statins, he added.

"Therapeutic lifestyle modification with healthy eating, exercise and a goal of achieving a healthy body weight is the foundation of management of abnormal lipid levels in youth," Fonarow said. Less than 1 percent of youth would require statin medications based on current guideline recommendations."

SOURCES: Ashleigh May, Ph.D., epidemic intelligence service officer, Division for Heart Disease and Stroke Prevention, U.S. Centers for Disease Control and Prevention, Atlanta; Gregg C. Fonarow, M.D., professor, cardiology, University of California, Los Angeles; Jan. 22, 2010, Morbidity and Mortality Weekly Report