As per new guidelines from the American Academy of Pediatrics published in Paedatrics cholesterol checks should be part of periodic well-child visits for all children. One should screen cholesterol at least once between the ages of 9 and 11 and again at 17 to 21.
Doctors previously had been directed to screen cholesterol only in children with risk factors like a family history of heart disease or high cholesterol. Routine screening need only be a non-HDL cholesterol measurement that doesn’t require fasting, said Padmashri and Dr B C Roy National Awardee Dr K K Aggarwal President Heart Care Foundation of India.
Dietary management is often effective and should be the first line of attack against elevated cholesterol. Short-term use of plant sterol or stanol esters — such as those in some margarines — have been shown safe at doses up to 20 g per day, but longer-term use hasn’t been tested and should be reserved for children who don’t respond to diet alone.
Statins should be considered for those with LDL levels at 190 mg/dL or higher for children who are at least 10 years old and haven’t responded after six months of lifestyle management or at an LDL of 160 to 189 mg/dL if risk factors are present.
3. One should emphasize on breastfeeding and a diet low in saturated fat after a child’s first year.
4. Advise parents on protecting children from tobacco exposure
5. Start active anti-smoking advice to children at ages 5 to 9.
6. Track weight-for-height, reviewing growth with parents and refer when above the 85th percentile without reductions for more than six months after age 4.
7. Start routine annual blood pressure checks at age 3.
8. Encourage physical activity and limiting time spent sedentary or in front of a screen to two hours or less per day.
9. Start measuring fasting glucose at age 9 to 11.
10. Detecting and intervening on these risks early should give children a healthier future.
